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Psychodynamic therapies

Discuss about the Psychodynamic and Behavioral Theories to Psychotherapy.

Counseling outcome also referred as the therapeutic change, measures extent up to which therapeutic goals are achieved after the completion of the therapeutic regimen.  There are different forces of psychotherapy theories corresponding to significant historical developments in psychotherapy theory and counseling. First three forces of counseling and psychotherapy are psychodynamic, cognitive behavioural and existential therapies.

Psychodynamic therapies: First force of the counseling and psychotherapy theories is psychodynamic theories of personality and psychotherapy. These psychodynamic theories are the most intricate portion of the psychological theories. For the first time work on the psychodynamic theories was carried out by Sigmund Freud through psychotherapy named psychoanalysis. Psychodynamic and psychoanalytic terminologies confound many people. However, work by Freud’s considered as psychoanalytic and work after that considered as psychodynamic. Psychodynamic therapists focus more on patients with depression and anxiety because these patients need more psychology counseling (Ferruccio & Mark, 2012).  

According to this psychoanalysis theory, individual’s present and future is mostly influenced by his/her past. Change and progression in the individual can be effectively achieved by invading in the past and becoming aware of the past instances. Working of the psychoanalysis is mainly based on the two factors like working alliance and transference. Both these factors has significant role in the psychoanalysis. In working alliance there is the successful analysis of the client and it depends on the balanced and supportive relationship between the therapist and the client. In transference, client unintentionally express feelings in front of the therapist and therapist makes conclusion of the client’s past through these feelings. Psychoanalysis is very accurate in understanding feelings of the clients through interpretations by the therapist and reflections by the client (Hayes, 2000). Psychodynamic theory is helpful in explaining the personality of the client both in conscious and unconscious state; however more emphasis is given to unconscious state. This unconscious mind always would be constant struggle. Most of the negative behavior has its own cause and it is mostly related to the unconscious state. Psychodynamic theory states that diverse conflicts at the childhood are responsible for the different personality characters of the person.

According to psychodynamic theory, human actions and functions are specifically based on the integration of drives and forces within the person and diverse characters of the personality.  Few people argued that psychodynamic theories are unscientific because these theories are more subjective in nature and it would be difficult to study it scientifically (Purton, 2014).

Cognitive-Behavioural therapies

Cognitive-Behavioural therapies : Cognitive-Behavioural Theories are the second forces of the counseling and psychotherapy theories. It is mainly based on two foundations like Cognitive and Behavioral foundation of the individual. In cognitive approach different types of therapies are available and these therapies are ranging from the solely cognitive to the behavioral and humanistic components. According to cognitive therapy person develops emotional impenetrability due to dilemma in thought process. Albert Ellis' Rational Emotive Therapy and Beck's Cognitive Therapy are the prominent cognitive psychotherapies available and these are problem-oriented, directive, and educational. Cognitive therapies brought positive changes in the clients by identifying and replacing unreasonable or maladaptive thoughts. Behavioral therapies are theoretically and technically varied from the cognitive therapies.  Behavioral therapies are based on the principle of alteration in the bothersome behavior with the help of principles of learning theory. In general, behavioral therapies are not much concerned about the causes behind the altered behavior (Prochaska & Norcross, 2013).

Techniques used in the behavioral therapies are specific and replicable. As these behavioral therapies are specific, therapeutic relationship in these therapies varied from one therapy and technique to another. Behavioral therapist understands clients very well and they are open and honest in their job. As congnitive-behavioural therapy gave more emphasis on the uniqueness of the individual, it also distinguishes individual from other people and presents individual as contrast as compared to the other individual. Cognitive- behavioural therapist prefers clinets to respond to them and therapist fascilitate this by supporting to cope up with negative events and providing the freedom. Cognitive-behavoural thearapy prefers to develop skills in the clients so that these clinets would be in good shape to choose and act in the direction of developing their own destiny. This results in the self-actualization in the client. In the recent years affects and emotions were given more emphasis in case of cognitive-behavioural therapy. According to cognitive-behavioural therapy, emotions of the clinets are required to be explored because emotions are directly related to the activities to control, master and emphasize internal events of the client (Holmes et al 2009). Cognitive-behavioral therapy states that healthy condition of the client is able to accommodate anxiety and trying to suppress the negative effects due to the anxiety. According to Rogers cognitive-behavioral, therapy changes can occur in the clients as these clients become more aware of the emotional feedback and use this to modify their relations with the therapist. Gestalt therapy also identified that the awareness acquired by the clients, is helpful for the bringing chnagfes in the clients. This awareness also would be helpful for the client to guide themselves towards the positive change and restrict themselves form the negative experiences. Cognitive- behavioral therapy emphasizes on the exploring different types of awareness and behaviours through different experiments.

Existential-Humanistic therapies


Existential-Humanistic therapies : This is the third force of the psychotherapy. Most important process of the counseling like listening skills were obtained from the Existential-Humanistic force of the psychotherapy. Existential theories are based on the genuine information about mind, body, experience and environment. Therapeutic relationship has its importance in two ways in existential therapy like as source of information for therapy and during process of the therapy. Existential therapists understand their clients and share their feeling, however they never lose their genuine relationship with the client. Existential theories can be categorized into traditional and humanistic existential theories. Traditional theories are mainly based on the traditional psychoanalytical procedures and humanistic theories are mainly based on the present conditions. Humanistic theories are more positive in nature and direct the client towards the meaningful aim in the life. Existential therapy stresses existence of the individual to the surrounding world and existence of the people is directly related to the environment surrounding the individual (Iacovou & Weixel-Dixon, 2015). There is the existence of the different humanistic existential therapies like Carl Rogers' Person Centered therapy, Viktor FrankPs Logotherapy and Fritz Perls' Gestalt Therapy. Carl Rogers' Person-Centered Therapy suggests that there is a difference between a person's self-image and actual condition, which is termed as incongruent. These realities created by individuals on their own. This dual reality in the person produces splitting up in the mind of the person and finally leads to the emotional distress. Carl Rogers' Person-Centered Therapy has significant contribution to the evolution and development of the psychotherapy (Dryden, 2002).

Integration of theories: In recent times, it has been proved that approaches used in the existential psychotherapy can be used effectively for the advancement of cognitive-behavioral therapy. As a result existential therapy can also be utilized as complement to the cognitive-behavioral therapy. These are also the characteristics of human being, hence integration of these two theories can proved to be more fruitful in the psychotherapy and counseling. Cognitive-behavioral therapy and existential therapy are based on the specific individuals and human beings also have their own freedom to think and act. Both cognitive-behavior therapy and existential therapy are based on the experience of the individual and makes conclusions based on the verbal processes instead of interpretations. However, integration of the existential and cognitive - behavioral therapy is not possible in all the cases. Loss on interest in life and hopeless thoughts about the future are very specific existential problems in the psychotherapy. These types of typical existential problems cannot be handled using traditional cognitive-behavioral therapy. Because, future is generally considered to be handled in the last relapse phase on the cognitive behavioral therapy. Hence, more research needs to be done for handling such difficult clients (Hayes 2004; Trower et al., 1988).

Integration of theories


In existential therapy, exploration of the existing things has more importance as compared to the non-existing things. In cognitive-behavioral therapy also more emphasis was given to existing things as compared to the non-existing things. Few approaches are followed in psychotherapy which has existence both in cognitive-behavioral therapy and existential therapy. These approaches are comprised of phenomenological approach, current approach, rational approach, training for coping skills, plan for the future, use of experimental techniques, conscious choice, consciousness, intentionality, freedom and non working with non-existing things (Beskow & Miro 2004). In cognitive-behavioral therapy more emphasis was given to the uniqueness of the individual and according to the existential therapy, person’s unique existence gets affected by the surrounding environment. By virtue of integration of the cognitive-behavioral therapy and existential therapy, these both issues can be addressed effectively. According to cognitive-behavioral therapy basic schemas developed in the early childhood and adolescence are due to the postulation about self, others and the world. In the similar way, existential therapy also based on the existence of evidence from the past. In general, Cognitive and behavioural therapy accepts existential perspective (Young et al 2003).        

These forces of the psychotherapy had major contribution for the evolution and development of the psychotherapy research, advancement and practice. For each of the forces therapeutic approach is different and unique to each force of the psychotherapy. Each of these approaches was derived from the individual theoretical principles. As a result, each of these forces develops different therapeutic methods with varied therapeutic relationship.     

Influences of theories: Being a counselor, these theories brought many positive and productive changes in me. Psychodynamic theory helped me to understand the unconscious motivations of the client which would be helpful in altering the problematic and unacceptable behavior, feelings and thought process of the client. Psychodynamic theories also helped me to work very closely with the clients. From the psychodynamic theory, I understand that patient can understand about themselves. I could understand this fact through interactions with them during therapeutic relations. Psychodynamic theory helped to link unconscious thoughts of the client from childhood experiences and client’s current behavior. Desensitizing is a classical conditioning action mentioned in the behavioral therapy. This desensitizing action helped me to reduce the phobia in clients due to repeated actions of anxiety. Operant conditioning was also mentioned in behavioral therapy. This operant conditioning helped to decide upon giving rewards for positive behavior and punishment for the negative behavior of the client. As cognitive-behavioral therapy incorporates both thoughts and behaviors of clients, it helped me to get complete insight into the client’s thinking. Cognitive-behavioral therapy helped me to work in the direction of changing thought process of the client. By changing thought process of the client, I could change the behavior of the client because people changes according to their own feelings. Cognitive-behavioral therapy helped me to understand the client’s external stimuli and corresponding changes in the behavior and learning ability. This theory helped me to make clients recognize about the negative thought pattern and change it to the positive thought pattern. Psychodynamic theory is related to the unconscious thoughts and cognitive-behavioral theory is related to the conscious thoughts. These two theories together helped me to understand both conscious and unconscious feelings of the client (McLeod, 2009).


Existential-Humanistic Theories helped me utilize client’s full potential to bring positive changes in them and to make rational choices. Existential-Humanistic Theories thought me to concern about clients and to respect for clients. Existential-Humanistic Theories helped me to work more towards the client-centered therapy. By virtue of this, I tried to keep myself away from the whole authorities of the client’s inner experience. Existential-Humanistic Theories helped me to understand the free will and self determination of the client. Cognitive behavioral theory is focused on the future development and Existential-Humanistic Theories are based on the past experience. Hence, both these theories together helped me to understand past of the client and also helped me to plan for the future of the client (Marty, 2012). As a counselor, these psychological theories helped me to build strong association with client and counsel them in the proper way.

References:

Beskow, A.P. & Miro, M.T. (2004). Cognitive psychotherapy and the development of consiousness. Living with conviviality. Intellecta DocuSys, Goteborg.

Dryden, W. (2002). Handbook of Individual Therapy . SAGE Publications Ltd.

Ferruccio, O. & Mark, J. S. (2012). Theory and Practice of Experiential Dynamic Psychotherapy.  Karnac Books.

Hayes, N. (2000). Foundations of Psychology. Cengage Learning EMEA.

Hayes, S.C. (2004). Acceptance and commitment therapy and the new behavior therapies: Mindfulness, acceptance, and relationship. In: Hayes SC, Follette VM, Linehan MM, editors. Mindfulness and acceptance: Expanding the cognitive-behavioral tradition. New York: The Guilford Press.

Holmes, E.A, Lang, T.J., & Deeprose, C. (2009). Mental Imagery and Emotion in Treatment across Disorders: Using the Example of Depression. Cognitive behavioral therapy, 20, 1.

Iacovou, S. & Weixel-Dixon, K. (2015). Existential Therapy: 100 Key Points and Techniques.  Routledge.

McLeod, J. (2009). Introduction To Counselling. McGraw-Hill Education.

Marty, S. (2012). Psychodynamic, Affective, and Behavioral Theories to Psychotherapy. Charles C Thomas Publisher.

Prochaska, J. O., & Norcross, J. C. (2013). Systems of Psychotherapy: A Transtheoretical Analysis. Cengage Learning.

Purton, C. (2014). The Trouble with Psychotherapy: Counselling and Common Sense. Palgrave Macmillan.

Trower, P., Casey, A., & Dryden, W. (1988). Cognitive-behavioural Counselling in Action. SAGE Publications Ltd.

Young, J.E., Weishaar, M.E., & Klosko, J.S. (2003). Schema Therapy: A Practitioner’s Guide. New York, Guilford.

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