What Is Psychotherapy?
Psychotherapy is known as the ‘talking therapy’ and conversation plays a vital role, but the psychotherapist is also listening intently. Its use ranges from helping people to cope with stress and emotional problems through to psychiatric and mental health disorders. It is a process that allows a person, in conjunction with the therapist, to come to a fuller understanding of their concerns, motivations or current difficulties.
The origins of psychotherapy can be traced to the work of Sigmund Freud, who practised psychoanalysis in Vienna in the 1930s. Having discovered the concept of the ‘unconscious mind’, he found that patients could reveal insights into their disturbed feelings and behaviour if allowed to talk freely to an attentive listener.
The process has progressed through the work of Carl Jung, one-time student and associate of Freud; he developed the idea of people’s minds being connected to a collective human consciousness, revealed through myths, fairy tales and dreams.
More recently, psychologists like Abraham Maslow and Carl Rogers developed Humanistic Psychology which encourages people to explore their feelings and take responsibility for their actions. Many other branches of psychotherapy have been developed, each one focussing on different aspects of people’s problems and the human capacity to change.
The main schools of psychotherapy are:
- Analytic (developed by Freud and Jung – looking at unresolved issues of childhood) ;
- Humanistic (self-development and self-determination);
- Behavioural (positive practical ways to confront difficulties and learn new strategies)
- Integrative (integrating mind, body and soul, using mixture of humanistic and other methods)
Many other types and branches of psychotherapy have been developed; different ones suit different individuals and different issues:
- Psychodynamic therapy
- Gestalt Therapy
- Transactional Analysis
- Transpersonal Therapy
- Primal Therapy
Some of the methods and tools psychotherapists use are:
- Art therapy
- Drama & role play
- Guided imagery
What to Expect
The key consideration in the relationship you will form with a therapist is ‘trust’; progress is based on the confidence you have in your therapist, as you will be sharing your most private thoughts, events from your past, and uncovering some insights that you may not even have been conscious of yourself. Confidentiality is a crucial requirement of the therapeutic process – both required by law, and part of the ethical undertaking of professional codes of conduct.
It has been found that the type of psychotherapy you undertake has less bearing on the success of the outcome, than the skill of the therapist as an individual. So it is important to check the credentials of a person you consult, and assess at an early meeting how well you are going to be able to relate to and trust the therapist you choose.
Each one has a different personality and a different approach to treatment. Find one you like. After all, you are the client, and the therapist works for you.
Sessions generally take place at the same place and time, at intervals arranged between client and therapist normally 50 or 60 minutes. Techniques involved are dialogue and communication, other forms employed may include artwork, drama or music and role playing .
In one-to-one sessions the client and therapist normally sit in chairs opposite each other. The use of a couch these days is not the norm.
Group therapy would consist of three or more individuals and for larger groups (up to 15 or so) there may well be two therapist/facilitators to help guide and where necessary to encourage and help individuals to interpret feelings and emotions which arise from discussion. The advantage here, for certain types of problems, is that the work being done by the group to help one individual may well resonate with another.
Some people use a combination of therapeutic techniques, such as individual and marital therapy (where a couple may meet with one therapist together or two therapists individually).
Benefits and Effects
We manage for most of our lives, without needing outside help. But experienced assistance can be helpful at certain times: when dealing with a new situation, loss or change at work, in health, home or around relationships. Psychotherapy can be used if you are feeling anxious, depressed or lacking in confidence. While most people approach a therapist for help with a particular problem (a mental, physical or emotional issue), many report that they experience an overall enrichment from the process, in self-awareness, creativity and perhaps a deeper satisfaction to their lives.
Although it is difficult to quantify the results of psychotherapy, researches have shown positive, provable outcomes. In the 1990s US studies published in the Journal of Consulting and Clinical Psychology have shown behavioural and cognitive therapies to be effective for anxiety, phobias, mild to moderate depression, sexual dysfunctions and a variety of relationship problems.
Psychotherapy of itself is not a magic remedy; however, the ability to become well and develop fully lies within each person. Over a period of time, clients develop a sense of empowerment and control over their feelings, thoughts and actions.
Although psychotherapy is not a ‘quick fix’, the length of the process can have the advantage of forming a mutually-trusting rapport. Caroline Garland, consultant clinical psychologist at the Tavistock Clinic in London, describes it as, ‘the most intimate relationship you’ll ever have with another human being’.
The work covered between a client and therapist may well improve mental health or improve group relationships – family or work situations and carries the long-term benefits throughout an individual’s life.
There is much debate on the difference between counselling and psychotherapy. The British Psychological Society defines counselling as a system intended to ‘help people improved their sense of wellbeing, alleviate their distress, resolve their crises and increase their ability to solve problems and make decisions for themselves’.
Psychotherapy is see as helpful for psychological problems that have built up over many years, perhaps from childhood, patterns of thought and behaviour that have become ingrained in a person’s life.
As a client, you will have – through this process of personal development – a better understanding of how thoughts, feelings and patterns of behaviour impact on your life. A growing awareness of self and the understanding of how to use the tools the therapist has passed on to you can be invaluable but the eventual outcome must come from the individual.
If you opt for person-centred psychotherapy (introduced by Carl Rogers in the 1950s) you will be invited to explore our feelings through a series of open questions, needing more than a simple yes or no answer. Each question taps in to what you have said about your feelings. In this way each session draws out the issues which are explored more deeply.
This approach of examining psychological problems through examining conscious thoughts thoroughly enabled a group a therapists to develop cognitive therapy.
The school of Cognitive Therapy takes a different approach. You could be led by a series of questions like this:
- What am I thinking about?
- How does that thought make me feel?
- Do I believe in that thought?
- If I become aware that I don’t really believe the thought, does it make me feel different?
Before you embark on what may be a long-term, it’s worth meeting different therapists and finding out which approach is likely to suit your particular issues.
Fascinating Facts about Psychotherapy
- Psychotherapy comes from the ancient Greek – psyche – meaning “breath”, “spirit”, “soul” and therapia – meaning “healing”, “medical treatment” .
- Modern psychotherapists could be said to have descended from ancient healers and shaman whose role was to interpret messages from the gods, to translate the meanings of illnesses, events and even dreams. Psychotherapists perform a similar role for their contemporary clients.
- In 1909 Sigmund Freud made his one and only trip to the USA. Since the sixties, the States, particularly the ‘west coast’ which has done more than anywhere to practise, promote and develop the use of psychotherapies.
- About one in five people in this country will suffer from depression at some point in their lives and that around 20 million people are suffering from the consequences of this condition. Research also shows that 10% of the population has some form of mental illness, but that only one in five of those is trying to get help.
- In the 1970s in the United States, Carl Simonton starting using imagery with cancer patients – from an initially aggressive technique of getting them to visualise their cancer cells being attacked and killed by sharks, he developed gentler images that were found to be more effective: imagining that the affected cells are being cured, healed, transported out of the body.
- Research published in 1994 in the British Journal of Psychiatry found cognitive therapies to be more effective than conventional medication or relaxation for dealing with panic attacks.
- Some people fear that seeking help for mental and emotional problems means that they are admitting they are unbalanced, ‘mad’, or insane. Yet, as R D Laing put it, ‘Insanity – a perfectly rational adjustment to an insane world.’
- As part of their training, most psychotherapy practitioners will have undergone therapy themselves to help them understand themselves and their potential clients. And even when qualified, they continue to receive regular support and supervision from other practitioners.
Psychotherapy in the United Kingdom
(At the present time Psychotherapy in the United Kingdom is only regulated on a voluntarily basis.) The United Kingdom Health Professions Council (HPC) is consulting on the potential for statutory regulation of psychotherapists and counsellors and it seems likely that the status may change.
The UK Council for Psychotherapy
The UK Council for Psychotherapy (UKCP) is a membership organisation, with over 75 training and listing organisations, and over 6,600 individual practitioners. UKCP holds the national register of psychotherapists and psychotherapeutic counsellors, listing those who meet its standards and training requirements.
British Association for Counselling and Psychotherapy (BACP)
The BACP states that its mission is to ‘Enable access to ethical and effective psychological therapy by setting and monitoring of standards’ The British Association for Counselling grew from the Standing Conference for the Advancement of Counselling, a grouping of organisations inaugurated in 1970 at the instigation of the National Council for Voluntary Organisations. Membership was extended to include individuals when in 1977, with the aid of a grant from the Home Office Voluntary Service Unit, the British Association for Counselling was founded.
British Psychoanalytic Council (BPC)
The British Psychoanalytic Council (BPC), formerly the British Confederation of Psychotherapists, is a professional association, representing the profession of psychoanalytic and psychodynamic psychotherapy. The organisation is itself made up of twelve member institutions (listed on its website) which are training institutions, professional associations in their own right and accrediting bodies.
British Association of Psychotherapists (BAP)
BAP claim to be one of the longest established and largest independent providers of Jungian analytic and psychoanalytic psychotherapy for adults and children in the UK. Its members work within the NHS and as private practitioners. They have been training Psychoanalytic and Jungian psychotherapists for 60 years.
Association of Child Psychotherapists (ACP)
The Association of Child Psychotherapists is the professional organisation for Child Psychotherapy in the United Kingdom. It was founded in 1949. The Association recognises and monitors seven trainings in Child & Adolescent Psychotherapy. The ACP has links with European psychotherapeutic organisations through the European Sector (EFPP), of which it is a founder member.