Psychodynamic psychotherapy
Psychodynamic psychotherapy helps the practitioner explore the content of the patient’s psyche so as to alleviate their psychic tension. As a kind of depth psychology, its main goal is to determine how unconscious processes affect the patient’s present behaviour. This approach is widely employed to help people who have experienced troubled relationships in the past address any unresolved conflicts – which often cause patients to develop unhealthy addictions. It is based on the assumption that most mental disorders stem from traumatic childhood experiences. Similarly to psychoanalysis, psychodynamic psychotherapy requires the therapist to build a positive and constructive relationship with their patients in order to be able to help them. Adjustment disorder and post-traumatic stress disorder are only some of the disorders that can be treated through this approach (British Psychoanalytical Council, 2017).
Advantages and Disadvantages
Recent studies have demonstrated that psychodynamic psychotherapy is a highly effective approach that has enabled therapists to resolve a significant number of cases over the years. A number of reviews have revealed that this approach is particularly useful when treating somatic disorders and depression. Since psychodynamic psychotherapy addresses the root causes of people’s dysfunctional behaviours, it is more likely to produce long-lasting effects.
Despite its remarkable advantages, psychodynamic psychotherapy involves numerous periodical sessions, which means that the entire treatment can take a relatively long time. While this approach is very collaborative in nature, it requires the therapist to guide the patient so as to get them to analyse their own psyche. Some may feel as if the therapist is trying to influence their thoughts and behaviour, thus preventing them from addressing the actual causes of their disorders. Finally, many people are reluctant to think and talk about their childhood, especially when they associate their early years with negative experiences that they have spent their entire lives trying to remove and forget.
Ethical considerations
Psychodynamic psychotherapy involves a significant power imbalance between the practitioner and the patient which can raise significant ethical issues.
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Behavioural
Behavioural therapy is a form of psychotherapy that draws from behaviourism, an approach whose main goal is to explore and understand human behaviour – as well as animal behaviour. Behaviourism is based on the assumption that all behaviours are learnt from the external environment and that symptoms emerge through operant and classical conditioning. Classical conditioning refers to one’s ability to learn by association, whereas operant conditioning refers to one’s ability to learn by reinforcement (e.g. through rewards or punishment). It is important to keep in mind that behavioural therapy is an umbrella term that encompasses many different therapies that are used to treat a variety of mental disorders. It analyses current problems in such a way to address unhealthy and potentially self-destructive behavioural patterns. It is primarily employed to treat anxiety-related disorders, depression, panic attacks and anger management issues. On top of that, it can also help people suffering from eating disorders, bipolar disorder, substance abuse, posttraumatic stress disorder, obsessive compulsory disorders and various phobias, to name but a few. There exist several forms of behavioural therapy, such as cognitive behavioural therapy (this is, of course, the most popular one), system desensitisation and aversion therapy.
(Since behavioural and cognitive approaches share the same advantages, disadvantages and ethical issues, these have been combined below.)
Cognitive
Developed by Aaron T. Beck, cognitive therapy is a therapeutic approach based on the so-called cognitive model, which states that behaviour, thoughts and emotions are all interconnected, and that people can solve their disorders by identifying and working on inaccurate thoughts, unhealthy behaviour and distressing emotional reactions. Cognitive therapy requires the patient to cooperate with the therapist in order to develop skills to analyse, examine whatever distorted beliefs and thoughts they may have so as to modify specific behavioural patterns. Cognitive therapy is particularly effective when treatment depression, which according to cognitive therapists, results from a series of negative, automatic thoughts (Hoffman, 2017). Cognitive therapy can also be used to treat low self-esteem, various phobias, personality-related disorders, bipolar disorder, anxiety-related disorders, various addictions and schizophrenia.
Advantages and disadvantages
Behavioural and cognitive approaches have been combined to produce cognitive behavioural psychotherapy. This approach has numerous advantages that are worth exploring in greater depth. Unlike psychodynamic psychotherapy, cognitive behavioural therapy requires the patient to analyse their on psyche thus allowing them to think independently. By minimizing patients ‘reliance on the therapist, this approach requires patients to make an extra effort to address their issues. Many prefer behavioural and cognitive approaches because of their limited duration, which doesn’t exceed 12 – 16 weeks in most cases. As a result, those who are not willing to commit to ongoing therapy (six months or even longer) may opt for cognitive behavioural therapy. Also cognitive behavioural therapy is particularly effective when treating newly-emerged disorders and trying to achieve specific goals (Spencer, 2010).
As far disadvantages are concerned, cognitive behavioural therapy tends to emphasize positive thoughts, which some patients may not like. By encouraging patients to focus on the positive side of their story, cognitive behavioural therapy may cause individuals to feel as if their history is being ignored and overlook. Also, therapists who resort to this approach may come across as overly superficial due to their excessive emphasis on positive thinking. In addition, cognitive and behavioural approaches tend to downplay emotions while stressing the important of the rational components of patients’ mental life. As a result, those who feel the need to talk about their emotions may dislike cognitive behavioural therapy.
Ethical issues
Group sessions are an excellent way to implement cognitive behavioural therapy. However, under such circumstances, patients are required disclose confidential and private information, which may cause them significant distress. Also, when treating particularly vulnerable patients (such as the ones who suffer from posttraumatic stress disorder) the therapist may end up doing more harm than good.
- British Psychoanalytical Council (2017). What is psychoanalytic psychotherapy?. [Online] Available at:
https://www.bpc.org.uk - Hoffman, M. (2017). Cognitive Therapy for Depression. [Online] Available at:
http://www.webmd.com - Spencer, R. (2010). CBT or Psychodynamic Therapy?. [Online] Available at:
http://cbtvspsychodynamic.com/ProsandCons.html
