Psychotherapy Techniques

Psychotherapy involves a number of techniques used to improve mental health or emotional and behavioral issues. Three common techniques are psychoanalysis, cognitive therapy and behavior therapy. Although these may have some fundamental similarities, especially in their objectives, there are some ways in which these approaches are different. Psychoanalysis began with Freud. Trained as a neurologist, Freud began seeing neurological problems that had no biological basis in his clients. He therefore looked towards the mind for answers. Psychoanalysis is based on the belief that change will take place when an individual becomes more self- aware by bringing unconscious thoughts and feelings into the conscious. Behavior must be based more on reality than instinct. The basic method of psychoanalysis is the free association method, where the client is directed to say whatever comes to mind on hearing a particular word. The analyst listens well and interprets the patterns and inhibitions in the patient's speech and behavior the analyst's main job is to help the patient to free his mind from unconscious barriers or past patterns of thought relatedness that are no longer helpful to the client. Recent psychoanalysis techniques try to help clients gain better trust in themselves, self -esteem and overcome the fear of death. Psychoanalysts believe that a more insight-oriented approach is to be used with healthier clients and a more supportive approach with more disturbed clients. This type of analysis is thought to be useful in clients with personality problems and neuroses, problems of intimacy and relationships. Psychoanalysis may include the client examining his relationship with the therapist. This is not included in cognitive or behavioral therapy. Cognitive therapy which also has its foundation in the concept of distorted thoughts and how they influence behavior uses a different technique for helping the client. The emphasis here is more on distorted thoughts interfering with the reality than on patterns of the client's personality as in the psychoanalytical model. The central premise is that our thoughts mediate between the stimuli in the environment and our emotions. Therefore a stimulus elicits a thought which in turn might stimulate a particular emotion, especially if that thought is an evaluative judgment. Cognitive therapists suggest that psychological distress is caused by distorted thoughts about stimuli giving rise to distressed emotions. In short, faulty thoughts cause psychological problems and therefore changing our thought patterns will lead to mental healing and changes in behavior. The analyst therefore attempts to help the client become aware of these distorted thoughts and the behavioral patterns which are re-enforcing these distorted thoughts and then to help the client correct them. The analyst has to understand the experiences from the client's point of view, unlike in psychoanalysis where the analyst only listens and points out insights to the client. The cognitive analyst then helps the client explore these distressed thoughts and put them against reality. The distorted thoughts are replaced by more accurate thoughts about the client and his life. Since this therapy is geared towards modifying people's core beliefs, it has been found to be more effective in treating conditions such as depression, substance abuse, anxiety disorders, eating disorders and phobias. A major difference observed with behavioral therapy is that it is focused on behaviors that are observable and measurable rather than on cognitions as in the two previous therapies. Behavioral therapy relies on principles of operant conditioning, classical conditioning and social learning theory. Generally behavior therapy works by changing the client's behavior through use of rewards, reinforcements and desensitization. There are many different techniques that are used by behavior therapists, including self-management, biofeedback, role-playing, modelling,etc. Unlike psychoanalysis and cognitive therapy, the client practices a particular behavior, accompanied by a reward or reinforcement of that positive behavior until change in behavior has taken place. Similar to cognitive therapy, behavior therapy is not generally used in dealing with issues of relationships. In some instances cognitive and behavior therapy are combined in one technique- cognitive-behavioral – where the analysts helps the client to understand the thinking behind his behavior while practicing alternative behaviors.