What are the different types of therapy like and when are they appropriate?

Psychoanalysis, cognitive behavioral therapy, and Gestalt therapy are the most common psychological currents. Each of them is based on particular bases and develops in a different way. It is convenient to know its characteristics to choose well which one we need.

Psychology studies human behavior and the processes that lie behind it, both to explain it and to help the person to know themselves better, to act with more awareness, and also therefore with more personal freedom. Usually through a process, psychological therapy helps the person deal with problems, disorders or conflicts that cause pain.

Irvin Yalom, a physician, psychologist and professor of psychiatry at the prestigious Stanford University, describes this process as “a genuine encounter with the other person.”

HOW DO I KNOW WHAT CURRENT I NEED?

It is interesting to reflect on what type of current can be best suited to the needs of each person. Although we can draw very positive aspects from the currents and they can help us in our situations of vital crisis, it is important to bear in mind that in some serious cases, coordination with other professionals is essential and even put ourselves in the hands of institutions that have the experience and expertise. more specialized professionals.

We must also take into account the words of Yalom and let ourselves be guided by our intuition and feelings that the person who accompanies us in our difficulties is the right one and the one who is doing well for us. That would be one of the indications to know if what I am receiving can help me or not.

Among the most frequent psychological currents in our country that carry out therapeutic processes are psychoanalysis, cognitivism and Gestalt therapy. It is important to know the problem we are facing and what each psychological current consists of. For example, if a behavior causes me a lot of anxiety, cognitive behavioral therapy will probably achieve results the fastest, which does not always mean that they are consolidated. On the other hand, in a case of anguish or vital crisis, psychoanalysis and Gestalt give more space to the analysis of this discomfort.

WHAT IS PSYCHOANALYSIS AND WHAT IS IT FOR?

• The bases of psychoanalysis

The foundations of psychoanalysis were developed above all by Sigmund Freud (1856 – 1939). This current seeks the resolution of problems through the exploration of the person”s unconscious. Freud defined the unconscious as the part that most determines and influences our daily actions, that is, our conscious mind.
Later his work was developed by Winnicott, Lacan, Klein, Mahler, among other disciples of his who expanded their knowledge and theories.

Psychoanalysis consists of a broad theoretical framework that has marked a before and after in the knowledge of the human psyche and has shaped both psychology and the history of thought.

Psychoanalysis proposes through therapy an investigation of the unconscious processes and defense mechanisms of the person that takes into account the history of the person, his childhood and also dreams, for Freud, a manifestation of the unconscious.

• How is a psychoanalytic session?

During the sessions the patient freely expresses what he thinks and feels, and the therapist listens to him without judgment. But it is also the orientation that more self-knowledge can offer to the client.

The psychoanalyst maintains total respect for the subjectivity of his patient. This is probably the current that implies a higher level of commitment in the therapeutic process on the part of the patient due to its duration.

In the sessions, the therapist has a fundamental role and usually makes his comments in the form of questions to give the person space and that he finds his own answers.

An example: If I feel an internal discomfort, an emptiness, an emotional hole, psychoanalysis will try to accompany me without telling me what to do. It will just ask questions so that I can develop my own thoughts about it so that I can fill and restructure the psyche. The therapist works from hypotheses that help him to investigate the client”s speech through questions. These hypotheses are based on the extensive theoretical body that supports this current.

• Disorders Addressed by Psychoanalysis

Psychoanalysis can address many issues such as anxiety, depression, obsessive compulsive behaviors, eating disorders, drug addiction … But it is not necessary to have a serious disorder to go to psychoanalytic therapy since this trend is highly recommended for personal analysis, thinking about ourselves and our history so that we can enrich our present.

WHAT IS COGNITIVE BEHAVIORAL THERAPY AND WHEN IT HELPS

• Foundations of cognitive behavioral therapy

Cognitive behavioral therapy focuses on observable behaviors and is the one with the most scientific studies as endorsement. This current is usually oriented to achieve specific objectives through different methodologies that offer a response to different needs and problems. It could be said that it is less introspective than psychoanalysis and that it is more oriented towards solutions and achieving changes in behavior that interfere with the daily life of the person.

Cognitive behavioral therapy postulates that people”s behavior can be shaped according to the work techniques that are applied as long as they have been previously evaluated and studied. It also contemplates everything about the person that is not an observable and assessable behavior as a black box, which in the beginning was not even indicated to study.

• What is a cognitive behavioral therapy session like?

The cognitive behavioral psychologist tends to have a more guiding, organizing and directing role than the psychoanalyst, despite the fact that each professional always gives a personal touch to their role, no two therapists work the same.

The sessions are very structured and follow very specific methodologies. The tools on which it relies are interviews, test batteries and the DSM-V diagnostic manual, among others. Here in Spain, the laws that regulate only a psychiatrist or a clinical psychologist are legally qualified to make a diagnosis. Once the diagnosis has been made, other professionals may intervene in the treatment, such as the figure of the general health psychologist.

• In which cases it can help

Cognitive behavioral therapy can treat observable behaviors of very complex pathologies such as anorexia, obsessions, anxiety, drug addiction, alcoholism, phobias, depressions, When it is a severe and critical case, your intervention can be very effective, although perhaps at the level of internal exploration it is a shallower system than the previous one.

WHAT IS GESTALT THERAPY AND WHEN IS IT APPROPRIATE?

• Bases of Gestalt therapy

The Gestalt therapy was developed by Fritz Perls (1893-1970) and their bases were born with the publication of a book – “I, Hunger and Aggression” – written with his wife Laura Perl’s (1905-1990), both psychoanalysts. In fact, Perl’s who had been psychoanalyzed for many years and was a follower of Freud with whom he argued.

Gestalt –at the beginning called Concentration therapy– works from the emotions, sensations and thoughts that the client has here and now, that is, in the present moment. It develops body awareness and when the person”s thoughts are very projected to the past or to future projections, it invites them to return to the present moment.

• What is a Gestalt therapy session like?

The sessions are based on customer demand. The Gestalt therapist is an experienced companion who helps you connect with your emotions to navigate them and give them a place. The patient has to take responsibility for his emotions and actions from an “awareness” of what he feels and needs for his well-being. It is a therapy more oriented to self-knowledge and personal growth to discover and explore parts of ourselves that we do not take into account and that are acting in us.

• What disorders does it address?

Cases of vital anguish, depression, obsessions can be addressed, Probably for more serious disorders or critical situations it would not be the most appropriate because it does not have therapeutic institutions (whether private or public) that can respond to serious health cases mental. However, as a self-knowledge tool it can be very interesting.

THE POWER OF LISTENING

A factor that guarantees good work is listening, something that occurs in all the aforementioned currents and is one of the great pillars of the therapeutic process beyond the theoretical position of the therapist.

When the therapist listens to the patient or client and gives a place to his discomfort, he lets him know that he cares about his pain and the very expression of it already constitutes by itself a form of healing in any of the three aforementioned currents. This ability to listen is made possible by the psychologist when he / she is continuously trained and supervised and works with involvement and professionalism with their clients.

MENTAL HEALTH AT THE INSTITUTIONAL LEVEL

It should be noted that many important mental disorders cannot be addressed in any way and require an institution and a particular approach. Only the psychoanalytic currents and the cognitive behavioral current have institutions that can provide a response to serious mental health disorders, whether they are private or public.

These approaches require the coordination of different professional psychiatrists, psychologists, integrators, educators, etc. Without this network of professionals, it would be impossible to attend to severe psychologies. For example, a case of serious drug addiction, before being able to make a deep analysis of the person, he / she must give guarantees of abstention from toxic substances. Once it is guaranteed that there are no more toxins at the level of analytics contrasted by a psychiatrist, then we can begin to think about an introspection work if there is will and interest on the part of the patient.

WHAT IS A GOOD THERAPIST?

Irvin D. Yalom in his book “The Gift of Therapy” gives some good clues about the characteristics that promote a good therapeutic process. Among them, he points out the importance of the therapist and the patient as traveling companions and that the therapist avoid diagnoses so as not to limit the possibilities of growth of the person.

“Although the diagnosis is indisputably critical for the consideration of treatments in many serious conditions with a biological substrate (for example, schizophrenia, bipolar disorders, severe affective disorders, temporal lobe epilepsy, drug toxicity, organic or brain diseases due to toxins, causes degenerative diseases or infectious agents), the diagnosis is often counterproductive in everyday psychotherapy of less severely damaged patients. Why? as completely as possible. A diagnosis limits vision; it diminishes the ability to relate to the other as a person. ”

The therapist must provide support, as well as the patient must be involved in the process. Invite professionals who feel they care about their client and create a therapy for each patient.