Psychoanalytic / Psychodynamic

Psychoanalytic Therapy

During the 1890s, an Austrian physician Sigmund Freud (1856-1939), who was trained as a neurologist and had no formal training in experimental psychology, had developed a method of psychotherapy known as psychoanalysis. Freud's understanding of the mind was largely based on interpretive methods and introspection and was focused on resolving mental distress and psychopathology. Freud's theories became well-known, largely because they tackled subjects such as sexuality and repression as general aspects of psychological development.

Carl Jung (1875-1961) continued in Freud’s path, although moved toward spirituality rather than the materialist determinism that Freud followed. Psychodynamic therapy developed from psychoanalysis, a long-term approach to mental health treatment. In this method you can expect to talk about anything on your mind to uncover patterns in thoughts or behavior that might be contributing to distress. It’s also common to talk about your childhood and past, along with recurring dreams or fantasies you might have. It explores the connection between your unconscious mind and your actions. This involves examining your emotions, relationships, and thought patterns with a goal of digging into the subconscious mind to bring out insights to light.

Sigmund Freud's famous couch is pictured below which still sits in the Freud Museum in London. Freud lived and practiced here for 47 years with his daughter Anna, it's considered the birthplace of psychoanalysis.

Psychodynamic Therapy

Cognitive / Behavioral

Behavioral Therapy

According to behavioral theory, certain behaviors develop from things you learned in your past. It is an action-oriented approach to mental health treatment. Some of these behaviors might affect your life negatively or cause distress. Behavioral therapy can help you change your behavioral responses. In behavioral therapy, you won’t spend much time talking about unconscious reasons for your behavior or working through emotional difficulties. Instead, you’ll focus on ways to change behavioral reactions and patterns that cause the distress. Founded by psychologists such as John Watson and BF Skinner, behaviorism gained popularity through the mid-20th century as a guiding psychological theory. Animals, rather than humans, were often studied. Behaviorists argued that psychology should be a science of behavior, rather than the mind, and rejected the idea that internal mental states such as beliefs, desires, or goals could be studied scientifically.

Cognitive Therapy

Cognitive psychology also arose during the mid-20th century which attempts to change the maladaptive thought processes that can lead to dysfunctional behaviors and certain neurosis. Cognitive therapy is a type of psychotherapy developed by Aaron Beck in the 1960s. Cognitive therapy is based on the cognitive model, which states that thoughts, feelings and behavior are all connected, and that individuals can move toward overcoming difficulties and meeting their goals by identifying and changing unhelpful or inaccurate thinking, problematic behavior, and distressing emotional responses.

Cognitive-Behavioral

Mixing the behavioral methods and cognitive treatments formed the cognitive-behavioral approach which still remains to this day the basic form of most talk psychotherapies. It attempts to change the thinking (cognitive) and the environment (behavioral) to create positive change in the person. Cognitive-behavioral therapy (CBT) is a short-term approach to mental health treatment. The idea behind CBT is that certain feelings or beliefs you have about yourself or situations in your life can lead to distress. This distress may contribute to mental health issues, occur alongside them, or develop as a complication of other mental health issues.

Three Waves of CBT

There are various types of CBT that developed throughout the 20th century and are often described to fall under “three waves”. The first wave used the behavioral principles of operant learning and classical conditioning which went no further than basic learning and conditioning paradigms. Based on empirical, research-based science, first wave CBT was used in the 1940s as a short-term treatment for cases of depression and severe anxiety which were common in veterans returning from World War II. The second wave CBT came from Aaron Beck’s cognitive therapy. Based on the cognitive model, it states that people are more negatively affected by their automatic thoughts and patterns of thought about negative events than the events themselves. Situations can create automatic physiological reactions, like an increase in heart rate, perspiration, or blood pressure, all of which can be interpreted cognitively as an awareness of perceived danger when there is none. Simply put, our ingrained beliefs, assumptions, and presumptions control us and our reactions far more than the events themselves. Everything we experience gets interpreted through cognitive filters. Cognitive filters tend to create cognitive distortions, that require therapy to correct. Second wave cognitive behavioral therapy helps people to identify their automatic thoughts, reflexive thinking that occurs without reflection or even input. People can learn to identify and evaluate their cognitive distortions and automatic thinking. It explores how cognitions (thoughts, values, attitudes, beliefs) affect emotions and behavior. CBT emphasizes the ways that internal states, like persistent and consistent patterns of thought and beliefs affect external states, like behaviors.  CBT maintains the principle that how we behave can be powerful tools for changing maladaptive thoughts and feelings. Essentially, there are real and measurable relationships between internal states (thoughts, beliefs, patterns of established thought) and behaviors.

The Third Wave Body & Mind

In the later part of the 20th century a new kind of thinking took hold that arose out of Eastern philosophy where the body and mind are studied and treated in a more holistic and integrative method. This mind and body treatment also encompassed human spirituality. Today this method is foremost in much integrated mental health treatment plans. This includes various methods such as dialectical behavior treatment, mindfulness meditation, yoga, dance, and art therapies. Third wave cognitive behavioral therapies began about 1990. It differed from second wave CBT therapies in several ways. Second wave CBT sought to reduce and eliminate the symptoms of problems by changing behaviors, whereas third wave therapies look at more comprehensive life goals. Third wave therapies still value behavior, however, are also concerned with doing more than simply changing what we think; third wave therapists help people change how they think and how they respond to challenging situations. Third wave CBT emphasizes accepting our thoughts within context instead of judging our thoughts as good or bad. Rather than focusing on the content of a person’s thoughts and internal experiences, third wave behavioral therapists are instead more focused on the context, processes, and functions of how a person relates to internal experiences (i.e., thoughts, urges, sensations). Third wave therapies value holism. Holism is the view of a human being as part of a complete and unique context, comprised of intimately interconnected physical, psychological, spiritual facets that are together greater than the mere sum of their parts. Third wave CBT sees the role of the therapist as that of a facilitator for good mental health, as opposed to a technician who only helps treat “illness” or maladaptive behaviors. The elimination of psychological issues is thus a highly desirable side-effect of striving for the most satisfying and mentally healthy life possible.

Mindfulness practice is a big part of the third wave, which is a meditative practice that teaches moderation. It is a learned awareness of being and staying in the present moment where mental clarity is most often found. It is the process of intentionally bringing attention to both internal and external stimuli occurring in an accepting way. The detached relationship to thoughts and feelings help to dismantle destructive cognitive patterns often leading to maladaptive behaviors. This process increases self-efficacy and enhances ability to more easily cope with stressors that trigger automatic responses. The goal is to enhance present awareness, so to more easily respond to situations by choice rather than react instinctually. This practice can help to clarify goals and direction and anchor you closest to the Divine or God’s plan for you.