What’s Your Therapy Style?
The more important issue, according to Binder, is that there is a good match between you and the therapist you will be seeing. “A good therapist will utilize different styles of therapies depending on the patient he or she is working with.” Here is a rundown of some of the most popular therapies and what kinds of problems or personality types might get the most help out of each one.
Cognitive Behavioral Therapy (CBT)
This is one of the most popular types of therapies. It is the kind of therapy that often comes to mind when we think about “counseling.” Cognitive behavioral therapy concentrates on the here and now, rather than going back and digging into your childhood and figuring out where your life patterns came from; it gives you tools that help you deal with your current circumstances. “If you are looking for relief from specific symptoms — particularly panic disorder but also depression — cognitive behavioral therapy is a good idea. It will give you a clear-cut road to help,” says Stuart Shipko, MD, a psychiatrist in private practice in Southern California. “So, if you don’t have any severe trauma in your background, and want help dealing with life the way it is, this is probably the best kind of therapy to start with.” Binder adds: “People who see their problems in a concrete fashion usually do well with CBT.”
“People who are more self-reflective in their approach to their lives might do better in a more emotional-based treatment,” says Binder. Psychodynamic, or insight-oriented therapy, is a form of in-depth psychology. Its primary focus is to reveal the unconscious content of a client's psyche in an effort to alleviate psychic tension. In this way, it is similar to psychoanalysis. “This kind of therapy is good for people who like to delve into the reasons why they are who they are,” says Shipko. “It is especially beneficial for people who have longstanding problems rooted in family issues. And it is usually a more long-term approach than CBT.”
In this kind of therapy, the therapist helps the patient gain insight into their past that can be used to address current problems. For example, if you find that you have extremely low self-esteem, through talking about and analyzing your past, the therapist would help you identify the causes (being the target of bullies as a child, distant parents, body-image issues) and how these past experiences affect your current behavior. The therapist would help you devise ways of avoiding these negative thought patterns and directing them toward more positive ways of thinking. By gaining insight about the past, you can often alleviate problems in the present.
“Tell me about your mother,” is the cliché and also the truth of psychoanalysis. “If you have a longing to know yourself on a deep level,” says Shipko, “psychoanalysis is definitely the best type of therapy to choose.” The methods used by a psychoanalyst include dream interpretation, free association and other similar tools. You will talk about your childhood in depth and delve into all of the experiences and feelings that have brought you to where you are.
Sigmund Freud, who founded psychoanalysis, believed that people could be cured by making conscious their unconscious thoughts and motivations, thus gaining insight. The aim of psychoanalysis therapy is to release repressed emotions and experiences. Its goal is to make the unconscious conscious. But it isn’t for people who need to change aspects of their lives quickly. “This type of therapy is a slow process and entails a long-term commitment to doing the work involved in understanding your life and what has made you who you are,” says Shipko.
Other Types of Therapy
While the above therapy modalities are the major ones, there are a great many more types of therapies. According to Shipko, “For psychosomatic problems like headaches and symptoms related to general tension, biofeedback is a great option.” Less of a talk therapy than other treatments, biofeedback is a practical way to lessen anxiety. With biofeedback, you’re connected to electrical sensors that help you receive information (feedback) about your body (bio). This feedback helps you focus on making subtle changes, such as relaxing certain muscles, to achieve the results you want, such as reducing pain. In essence, biofeedback gives you the power to use your thoughts to control your body, often to improve a health condition or physical performance.
If you have long-term trauma or post-traumatic stress disorder, a fairly new therapy called eye movement desensitization and reprocessing (EMDR) therapy is a good choice. EMDR is an integrative psychotherapy approach that has been extensively researched and proven effective for the treatment of trauma. EMDR is a set of standardized protocols in which the therapist leads the patient in a series of eye movements or other forms of stimulation as anxiety levels are decreased. The therapy also incorporates elements from many different treatment approaches. EMDR seems to have a direct effect on the way that the brain processes information. Normal information processing is resumed, so following a successful EMDR session, a person no longer relives the images, sounds and feelings when the event is brought to mind. You still remember what happened, but it is less upsetting.
“The best treatment for borderline personality disorder (BPD) seems to be dialectic behavioral therapy (DBT),” says Shipko. Dialectical behavior therapy is a cognitive-behavioral approach that emphasizes the psychosocial aspects of treatment. The theory behind the approach is that some people are prone to react in a more intense and out-of-the-ordinary manner toward certain emotional situations, primarily those found in romantic, family and friend relationships. DBT theory suggests that in people with BPD, arousal levels in such situations can increase far more quickly than the average person’s, attain a higher level of emotional stimulation, and take a significant amount of time to return to baseline arousal levels. The DBT therapist works to help the patient return to a comfortable baseline.
“The bottom line is that you have to feel comfortable with the therapist, no matter what the approach,” says Binder. “The best therapists approach their work with flexibility, creativity and improvisation. They work to make the people they see comfortable.”