It's hard to imagine that less than a century ago, the "talking cure" — alleviating physical and emotional pain through talking — was a revolutionary idea. Now, with images of men in white coats and patients on couches stuck in our minds by Hollywood, psychotherapy has become a fixture of popular culture. But what exactly is psychotherapy and how is it used to treat mental illness?
Psychotherapy is a technical term defined in the mental health field as "any form of communication between a psychotherapist and a patient which involves a relationship between them for the purpose of remedying whatever disturbance, physical or psychic the patient brings for treatment." [Source: Nicholi] There are a variety of different kinds of psychotherapies which differ in intensity and duration. Three of the most common classifications are: individual, group, and pharmacological (drug). Different types of individual therapies include: psychoanalytical, behavioral, cognitive, and cognitive-behavioral. Differing types of group therapies include family therapy and psychodrama. And, quite recently, the types of pharmacological or drug treatments available to treat mental illnesses have resulted in four different classifications: antipsychotic agents, antimanic or mood-stabilizing agents, antidepressants, and antianxiety agents.
In order to better understand individual therapy, recall the popular image of the white-coated psychiatrist who was puffing his cigar and saying to his patient, "Well, tell me more about why you think your mother did that?" or "How did you feel?" Though these images were often exaggerated for comic purposes, there is some truth in this portrayal. Individual psychotherapy is most often associated with "psychodynamic" psychotherapy. Psychodynamic is an umbrella term for therapies which include psychoanalytical, cognitive, behavioral and cognitive-behavioral therapies. The founder of psychoanalytical therapy was the Viennese physician Sigmund Freud. The two main principles behind psychoanalysis are that [Source: Nicholi] we all have unconscious thoughts and when our unconscious and conscious thoughts are in conflict, emotional problems can result and, [Source: Gorman] early childhood experiences are critical in shaping our personalities, our unconscious thoughts, our emotions and our behaviors. [Source: Gorman]
Thus, the basic principle behind psychoanalysis is to make conscious what is unconscious through "free-association" therapy sessions. Particularly in psychoanalytical therapy, patients are asked to say whatever pops into their minds, which may also include dream interpretations. Psychoanalysis is most effective for treating personality disorders, neuroses and depression.
Behavioral, cognitive and cognitive behavioral therapies are more practically-oriented, individualized treatments for mental illnesses. Compared to the traditional psychoanalytical therapy, sessions are often much shorter in duration and focus on the present and the conscious. The main objective of the therapist is to help the patient identify faulty adaptations and change these adaptations through repeated behavioral changes. For example, in the treatment of the fear of heights, the patient must gradually climb a stair each day to become desensitized to her fear. Negative and positive reinforcements are often used in behavioral therapies.
The premise of cognitive therapy is that patients have negative thoughts throughout the day, which leads to unwanted behaviors and feelings. This habitual negative thinking must be altered in order for the patient to get well. First, the cognitive therapist helps the patient become aware of the negative thoughts and the habit of thinking this way and then he or she is asked to replace these thoughts with more positive, reinforcing feelings or behaviors. Gradually the patient is able to stop his or her negative pattern of thinking and use positive imagery to feel better. Cognitive therapists typically treat mild depression, anxiety and eating disorders.
Cognitive-behavioral therapy is exactly as it sounds. It is the combination of identifying negative thoughts and processes, as well as modifying negative feelings and behaviors. Cognitive-behaviorists believe that what has been learned can be unlearned. The cognitive-behavioral therapist will be very specific about what the problems are and provide specific homework assignments for the patient to practice in order to overcome ways of thinking and behaving. Cognitive behaviorists treat mild depression, anxiety, eating disorders, specific phobias (e.g., claustrophobia) and sexual disorders (e.g., premature ejaculation).