“…psychotherapy is also profoundly misunderstood and the subject of a host of unhelpful fantasies, hopes and suspicions. Its logic is rarely explained, and its voice seldom heard with sufficient directness.”School of Life, 2018
As we start the new year, I thought I’d pepper my monthly pieces of 2022 with some of insight into the weird and wonderful world of therapy. As the astute people at The School of Life explain above, psychotherapy can seem quite confusing from the outside. For this month, I want to talk about the different types of therapy and what they involve (a whistle stop tour if you like).
First, a caveat. There are loads of different modes of therapy. The BACP alone lists around 30 on their website and there are new ones being developed all the time. For this piece I’m going to focus on what I consider to be the most common. So, in no order of preference, here we go!
Psychoanalysis and Psychodynamic
We probably have all seen the classic portrayal of the shrink and the client. The client laid out on a couch, the shrink sitting behind, out of sight. This is psychoanalysis and it’s derived from the work of Mr Sigmund Freud. This type of therapy is normally long term (years and years), and clients attend several times a week. So, it can be pretty intense. Freud believed that the answers to our problems in life are deep rooted in our unconscious. In each session the client talks freely, often exploring dreams and associations.
Out of psychoanalysis, came the sub-type of therapy called psychodynamic. This is less intense in terms of how often you attend therapy and how long you remain in treatment (and there normally is no lying down involved). The main premise of psychodynamic therapy is that your past, especially your childhood, informs your present. Exploring your family of origin, childhood etc is the main focus of this type of therapy.
CBT’s (Cognitive Behavioural Therapy) basic premise is that what we think and do impacts how we feel. By changing our thoughts/actions we can alter our feelings. This is a popular type of therapy as its normally short-term (12 sessions or so). It’s often the type of therapy offered to people when they go to their GPs for support with their mental health. Worksheets and homework are quite common with CBT. Often clients are asked to complete diaries and practice different ways of behaving in between sessions (for example exposing themselves to the focus of their anxiety).
Gestalt translated as “whole” deals with the total experience of the client and believes that the living whole is always more than the sum of its parts. One of the key aspects of the Gestalt approach is the focus on the immediate experience of the client in the here and now, known as phenomenology. Techniques in Gestalt therapy include dream analysis (e.g., talking through the dream in the present tense) and the infamous chair work (when the client talks to a part of themselves/others close to them by swapping chairs or looking towards an empty chair).
Sometimes called Rogerian Therapy (after its founder Carl Rogers), person-centred therapy moved away from traditional models of therapy where the therapist is sometimes seen as the “expert”. The main elements of this type of therapy include the therapist offering unconditional positive regard, congruence and empathetic understanding towards the client. Focus is on working towards the client’s aspirations and the belief that we all the ability and desire for growth and change, given the right psychological environment.
This type of therapy places an emphasis on the spiritual life of the client, going beyond the personal. Carl Jung (once good pals with Freud) is a key figure in this type of therapy (as well creating Jungian psychoanalytic therapy). One core belief is that we are more than just the combination of our parents and we come into this world with a vast range of qualities. Issues arise in our lives when some of these qualities get blocked. Aspects of soul and working with our soul nature can be a strong theme of transpersonal work. Working methods include dream analysis and working with the creative imagination (e.g., through visualisation or sand play).
What about me I hear you ask? How do I describe my ways of working as a therapist? I describe myself as an integrative transpersonal psychotherapist.
Integrative is a word you may see on a lot of therapist profiles. It essentially means the therapist has been trained in lots of different types of therapy and so will be able to use these as and when appropriate in their work. Some therapists don’t describe themselves as integrative and so will work pretty strictly to their training, e.g., a pure gestalt and Jungian therapist.
My overall approach to therapy is transpersonal so I will hold in mind the soul nature of my clients and wonder about their spiritual lives and experiences. Transpersonal acts like an umbrella in my approach, and underneath that umbrella, I have all the other types of therapy at my disposal. I prefer my integrative approach (of course I am pretty bias) as it means I get to use different therapies in my toolbox to match the needs of my clients and I am not confined to just one approach.
And what’s right for you?
Given the numerous types of therapy, how on earth do you pick what’s right for you? I purposefully haven’t included a critique of each therapy as what’s right for someone, might not work for someone else. The type of therapy which might suit you is a personal choice.
For me, the relationship you have with your therapist, regardless of their way of working, is an essential element to the work. If you find a therapist you feel safe, secure and comfortable with, then you’re off to a very good start.
I hope you found my little foray into the weird and wonderful world of therapy enlightening. I’ll be exploring and sharing more in the coming months.
Photo by Towfiqu barbhuiya on Unsplash