The majority of people have perceptions of psychologists that stem from movies and television programs. The earlier representation of psychologists and psychiatrists was modeled on the early 1900 Freudian psychoanalysts. Everyone thought that psychologists sat there, said very little, and the patient did all of the talking. All mental health problems were seen as some outgrowth of poor mothering or some early childhood trauma. Therapy was believed to be an expensive, long-term proposition, which was a luxury for the wealthy, or for those people who could not handle their lives on their own. In either case, for the longest time, the public did not avail themselves of the services of psychologists. More recently, psychologists have been portrayed in the media more positively and more accurately. The field has been demystified and the average individual is now seeking treatment more readily. The old psychoanalysis style treatment, although still in practice, has been replaced with more scientifically based treatment approaches.
In addition to the psychoanalysts, there are two other major classifications of treatment modalities. These two are Behavioral Therapy, and the combined Cognitive/Behavioral Therapy. I will briefly review the three major theoretical styles of treatment.
Let's start with psychoanalysis. The theory was based upon the belief that we have an ego, superego, and id. These three factions of out personality grapple to control our behaviors. Difficulties in the primary years of development cause problems with these aspects of our being. The belief is that we are unaware of these problems since they reside in our unconscious minds, but they surface in our dreams and in our thoughts. To fix the problems one has to go back, uncover the conflicts in our unconscious, and allow the information to enter our conscious mind so we can correct the problems.
Behavioral research in the 1950's started some psychologists off on looking at behaviors and not the unconscious . This was the beginning of the Behaviorist movement. These theorists believed that thoughts were less important since the could not be read by others and that there was no structure in the brain that could explain an "unconscious" mind. They started to look strictly at behaviors and believed that if only behaviors were modified the person would improve. Thoughts and feelings were not seen as being that necessary to alter or even consider. Some individuals found this dismissal of feelings and thoughts as too limiting and restrictive. They perceived the practitioners to be too scientific and not personable enough.
Then in the 1970's, a new orientation of therapy started to emerge. It was called Cognitive/Behavioral Therapy. This philosophy was borne out of the clinical research in human emotions and behaviors. It was based upon the belief that feelings are a response to thinking. It was believed that by altering interpretations and beliefs, emotions would change. The result would be behavioral changes that would improve the quality of a person's life. Within Cognitive/Behavioral therapy, there were a variety of tools and measures that have been found to be effective in relatively short-term treatments. Therapy did not have to be a lifetime commitment, and, in fact, many problems could be significantly improved within the first 10 sessions. In our present system of managed care and the need for speedy results, Cognitive/Behavioral Therapy has been shown to be most cost effective. In light of the findings of the benefits of short-term treatments, the psychoanalytic therapies have become less popular.
If my bias has not come through yet, let me say that I am primarily a Cognitive/Behavioral Therapist. However, I am also a practical therapist, therefore, I do use effective techniques from the other theories. It is my belief that they all have something to offer, and not all problems or patients can be treated in some cookie cutter fashion. It is important to be aware that whatever therapy one chooses, the data still indicates that there is a personal relationship between the patient and the therapist is essential for treatment to be productive. Therefore, in addition to a therapist being competent, it is important to feel your therapist understand you and to be comfortable with your therapist as a person.