Psychotherapy
Psychotherapy
Definition
Psychotherapy is the treatment of mental or emotional disorders and adjustment problems through the use of psychological techniques rather than through physical or biological means.
Description
Psychoanalysis, the first modern form of psychotherapy, was called the “talking cure,” and the many varieties of therapy practiced today are still characterized by their common dependence on a verbal exchange between the counselor or therapist and the person
seeking help. The therapeutic interaction is characterized by mutual trust, with the goal of helping individuals change destructive or unhealthy behaviors, thoughts, and emotions. It is common for experienced therapists to combine several different approaches or techniques. Therapy is terminated when the treatment goals have been met or if the client and/or therapist conclude that it is not working. It can be effective to phase out treatment by gradually reducing the frequency of therapy sessions. Even after regular therapy has ended, the client may return for periodic follow-up and reassessment sessions.
Psychodynamic approach
Freudian psychoanalysis places emphasis on uncovering unconscious motivations and breaking down defenses. Therapy sessions may be scheduled once or even twice a week for a year or more. This type of therapy is appropriate when internal conflicts contribute significantly to a person’s problems.
Behavioral techniques
In contrast to the psychodynamic approach, behavior-oriented therapy is geared toward helping people see their problems as learned behaviors that can be modified, without looking for unconscious motivations or hidden meanings. According to the theory behind this approach, once behavior is changed, feelings will change as well. Probably the best-known type of behavioral therapy is behavior modification, which focuses on eliminating undesirable habits by providing positive reinforcement for the more desirable behaviors.
ALFRED ADLER (18970-1937)
The Austrian psychiatrist Alfred Adler founded the school of individual psychology, a comprehensive “science of living.” His system emphasizes the uniqueness of the individual and his relationships with society. In 1902 Sig-mund Freud invited Adler to join a small discussion group, which became the illustrious Vienna Psychoanalytic Society. Adler was an active member but did not consider himself a pupil or disciple of Freud. He could not agree with Freud’s basic assumption that sex was the main determinant of personality, and all that this implied: the dominance of biological factors over the psychological; the push of drives, making for identical, predictable patterns; the part commanding the whole; pleasure-seeking as man’s prime motivation. Whereas Freud tried to explain man in terms of his similarity to machines and animals, Adler sought to understand and influence man precisely in terms of what makes him different from machines and animals (concepts and values). This humanistic view characterized all the principles of his theory. Adler’s views diverged ever more from those of Freud, and in 1911 he resigned from Freud’s circle to formulate and found his own school.
Adler’s psychology has been judged the first in asocialscience direction. “In addition to regarding an individual’s life as a unity, we must also take it together with its context of social relations… [it] is not capable of doing just as it likes but is constantly confronted with tasks… inseparably tied up with the logic of man’s communal life.” Adler specified three main tasks of life: occupation, association with others, and love and marriage. He also referred to them as social ties, for they all require cooperation for their solution. Man’s very uniqueness is influenced by his relations to others: “The style of the child’s life cannot be understood without reference to the persons who look after him.”
The therapist’s function, according to Adler, is not to treat “mental disease” but to divine the error in the patient’s way of life and lead him to greater maturity. To this end Adler introduced a number of diagnostic approaches. Among these, his theory of dreams, the meaning of early childhood recollections, and the role of birth order in the family have become widely known and adopted. The understanding of the patient achieved in this way is not one of depth but of context in the larger whole of his total transactions. This is the basis for changing the patient’s picture of himself and the world. In addition to this reorganization, Adler wished the patient to appreciate his own power of self-determination and have the courage to exercise it. To encourage the patient, the therapist must express a disinterested concern that evokes and fosters feelings of trust and fellowship–fulfilling a function at which the mother had failed.
Another behavioral technique is systematic desensitization, in which people are deliberately and gradually exposed to a feared object or experience to help them overcome their fears. A person who is afraid of dogs may first be told to visualize a dog, then is given a stuffed toy dog, then exposed to a real dog seen at a distance, and eventually forced to interact with a dog at close range. Relaxation training is another popular form of behavior therapy. Through such techniques as deep breathing, visualization, and progressive muscle relaxation, clients learn to control fear and anxiety.
Cognitive methods
Some behavior-oriented therapy methods are used to alter not only overt behavior, but also the thought patterns that drive it. This type of treatment is known as cognitive-behavioral therapy (or just cognitive therapy). Its goal is to help people break out of distorted, harmful patterns of thinking and replace them with healthier ones. Common examples of negative thought patterns include: magnifying or minimizing the extent of a problem; “all or nothing” thinking (i.e., a person regards himself as either perfect or worthless); overgeneralization (arriving at broad conclusions based on one incident, for example); and personalization (continually seeing oneself as the cause or focus of events).
In cognitive-behavioral therapy, a therapist may talk to the client, pointing out illogical thought patterns, or use a variety of techniques, such as thought substitution, in which a frightening or otherwise negative thought is driven out by substituting a pleasant thought in its place. Clients may also be taught to use positive self-talk, a repetition of positive affirmations. Cognitive therapy usually takes a longer amount of time as it treats more serious problems.
Couples therapy
Couples therapy focuses on the relationship between two people, typically who have a romantic or sexual connection. The aim of the therapy is to concentrate on the problems of the relationship and make each partner feel that they have an equal role. The therapy can be administered by either a male or female therapist, but many couples feel that having both a male and female therapist in the session is beneficial.
Family and group therapy
Family therapy has proven effective in treating a number of emotional and adjustment problems. While the client’s immediate complaint is the initial focus of attention, the ultimate goal of family therapy is to improve the interaction between all family members and enhance communication and coping skills on a long-term basis (although therapy itself need not cover an extended time period). Group therapy, which is often combined with individual therapy, offers the support and companionship of other people experiencing the same or similar problems and issues.
Resources
BOOKS
Corey, Gerald. Theory and Practice of Counseling and Psychotherapy, 7th ed. Belmont, CA: Thomson/Brooks Cole, 2005.
Corsini, Raymond J., and Danny Wedding. Current Psy-chotherapies. Belmont, CA: Wadsworth, 2007.
Seligman, Linda. Theories of Counseling and Psychotherapy: Systems, Strategies, and Skills, 2nd ed. Upper Saddle River, NJ: Prentice Hall, 2005.
Sharf, Richard S. Theories of Psychotherapy & Counseling: Concepts and Cases. Belmont, CA: Wadsworth, 2007.
PERIODICALS
Anderson, Rebecca A., and Clare S. Rees. “Group Versus Individual Cognitive-Behavioural Treatment for Obsessive-Compulsive Disorder: A Controlled Trial.” Behaviour Research and Therapy 45.1 (Jan. 2007): 123–37.
Pepper, Robert. “Too Close for Comfort: The Impact of Dual Relationships on Group Therapy and Group Therapy Training.” International Journal of Group Psychotherapy 57.1 (Jan. 2007): 13–23.
Powles, William E. “Reflections on ‘What is a Group?”’ International Journal of Group Psychotherapy 57.1 (Jan. 2007): 105–113.
Roback, Howard B., and Randall F. Moore. “On the Ethical Group Psychotherapist.” International Journal of Group Psychotherapy 57.1 (Jan. 2007): 49–59.
Ruth A. Wienclaw, PhD