Psychotherapy

Psychotherapy

Introduction

Do you ever feel too overwhelmed to deal with your problems? If so, you’re not alone.

According to the National Institute of Mental Health, more than a quarter of American adults experience depression, anxiety, or another mental disorder in any given year. Others need help coping with a serious illness, losing weight, or stopping smoking. Still, others struggle to cope with relationship troubles, job loss, the death of a loved one, stress, substance abuse, or other issues. And these problems can often become debilitating.

 

What is psychotherapy?

A psychologist can help you work through such problems. Through psychotherapy, psychologists help people of all ages live happier, healthier, and more productive lives.

In psychotherapy, psychologists apply scientifically validated procedures to help people develop healthier, more effective habits. There are several approaches to psychotherapy—including cognitive-behavioral, interpersonal, and other kinds of talk therapy—that help individuals work through their problems.

Psychotherapy is a collaborative treatment based on the relationship between an individual and a psychologist. Grounded in dialogue, it provides a supportive environment that allows you to talk openly with someone objective, neutral, and nonjudgmental. You and your psychologist will work together to identify and change the thought and behavior patterns that are keeping you from feeling your best.

By the time you’re done, you will not only have solved the problem that brought you in, but you will have learned new skills so you can better cope with whatever challenges arise in the future.

 

When should you consider psychotherapy?

Because of the many misconceptions about psychotherapy, you may be reluctant to try it out. Even if you know the realities instead of the myths, you may feel nervous about trying it yourself.

Overcoming that nervousness is worth it. That’s because any time your quality of life isn’t what you want it to be, psychotherapy can help.

Some people seek psychotherapy because they have felt depressed, anxious, or angry for a long time. Others may want help for a chronic illness that is interfering with their emotional or physical well-being. Still, others may have short-term problems they need help with navigating. They may be going through a divorce, facing an empty nest, feeling overwhelmed by a new job, or grieving a family member’s death, for example.

Signs that you could benefit from therapy include:

  • You feel an overwhelming, prolonged sense of helplessness and sadness

  • Your problems don’t seem to get better despite your efforts and help from family and friends

  • You find it difficult to concentrate on work assignments or to carry out other everyday activities

  • You worry excessively, expect the worst, or are constantly on edge

  • Your actions, such as drinking too much alcohol, using drugs, or being aggressive, are harming you or others

 

What are the different kinds of psychotherapy?

There are many different approaches to psychotherapy. Psychologists generally draw on one or more of these. Each theoretical perspective acts as a roadmap to help the psychologist understand their patients and their problems and develop solutions.

The kind of treatment you receive will depend on a variety of factors: current psychological research, your psychologist’s theoretical orientation, and what works best for your situation.

Your psychologist’s theoretical perspective will affect what goes on in his or her office. Psychologists who use cognitive-behavioral therapy, for example, have a practical approach to treatment. Your psychologist might ask you to tackle certain tasks designed to help you develop more effective coping skills. This approach often involves homework assignments.

Your psychologist might ask you to gather more information, such as logging your reactions to a particular situation as they occur. Or your psychologist might want you to practice new skills between sessions, such as asking someone with an elevator phobia to practice pushing elevator buttons. You might also have reading assignments so you can learn more about a particular topic.

In contrast, psychoanalytic and humanistic approaches typically focus more on talking than doing. You might spend your sessions discussing your early experiences to help you and your psychologist better understand the root causes of your current problems.

Your psychologist may combine elements from several styles of psychotherapy. Most therapists don’t tie themselves to any one approach. Instead, they blend elements from different approaches and tailor their treatment according to each patient’s needs.

The main thing to know is whether your psychologist has expertise in the area you need help with and whether your psychologist feels he or she can help you.

 

Psychotherapy refers to a range of treatments that can help with mental health problems, emotional challenges, and some psychiatric disorders.

It aims to enable patients, or clients, to understand their feelings, and what makes them feel positive, anxious, or depressed. This can equip them to cope with difficult situations in a more adaptive way.

Often, the course of therapy lasts under 1 year; individuals who are eager to change and willing to put in the effort often report positive results.

Psychotherapy can provide help with a range of problems, from depression and low self-esteem to addiction and family disputes. Anyone who is feeling overwhelmed by their problems and unable to cope may be able to benefit from psychotherapy. Combined with medication, it can play a role in treating bipolar disorder and schizophrenia.

 

What to expect

Psychotherapy is sometimes called a “talking treatment” because it uses talking, rather than medication. Some forms of psychotherapy last only a few sessions, while others are long-term, lasting for months or years. Sessions are usually for 1 hour, once a week, and they follow a carefully structured process.

Sessions may be one-to-one, in pairs, or groups. Techniques can include other forms of communication, such as drama, narrative story, or music. A psychotherapist may be a psychologist, a marriage and family therapist, a licensed clinical social worker or mental health counselor, a psychiatric nurse practitioner, psychoanalyst, or psychiatrist.

 

Who can benefit?

Psychotherapy can be used to help a range of people. The following feelings are signs that an individual might benefit from this type of therapy:

  • Overwhelming feelings of sadness or helplessness.

  • An inability to cope with everyday problems.

  • Difficulty concentrating on work or studies most of the time.

  • Drinking too much, taking drugs, or being aggressive to an extent that is harming themselves or others.

  • A sense that problems never improve, despite receiving help from friends and family.

  • Feeling constantly on edge or worrying unnecessarily.

Types

There are several styles and approaches in psychotherapy:

Behavioral therapy

Behavioral therapy helps clients to understand how changes in behavior can lead to changes in how they feel. It focuses on increasing the person’s engagement in positive or socially reinforcing activities. The approach assesses what the client is doing, and then tries to increase the chance of having positive experiences.

The goal is for desirable behavior responses to replace undesirable ones. Behavioral therapy can help people whose emotional distress stems from behaviors that they engage in.

Cognitive therapy

Cognitive therapy starts with the idea that what we think shapes how we feel. Depression, for example, may stem from having thoughts or beliefs that are not based on evidence, such as “I am useless,” or “Everything goes wrong because of me.” Changing these beliefs can change a person’s view of events, and their emotional state. Cognitive therapy looks at current thinking and communication patterns, rather than the past.

The therapist works with the client to confront and challenge inappropriate thoughts by encouraging different ways of viewing a situation. Cognitive therapy can help in treating conditions such as post-traumatic stress disorder (PTSD). Cognitive-behavioral therapy (CBT) pairs cognitive with behavioral therapy, to address both thoughts and behaviors.

Interpersonal therapy

Share on PinterestPsychotherapy can involve movement, drama, and music that can help people of any age and can be done in groups, pairs, or one-on-one. This approach focuses on interpersonal relationships. Depression, for instance, may stem from a person’s relationship with others. Learning skills for improving communication patterns may help the client to manage the depression.

First, the therapist may help the client to identify relevant emotions, and where these are coming from. Then they can help them to express their emotions more healthily. For example, someone who responds to feeling neglected by getting angry may trigger a negative reaction in a loved one. Learning to express the hurt and anxiety calmly can increase the chances of the other person reacting positively.

The client learns to modify their approach to interpersonal problems, understand them, and manage them more constructively. People who might benefit from this type of therapy include individuals who are eager to please others at their own expense, or who find that they have volatile interpersonal relationships.

Family therapy

A family therapist looks at symptoms in the family context. Some conditions require the treatment of the family unit. An example is when a client has depression because of marital problems. Cognitive therapy, behavioral therapy, and especially interpersonal therapy may help.

Identifying family patterns that contribute to a behavior disorder or mental illness can help family members to break negative habits and patterns. Often, family therapy focuses on improving communication within the family. Participants learn new ways of listening and how to ask and respond to questions openly rather than defensively. Family therapy generally involves discussion and problem-solving sessions with the client and the family, as a group, in couples, or one-to-one.

Group therapy

A group therapy session usually involves 6-12 clients and one therapist. The participants have similar problems, and they benefit from the therapist, and by observing how others handle their issues and respond to feedback.  Getting feedback from other people with related problems can give a new perspective and help to facilitate improvement and change.

Group therapy can help those who may feel a sense of isolation because of their issue. Although participating in a group may seem intimidating, it helps people to realize that they are not alone and that others share the same problem. The sense of support is generally powerful and many participants in group therapy find the experience rewarding.

Psychodynamic therapy

Psychodynamic therapy, or insight-oriented therapy, focuses on the deep-seated causes of behavior. For instance, patterns of behavior stemming from a person’s upbringing or earlier life experiences, which continue to impact present-day behaviors. The aim is to increase self-awareness and understanding of how the past affects present behavior.

The client will consider unresolved issues and symptoms that stem from past dysfunctional relationships. Unresolved problems can underlie behaviors such as drug or alcohol abuse. This can help people to understand the source of their emotional distress, usually by exploring motives, needs, and defenses that they are not aware of. Psychodynamic therapy can help people whose symptoms have not been resolved by other forms of psychotherapy.

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Effectivenes

Psychotherapy has the benefit of giving clients someone to talk to. It can create a new way of looking at difficult problems and help people move towards a solution. Participants can gain a better understanding of themselves and their own goals and values and can develop skills for improving relationships. It can help to overcome specific problems, such as an eating disorder or a phobia.

For psychotherapy to work, the person must be actively engaged and work during the session as well as between sessions, by practicing new skills, for example.

 

Function

Psychotherapy is a two-way process, and there must be a trusting relationship between the client and the therapist. To benefit from the process, a person must first want to participate. They should then attend appointments as set, be honest when describing symptoms, and be willing to complete any assignments set. Some clients may experience changes they had not expected or did not want.

Some people do not like to have to relive unpleasant events, but this does not happen in all psychotherapy techniques. No therapist can ever predict when an unpleasant memory will resurface, but if it does, the therapist is skilled in addressing the recalled memory.

Psychotherapy can seem expensive and time-consuming. If treatment is considered necessary, the Mental Health Parity Act requires that insurance companies pay for mental health care similar to the way they pay for medical care. However, the definition of “reasonable and appropriate” or “medically necessary” may vary.

Parapsychology

Parapsychological phenomena of two types have been described. They may be cognitive, as in the case of clairvoyancetelepathy, or precognition. Here one person is believed to have acquired knowledge of facts, of other people’s thoughts, or of future events without the use of the ordinary sensory channels—hence the term extrasensory perception (ESP), often used to designate these phenomena. Alternatively, parapsychological phenomena may be physical: the fall of dice or the dealing of cards is thought to be influenced by a person’s “willing” them to fall in a certain way; or objects are moved, often in a violent fashion, by poltergeists (see poltergeist). The term psychokinesis is often used in this connection. The general term psi has become established to denote all kinds of parapsychological phenomena.

Scientific interest in the subject is of relatively recent origin, but belief in the reality of such phenomena has been widespread since the earliest recorded times. Before the rise of modern science the causation of all complex physical phenomena was very poorly understood, and hence appeals to nonmaterial agencies (ghosts, sorcerers, demons, mythological beings) took the place of a causal, scientific explanation. Even so, there were widespread debates about the reality of phenomena that transcended the bounds of everyday happenings, such as veridical prophecies, as by the oracle of Delphi, or the revival of the dead.

The existence of parapsychological phenomena continues to be a subject of dispute, although societies for the study of psychic phenomena, made up of eminent scientists and laymen, have been in existence for over a century. In 1882 the Society for Psychical Research was founded in London, followed six years later by the founding of a similar society in the United States, partly through the efforts of psychologist William James. Such societies were founded later in most European countries, and active work is carried on, particularly in the Netherlands, France, Italy, Russia, and Japan. Universities have been slower to recognize psychical research as a serious subject for study. The activities of the parapsychological laboratory at Duke University, Durham, N.C., under the American parapsychologist J.B. Rhine from the 1930s to the 1960s attracted considerable interest. A department of psychical research later was opened at the University of Utrecht under W.H.C. Tenhaeff.

One of the reasons for interest in psychical research in the last half of the 19th century was the rise of the spiritualist movement that grew out of the acceptance of spirit communication as real and the use of this as the basis of a new religion. Some of the early psychical researchers were also spiritualists, as, for example, British spiritualist F.W.H. Myers and the British physicist Sir Oliver Lodge. Other psychical researchers (such as the French physiologist Charles Richet) accepted paranormal activity as real but rejected the spiritualist explanation, while others were not committed to either view.

Discussion about parapsychological phenomena has sometimes assumed emotional overtones, unsuitable to scientific discipline, and outspoken but contradictory opinions are still frequently voiced. Believers and nonbelievers in psi may base their belief or disbelief on what they consider to be the scientific evidence, on their personal experiences, or on some larger system of attitudes and values into which ESP does or does not fit. When such extreme and contradictory views are widely held, it is almost certain that the evidence is not conclusive either way and those confident conclusions are unlikely to be supported by a survey of all the known facts.

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