So many therapies, so little time. “Do not be fooled” by the plethora of treatments and the promises for short-term solutions to long-standing problems.
Therapy and counseling have a long history that begin with the father of talk therapy, Sigmund Freud. Freud was the founder of Psychoanalysis and Psychodynamic therapy. These treatments foster self- awareness in the context of a meaningful, ongoing therapy relationship. Central to Psychoanalysis is the focus on making you aware of what was previously out of your awareness. The idea is that insight combined with a therapeutic relationship will promote awareness and an opportunity to make different choices. You can gain understanding as to how your mind affects your thinking, feeling, and behaving, and most importantly, your relationships. Psychoanalysis helps you when you have tried every solution that you can think of. The frequency of meetings and the catharsis that comes with Psychoanalysis affords you a setting to tackle long standing patterns which get in the way of a quality life. It has been understood since Freud that the unconscious parts of our minds greatly influence us in many ways.
A movement away from one’s internal life followed Psychoanalysis with a pursuit of symptom relief. Behavioral Therapy was developed as a way for clinicians to focus on a person’s unwanted behaviors and focus on what the patient was aware of and defines as the problem. The basis of this type of therapy is that all behaviors are learned either through classical conditioning, by association or by operant conditioning through rewards and punishments. Behavioral therapy was a move away from the unconscious mind and toward fixing the unwanted behavior. Smoking cessation programs were based on behavioral therapy by concentrating on reducing the antecedents to smoking and thereby delaying the gratification.
Following Behavioral Therapy came CBT (Cognitive Behavioral Therapy). This refers to a group of therapies that are considered short-term and problem focused. The concept is that a person’s thought process influence their behaviors. Some techniques that are used in different forms of CBT are mindfulness, journaling, and homework. Cognitive Behavioral Therapy is considered structured. CBT focuses on the conscious mind and both the patient and the therapist are aware of the problems the patient is struggling with. These types of therapies focus on one’s thinking and how it impacts one’s behavior. They are generally short-term treatments. Under the umbrella of CBT therapies are Dialectical Behavior Therapy, EMDR (Eye Movement Desensitization Reprocessing), supportive therapy, eclectic therapy and systems therapy.
If therapy was like an onion, there would only be one theory at it’s core. It is tempting to be seduced by a quick fix offered by some of the shorter-term therapies such as Cognitive Behavioral Therapy or Dialectical Behavior Therapy or even Supportive Therapy. Meditation and Mindfulness, while extremely useful tools for reducing internal noise while also creating awareness and space for thinking, are reductionist especially when problems are longer standing. While therapy that focuses on relieving one’s suffering in the short term is helpful, it can be temporary. The most important difference between other modalities and Psychoanalysis is the emphasis on the unconscious understanding of a person’s problems. It is said that most of how we operate is from out of our awareness. That is why treatment that focuses on what you can’t see about yourself is essential. It isn’t what you are aware of that is at the center of your difficulties. While Psychoanalysis requires a deeper commitment to working through problems, it also provides life-long results. By the nature of the multiple visits per week, the nurturing understanding, the consistency of the analyst, you can learn about what has been in the way of your happiness. Psychoanalysis requires patience, you might not arrive at your difficulties overnight as most therapies over promise quick fixes for treatment. Psychoanalysis is a longer therapeutic journey that offers a place and a space unlike any place in the world. You can say anything and everything that comes to your mind…the good, the bad and the ugly. You will never be judged, criticized, or retaliated against. As you understand your words and their meanings you discover the real you. You may ask yourself, “Why do I want to know the ugly sides of myself?” The answer is simple, without awareness of our whole self, we are prone to have many unpleasant psychological symptoms such as sleep disturbances, physical symptoms without medical explanation, “stuckness”, derailment of our goals, boredom, and lack of motivation, avoidance, and the list goes on.
Psychoanalysis helps with the following problems; anxiety, panic attacks, depression, bipolar, eating disorders, mourning, transitions, marriage, divorce, self-esteem, narcissism, personality disorders, “stuckness”, motivation, creativity, raising healthy children, angry and irritability, speedy thinking, loneliness, feelings of abandonment, disconnected to people, decision making, and addictions.
The idea that short-term problem focused therapies have such a following especially in this country is not surprising. Culturally we look for a quick fix or something closer to “on demand” fix for suffering. Other therapies offer help and solutions to what is in everyone’s awareness, yet most of what we are unaware of causes our suffering and symptomatology. If you feel you are a hamster on a wheel trying the same old thing and getting nowhere you may want to explore a solution that has lifelong staying power, Psychoanalysis.