Psychotherapy
An old art, but a new science.
Psychotherapy is therapy that addresses the psyche in the context of an interpersonal relationship and on the basis of a scientific theory of personality. Through its method, psychotherapy addresses the psyche through the only possible path: communication. The medium of psychotherapy is therefore verbal and non-verbal communication in the context of the intersubjective relationship co-created between therapist and client.
Although the dynamics of (somatic) psychism are not fully understood, it seems that psychic phenomena stem from highly complex interactions between biological, psychological and environmental factors. Consequently, the parameters that determine a person’s somatopsychic/inner reality include physiology, developmental history, interpersonal relationships, sensory input, emotional experiences and the characteristics of the environment with which he or she interacts.
Types of psychotherapy
Psychotherapy is a general term that includes several different psychotherapeutic directions and approaches. These directions differ mainly in the theory on which they are based and the technique they follow. It is nowadays widely accepted that depending on the person seeking help and the type of difficulties he or she is experiencing at a given moment in time, a therapeutic proposal can be formulated as to the type of psycho-therapeutic approach that might be most appropriate for him or her.
Psychotherapy can be individual, group, couple or family. It may also use an art form as a medium, for example, art therapy, dance therapy and drama therapy. It may also be differentiated in terms of the target population, for example, child and adolescent psychotherapies or psychotherapies for people with substance or behavioural addiction.
Although several types of psychotherapeutic orientations have now been identified, some of the best known are psychoanalysis and psychoanalytic psychotherapy, cognitive behavioural psychotherapy, person-centered psychotherapy, systemic psychotherapy, existential psychotherapy, dialectical psychotherapy, cognitive analytic psychotherapy and others. As noted above, the differences between them have to do with the theory and the technique they follow.
However, despite the differences in theory and technique, the psychotherapeutic orientations share some important characteristics. The establishment of a therapeutic relationship (or therapeutic alliance) that will enable the psychotherapeutic process to be fulfilled is a commonplace and an important element in every psychotherapeutic approach. Still, most psychotherapies are oriented toward the person seeking help and not just the withdrawal of symptoms. They are open-ended, i.e. their duration is not predetermined from the outset (unless external factors dictate otherwise) and most often they are not directive in nature.
The capacity for empathy and neutrality is, moreover, commonplace in the practice of most psychotherapeutic approaches. The therapist expresses the quality of genuine appreciation through empathy. Empathy reflects an attitude of deep interest of the world of the therapeutee’s mind so that he or she can go further or deeper. What happens is an interaction where one is a respectful companion in the difficult exploration of the other’s mental world. Neutrality is the function that allows the therapist to maintain the distance needed to enable observation and meaning-making of the functioning of the therapist’s psyche without becoming judgmental or directive.
The psychotherapeutic framework
The therapeutic framework is characterised by the constants within which the therapeutic process is ensured to take place. The place where sessions take place, their frequency and duration, remuneration, confidentiality, the absence of dual relationships outside therapy are some of the external constants of a therapeutic framework. The framework creates a safe environment within which therapist and client can enter a space where feelings, thoughts, memories can be explored and contained.
The use of the therapeutic space allows for the fulfilment of a purpose possibly different for each person. The purpose of the psychotherapeutic process extends beyond symptom relief and relief from mental pain. The overall purpose of all psychotherapy is to bring a person into greater contact with his or her psychic reality. As a consequence psychotherapy aims to be a potentially restorative experience that will allow for the making of meaning in a person’s history by ensuring the restoration of continuity and unity between the present, the past and the future.
Psychotherapeutic approaches
Psychodynamic Psychotherapy: derived from psychoanalytic theory and technique. Its basic principle is the existence of unconscious processes that influence a person’s mental reality. Therapy aims to uncover the unconscious psychic conflicts and to understand the meaning and underlying mechanisms that characterize different psychopathological states.
Cognitive Behavioral Therapy: Addresses a range of mental disorders and difficulties and is based on identifying dysfunctional thought patterns in order to alleviate symptomatology, regulate emotions and develop functional ways of coping.
Systemic: The systems approach has its foundations in general systems theory and is composed of systemic individual psychotherapy, group, family and systemic couple psychotherapy. The aim of the systems approach is to analyze and understand the internal organisation and functioning of systems and their interaction with the external environment.
EMDR (Eye Movement Desensitization and Reprocessing): It is a structured therapy that focuses on psychological trauma and aims to process and repair psychological and physical trauma.
DBT (Dialectical Behavior Therapy): is also a science-based approach aimed at learning skills related to mindfulness, acceptance and management of intense emotion, emotional regulation, and interpersonal effectiveness.
ACT (Acceptance Commitment Therapy): ACT aims to increase the psychological flexibility of the therapeutee and to achieve a healthy balance between acceptance and detachment of difficult thoughts and feelings.
CAT (Cognitive Analytic Therapy): cognitive analytic therapy primarily focuses on the way people think, feel and behave and how this shapes the relationships they have developed. It is based on the idea that our early experiences influence the way we relate to others and how they relate to us.