Psychotherapy can be defined as a means of treating such psychological or emotional problems as neurosis or personality disorder through verbal and nonverbal communication. It is the treatment of psychological distress through talking with a specially trained therapist, and learning new ways to cope rather than merely using medication to alleviate the distress. It is done with the immediate goal of aiding the person in increasing self-knowledge and awareness of relationships with others. Psychotherapy is carried out to assist people in becoming more conscious of their unconscious thoughts, feelings, and motives.
Psychotherapy's longer-term goal is making it possible for people to exchange destructive patterns of behavior for healthier, more successful ones.
Different approaches to psychotherapy
The psychodynamic approach was derived from principles and methods of psychoanalysis, and it encompasses psychoanalysis, Jungian analysis, Gestalt therapy, client-centered therapy, and somatic or body therapies, among other forms of psychotherapy. Psychoanalysis is therapy based upon the work of Austrian physician Sigmund Freud (1856–1939), and those who followed—Carl Jung, Alfred Adler, Erich Fromm, Karen Horney, and Erik Erikson. The basis of psychoanalytic therapy is the belief that behavior and personality develop in relation to unconscious wishes and conflicts from childhood. Gestalt therapy, developed by Frederick (Fritz) Perls, emphasizes the principles of self-centered awareness and accepting responsibility for one's own behavior. Client-centered therapy was formulated by Carl Rogers; it introduced the idea that individuals have the resources within themselves for self-understanding and for change. Part of this concept is that the therapist exposes his or her own true feelings and does not adopt a professional posture, keeping personal feelings unclear. Somatic or body therapies include: dance therapy, holotropic breathwork, and Reichian therapy.
The behavioral approach to psychotherapy encompasses various behavior modification techniques and theories, including assertiveness training/social skills training, operant conditioning, hypnosis/hypnotherapy, sex therapy, systematic desensitization, and others. Systematic desensitization was pioneered by Joseph Wolpe after he became frustrated with psychoanalysis. This therapy is a combination of deep muscular relaxation and emotive imagery exercises, in which the client relaxes and the therapist verbally sets scenes for the client to imagine. These scenes include elements of the client's fears, building from the smallest fear toward the largest fear. The therapist monitors the client and introduces the scenes, working to maintain the client's relaxed state.
The cognitive approach stresses the role that thoughts play in influencing behavior. Rational-emotive therapy and reality therapy are both examples of the cognitive approach. Rational-emotive therapy was pioneered by Albert Ellis in the mid-1950s. This therapy is based on the belief that events in and of themselves don't upset people, but people get upset about events because of their attitudes toward the events. Ellis's therapy set out to change people's attitudes about events through objective, firm direction from the therapist and talk therapy. Reality therapy, developed by William Glasser, is based upon the idea that humans seek to satisfy their complex needs, and the behaviors they adopt are intended to accomplish that satisfaction. In Glasser's theory, some people usually fulfill themselves and are generally happy, while others are unable to fulfill themselves and get angry or depressed.
The family systems approach includes family therapy in several forms and attempts to modify relationships within the family. Family therapy views behaviors and problems as the result of family interactions, rather than as belonging to a specific family member. One theory, developed by Murray Bowen, has become its own integrated system with eight basic concepts, including differentiation of self and sibling position. This system attempts to help an individual become differentiated from the family, while remaining in touch with the family system.
In the practical application of these approaches, psychotherapy can take many forms. Some of the most commonly practiced forms include:
Counseling, the provision of both advice and psychological support, is the most elemental form of psychotherapy. Counseling can be short-term therapy done to assist a person in dealing with an immediate problem such as marital problems or family planning, substance abuse, bereavement, or terminal illness. Or it can be longer-term, more extensive treatment that addresses feelings and attitudes that impair success.
Group psychotherapy requires less therapist time, and is thus less expensive. In fact, the interactions that occur between members of the group are expected to provide the change and healing each member receives. The therapist functions as a facilitator, or one who encourages and directs the group interchanges. Group therapy provides each member with the additional benefit of sharing and feedback from others experiencing similar emotional problems. This sharing and feedback has been found to be therapeutic; and the group can actually function as a trial social setting, allowing people to try out newly-learned behaviors.
Family therapy began in the 1930s, when Freudian analyst Alfred Adler used it in working with his patients' entire families. Since the 1950s, it has been a widely used and highly respected modality of therapy based upon the belief that the relationships and interactions within a family have a profound impact upon the patient's mental difficulties. Family therapy generally does not deal with internal conflicts, but rather encourages positive interactions between the various family members.
All forms of psychotherapy require an atmosphere of absolute mutual trust and confidentiality. Without this total safety, no form of therapy will be successful.
Joan Schonbeck, The Gale Group Inc., Gale, Detroit,