About Therapy
When people go to a Psychologist they have typically already tried other approaches to solving personal problems, including talking to friends and relatives. Some people may find that talking to a friend or relative is not enough to resolve their problems. Others may want to talk to a Psychologist about problems they would feel uncomfortable discussing with friends or relatives.
Though a Psychologist may be a “stranger” compared to a friend or a relative, talking to a Psychologist is better than talking to a friend or relative in two ways: First, a Psychologist is knowledgeable about emotional problems, has the patient’s best interests at heart, and is objective. In addition, a Psychologist uses treatment methods that are guided by well-developed theories about the sources of personal problems. Studies have confirmed that overall, Psychodynamic Therapy is better than no therapy at all.
Psychologists have a Ph.D. (doctor of philosophy) degree that requires four to six years of graduate study after a four-year college degree. Licensing requirements in Michigan require one full year of a predoctoral internship and two full years of a postdoctoral fellowship, as well as completion of dissertation research and competency on a written national exam.
Psychologists may practice different types of therapy depending on their philosophy and the presenting problem. Some of the major types of approaches include Behavioral Therapy, Cognitive-Behavioral Therapy, Humanistic Therapy, Family Systems Therapy, Interpersonal Therapy and Psychodynamic Therapy,
In the United States, about 40 percent of therapists consider their approach eclectic, meaning that they use ideas and techniques from a variety of therapies. Most therapists who adopt an eclectic approach have a rationale for which techniques they use with specific clients or specific issues rather than just choosing an approach randomly or because it suits them at the time. Although different therapeutic approaches may be equally effective on average, mental health researchers agree that some types of therapy are best for particular problems.
Cognitive Behavioral Therapy emphasizes changing feelings through changing what one does and how one thinks about them self and their situation. Cognitive-Behavioral Therapy (CBT) typically addresses the ways in which our thoughts and actions have a positive or negative impact on our mood and day to day functioning. Topics such as diet, sleep, exercise and relaxation are important components of CBT. During a therapy session there may be instruction and practice on diaphragmatic breathing, self-hypnosis or progressive muscle relaxation and there is often homework between appointments. CBT can be very helpful for anxiety, depression and to change dysfunctional behaviors and is usually a shorter-term therapy. The focus on CBT is in the present, not in the past.
Psychodynamic Therapy emphasizes the importance of discovering and resolving internal, unconscious conflicts, often through an exploration of one's childhood and past experiences as well as through analysis of the relationship one has with their therapist. Through empathy, interpretation and other methods, the therapy setting encourages exploration of the unconscious and the full range of emotions. Psychodynamic Therapy is also referred to as Insight Oriented Therapy and it can be a lengthy process that involves layers or stages of interventions.
Because it can be so lengthy, the way in which Psychodynamic Therapy works is shrouded in mystery. However, research has identified six sequential processes which bring about meaningful and lasting emotional change.
The first step toward emotional change needs to be access to and awareness of emotions. Psychodynamic Therapy provides the time and setting where an individual is prompted to reflect upon feelings which are experienced in various situations. Through the technique of active listening the therapist prompts the individual’s efforts to verbalize their thoughts, ideas and feelings.
The expression of emotion in a Psychodynamic Therapy setting allows the individual to move beyond merely saying the words that symbolize their emotional states. By providing empathic validation, the therapist supports the individual in their full expression and re-experiencing of the emotions which have been identified. The second process identified as part of emotional change is this experience of freely and fully expressing emotions.
By experiencing empathy provided by the therapist week after week, an individual will internalize this technique and other tools for self-soothing. During therapy the therapist exerts some control over the intensity of the re-experienced emotions. Through the repetition of this process the individual learns ways to regulate their own emotions. This self-regulation of emotion is the third variable involved in the process of emotional change in Psychodynamic Therapy.
The fourth process identified that is responsible for bringing about emotional change is the habit of reflection. Weekly psychotherapy is a formalized way to reflect on thoughts and feelings; an individual will find the experience of having feelings validated by the therapist reinforces this habit of reflection.
The therapy setting also promotes the observation of the transformation of emotions over time. The therapist employs the technique of clarification to help the individual reformulate the understanding of their emotions into a more coherent view, sometimes utilizing interpretation to link a patient’s feeling, thoughts, behavior or symptom to its unconscious meaning or origin. It is this process of transformation, which involves the experience and understanding of multiple emotions in a coherent way, that has been identified as the fifth variable and the truly dynamic part of Psychodynamic Therapy.
The sixth process which brings about meaningful emotional change is the corrective emotional experience of having a different emotional response to a particular situation. The therapist can provide a different emotional response to an individual and can help them gain awareness of many differing responses across an array of situations. Sometimes a therapist may use gentle confrontation to assist an individual in addressing avoided emotions. Having a wider range of emotions is the end result of the experience of these six processes which bring about emotional change.
The length of therapy usually depends on the severity and number of the patient’s problems and the therapy interventions used. In general, Psychodynamic or Insight Oriented Therapy is usually not time limited and Cognitive- Behavioral Therapy is generally less lengthy. When therapy ends is determined by the patient and the therapist together and ideally their decision depends on their judgments about the degree of progress and improvement. At the end of therapy, the therapist and patient agree on what to do if the problems recur.
