Most people who have not studied the Psychology Degree, when they hear the word psychotherapy the first thing they imagine is a patient lying on the couch and an old man (the therapist) with a notebook writing down what he tells them.
There is a great lack of knowledge in the population about psychology and psychotherapy. Many people do not know the difference between a psychologist, a psychoanalyst and a psychiatrist, or the difference between a psychologist and a coach, nor do they know the different types of therapy to that exist.
What types of mental health professionals are there?
On this last point, the problem arises when they decide to go to psychological therapy and meet with the different professional categories: psychoanalytic therapist , cognitive-behavioral therapist , systemic therapist … then they ask themselves: "What is that?
In the world of psychological therapy there are different theoretical and practical perspectives that treat problems differently . For those who would like to know what types of psychotherapy exist, in this article we collect and explain the different psychotherapeutic approaches.
The benefits of going to psychological therapy
Patients come to psychological therapy for various reasons. But it is not easy to make the decision to go to a therapist’s office.
Unfortunately, there are still prejudices regarding this practice , especially because of false beliefs about what psychotherapy is and who it is aimed at. In addition, many individuals think that going to a psychologist is synonymous with being a weak person, although going to psychological therapy helps to be a stronger person emotionally and provides tools for better adaptation to the complicated situations that may arise in daily life.
In summary, psychological therapy provides these benefits :
- Improves well-being and helps you feel better
- Provides tools for better conflict management
- Helps change limiting beliefs
- Allows you to live in harmony
- Sessions are confidential, so secrets can be told
- The psychologist will provide support and is a person who can be trusted
- Advice from a qualified professional
- Empowering in the face of life
- Helps you get to know yourself better
- If you are curious to know more about the psychological benefits of psychotherapy, you can read the following article or : "The 8 benefits of going to psychological therapy"
Reasons to go to psychological therapy
Psychotherapy is effective in overcoming many psychological problems and improving well-being. Despite the many studies that support its effectiveness, there are people who, even in need of help, are not aware that they have the problem or avoid facing reality.
The following list shows some signs that may indicate that it is time to see a psychologist :
- Nothing you’ve done so far seems to work
- Your friends or family are already tired of listening
- You start abusing substances to relieve negative symptoms
- Your acquaintances are worried about you
- You can’t stop thinking about the negative
- You feel an aggressiveness that you cannot control and you think everyone is against it
- You have trouble sleeping
- You don’t enjoy things the same way and nothing motivates you
- You can continue reading about the reasons to go to psychotherapy in this article: "The 8 reasons why you should go to the psychologist"
Types of psychological therapy
If you’ve never been to psychological therapy, the experience can be a bit mysterious at first and even intimidating. Since there are different types of psychotherapy with different ways of solving problems, below we explain the psychotherapeutic approaches or models that exist n .
Psychoanalytic and Psychodynamic Therapy
The psychoanalytic therapy has its origin in the theoretical model proposed by Sigmund Freud , father of psychoanalysis. His theory explains the behavior of human beings and is based on the analysis of unconscious conflicts originating in childhood. To understand dysfunctional thoughts, psychoanalysis emphasizes instinctive impulses that are repressed by the consciousness and remain in the unconscious affecting the subject.
The psychoanalyst is in charge of bringing unconscious conflicts to the surface through the interpretation of dreams, failed acts and free association . The “free association” has to do with emotional catharsis, and is a technique that intends that the patient expresses, in the psychotherapeutic sessions, all his ideas, emotions, thoughts and images as they are presented to him, without repressing them. Once the patient has expressed himself, the psychoanalyst must determine which factors within those manifestations reflect an unconscious conflict.
This model of psychotherapy also focuses on the defence mechanisms , which are incorrect ways of resolving psychological conflict and can lead to disorders in the mind and behaviour, and in the most extreme cases to the somatisation of the psychological conflict and the physical dysfunctions that express it.
If you want to know more about psychoanalysis , we recommend the following readings:
- “Sigmund Freud: life and work of the famous psychoanalyst”
- “Defense mechanisms: 10 ways not to face reality”
- “Sigmund Freud’s Theory of the Unconscious”
The psychodynamic therapy follows the line of psychoanalytic thought of post-modernity . Therefore, it is derived from psychoanalysis, although with a greater brevity, through the focus of the intervention on certain conflicts highlighted in the patient’s current condition.
Since it leaves behind the classical vision, it gathers contributions such as the analytical approach of the self or the one of the object relations of the Kleinian current . In addition to Melanie Klein’s contribution, other psychologists such as Adler or Ackerman have participated in the development of psychodynamic therapy.
For the practice of this form of therapy, changes have been proposed in the ways of conducting therapy, however, the objective remains the same: to help the client gain “insight” into his or her motives and hidden conflicts . Currently, psychodynamic and psychoanalytic therapies still coexist, the latter still focusing on Freud’s vision and being called “psychoanalytically oriented psychotherapies”.
The clearer differences between the two orientations may be:
- In psychodynamic therapy the typical weekly frequency of sessions is 1 or 2 , while in psychoanalytic therapy it is 3 or 4.
- The therapist assumes an active and direct position in psychodynamic therapy. In psychoanalytic counselling it is a neutral and non-intrusive approach.
- The psychodynamic therapist advises and reinforces non-conflicting aspects of the subject . The psychoanalytic therapist avoids giving advice and limits his interventions to interpretations.
- The psychodynamic approach uses a wide range of interventions including interpretative, educational and supportive techniques. The psychoanalytic approach emphasizes free association, interpretation and dream analysis.
From the cognitive-behavioral perspective it is understood that thoughts, beliefs and attitudes affect feelings and emotions and behavior. Therefore, this form of therapy combines different methods derived from cognitive therapy and behavioural therapy. That is, cognitive-behavioral therapy (CBT) consists of a series of techniques that focus on teaching the patient a series of skills to better cope with different problems .
CBT is based on the idea that what we think about different situations affects the way we feel and behave. For example, if we interpret a situation in a negative way we will experience negative emotions as a result, and that will cause us to behave in an unadaptive way. It is the treatment par excellence for anxiety disorders such as phobias, since it is understood that. in this case, a traumatic situation causes analogous situations to be interpreted as threatening. This causes the patient to avoid exposure to these situations because of the intense and irrational fear that he feels.
In CBT the patient works with the therapist to identify and change dysfunctional thought patterns . To identify the problem, the therapist carries out what is known as functional analysis of behaviour . The functional analysis of behaviour attempts to find out the factors responsible for the production or maintenance of the behaviours classified as maladaptive and the relationship of contingencies that is established between them.
Once the problem has been detected and analyzed, different cognitive-behavioral techniques are used such as training in social skills, expository techniques, problem-solving techniques, cognitive restructuring, etc.
The humanist psychology is considered the third wave of psychology , contemplating the cognitive-behavioral and psychoanalytic perspectives as the two predominant forces prior to the humanist one. The latter emerged in the mid-20th century, mainly through the proposals and work of Abraham Maslow and Carl Rogers .
It is strongly influenced by phenomenology and existentialism. From the first, it is emphasized that we are never able to experience “reality itself” in a direct way, while the opposite occurs with those subjective aspects of which we are aware. The legitimate sources of knowledge are intellectual and emotional experience. From existentialism, this form of therapy includes reflection on human existence itself.
Therefore, from this humanist perspective the individual is a conscious, intentional, constantly developing being , whose mental representations and subjective states are a valid source of knowledge about himself. The patient is seen as the main actor in his existential search. This search forces him to go through a series of stages or subjective states in which he asks himself the “why” of what is happening to him, the meaning of what he is living, and what he can do to improve his situation.
The humanist therapist has a secondary role as facilitator of the process, allowing the subject to find the answers he or she is looking for on their own. One of the key concepts of this type of therapy is the self-realization of the human being .
Maslow’s Pyramid and Human Self-Realization
Maslow was the author of Maslow’s Pyramid , which is a psychological theory that explains human motivation . According to Abraham Maslow, our actions are motivated to cover certain needs. In other words, there is a hierarchy of human needs, and he argues that as the most basic needs are satisfied, human beings develop higher needs and desires. At the top of the pyramid are the needs for self-realization.
- To learn more about Abraham Maslow’s theory, you can read this article: “Maslow’s Pyramid: The Hierarchy of Human Needs”
Carl Rogers and Person-Centered Therapy
Another famous humanistic psychologist, Carl Rogers , developed what is known as person-centered therapy , whose goal is to allow the patient (whom Rogers prefers to call a client) to be in control of his own therapy.
Person-centred therapy allows the client to enter into a process of awareness of the real experience and restructuring of his or her self , by establishing a solid therapeutic alliance with the therapist and by listening to the deep meanings of his or her own experience.
To achieve this, the therapist is:
- Authentic/congruent . The therapist is honest with both himself and the client.
- Empathic . The therapist places himself on the same level as the client, understanding him not so much as a psychologist but as a person he can trust. The therapist is able to put himself in the other’s place, and through active listening shows that he understands the client.
- M ur unconditional positive consideration . The therapist respects the client as a human being and does not judge him/her.
The Gestalt Therapy was developed by Fritz Perls, Laura Perls and Paul Goodman in the 1940s, and is a type of humanistic therapy , because it conceives the human being, his goals and his range of needs and potentialities. Therefore, from this position it is understood that the mind is a self-regulating and holistic unit, and it is based on the basic principle of Gestalt Psychology that “the whole is more than the sum of the parts”.
Gestalt therapists use experiential and creative techniques to improve the patient’s self-awareness, freedom and self-direction . This is a therapeutic model that not only has its roots in Gestalt psychology, but is also influenced by psychoanalysis, Reich character analysis, existential philosophy, oriental religion, phenomenology and Moreno’s psychodrama.
For many, Gestalt therapy is more than a therapeutic model, it is a real philosophy of life, which contributes positively to the way the individual perceives the relations with the world. The present moment and the self-awareness of the emotional and corporal experience have great importance, and the individual is seen from a holistic and unifying perspective, integrating at the same time, his sensory, affective, intellectual, social and spiritual dimensions. In other words, he understands the latter in his global experience.
Therapy sessions are based on insight into the patient’s experiences, and encourage the patient to creatively explore how to find their own satisfaction in the different areas of their life , and in this way, the patient can live and experience new solutions. This is a more educational than medical approach. The therapist is not directive, i.e. he does not tell the patient what to do, but uses the educational capacity of dialogue and is more concerned with the bond of trust with the patient, with the aim of increasing the authenticity of the relationship to allow the patient to explore the experience in its entirety.
Systemic therapy takes into account the representation of reality seen from a holistic and integrative perspective , where the important thing is the relationships and the components that arise from them. In therapeutic sessions, relationship and communication are very important in any group that interacts and affects the patient (or patients), understood as a system .
It is applied in the treatment of conceptualized disorders such as the expression of alterations in the interactions, relational styles and communicational patterns of a group, such as couples or families, but also to individuals, taking into account the different systems that make up their context.
It has a more practical than analytical approach to problem solving. It is not so important who has the problem (e.g. who is aggressive), but rather focuses on identifying the dysfunctional patterns within the group of people’s behaviour , in order to redirect those patterns directly. In other words, it is about systems finding balance.
Brief therapy (or brief systemic therapy)
The short therapy is developed from the systemic therapy. In the early 70’s it was proposed that the systemic model could be applied to a single individual even if the whole family did not attend. This meant the birth of the Palo Alto MRI brief therapy , which is a set of procedures and intervention techniques that aim to help individuals, couples, families or groups mobilize their resources to achieve their goals in the shortest time possible.
Brief therapy has brought about a radical change in psychotherapy by developing a brief, simple, effective and efficient model to help people produce change.
Other types of psychotherapy
The models of psychotherapy proposed so far are the best known and applied for psychological treatment. But they are not the only ones, since there are other forms of psychological therapy that have emerged recently and others that have evolved from the previous ones.
For example, narrative therapy, acceptance and commitment therapy, cognitive-social therapy, hypnotic therapy, etc.
Bonus: Mindfulness therapy
One model of psychotherapy that is very much in vogue and has generated great interest in scientific circles is Mindfulness Therapy. This model includes concepts from the Buddhist philosophy and from the Acceptance and Commitment Therapy (ACT) and is located within what is known as the third generation or third wave of psychological therapies.
The aim of Mindfulness is for participants to acquire a state of awareness and calm that helps them to self-regulate their behaviour and get to know themselves better . In addition to accepting oneself as one is and being in the present. But more than a set of techniques to be in the present moment, it is an attitude towards life. It is a coping style that builds on personal strengths.
Mindfulness provides patients with a method to learn how to manage emotions, reactions, attitudes and thoughts so that they can cope with the situations that arise in their lives, by practising and perfecting mindfulness. With progress through the practice of full awareness in the present moment and with an attitude of compassion towards oneself, certain positive attitudes are developed in relation to the state of mind and emotions, coming to control them from freedom, knowledge in oneself and acceptance.
- Ackerman, N. (1970). Theory and practice of family therapy. Buenos Aires: Proteus.
- Haley, J. (1974). Treatment of the family. Barcelona: Toray.
- McNamee, S. and Gergen, K.J. (1996). Therapy as a social construction. Barcelona: Paidós.
- O’Hanlon, W.H. (1989). Deep roots. Basic principles of therapy and hypnosis by Milton Erickson. Buenos Aires: Paidós.