Kinstler: Your roadmap to treatment

Ethan Kinstler, Staff Columnist

What comes to mind when someone says “therapy?” Perhaps you think about lying on a couch with a therapist asking you questions about your childhood. While this is indeed one form of therapy, it is not by any means an all-encompassing definition. Understanding the different forms of therapy can help determine which treatment is best for you.

Unlike physical medicine, mental health does not come with one correct answer. If you break your arm, your treatment is largely going to be the same as anyone else’s and the doctors will know how well that treatment is going to work. Therapy is not as straightforward, and so there are many different types of treatment that all aim to solve the same problems.

There are four main “types” of psychotherapy including psychodynamic, behavioral, cognitive behavioral and humanistic. Each type of therapy has its own techniques, ideologies and “strengths and weaknesses”—a term I use loosely, as a technique that works for one person may not work for someone else with the same problem.

Psychodynamic therapy describes that image of us lying on a couch, talking about our childhood and feelings. It is a long-term approach to mental health. Psychodynamics attempt to uncover the connection between the “unconscious mind” and our actions. In other words, our current problems stem from past traumatic experiences that manifest in ways that we are not yet aware of, and therefore psychoanalysts attempt to uncover and understand these unconscious pathways. A hallmark of psychodynamics is its focus on the past as it relates to our current condition.

Alternatively, you may seek behavioral therapy. Like psychodynamic therapy, behavioral therapy also looks at past experiences as they relate to our current situation. However, whereas psychodynamics focuses on understanding the reasoning behind these unconscious pathways, behaviorism focuses on changing and understanding our current behaviors. Behavioral therapy views our current problematic behaviors like anxiety as a reaction to our past experiences, and aims to augment those behaviors. Even though behaviorism does look at our past, it places the therapeutic emphasis on understanding and changing current behaviors.

Another popular treatment is cognitive behavioral therapy (CBT), a short-term approach to therapy. Similar to behavioral therapy, CBT addresses problematic patterns in our current behaviors, however it does not focus at all on past experiences. Unlike with psychodynamics, there will be no laying on couches discussing your eighth birthday in a CBT session. Rather, CBT focuses on existing symptoms that may contribute to our current thinking and behaviors and works to change these. A large part of CBT happens outside your session. For example, a cognitive-behavioral therapist might have you keep track of your negative thoughts outside of a therapy session and give you strategies to counter those negative thoughts in your daily life. Notice, the point of this technique is to highlight our current thoughts and behavior patterns, regardless of past experiences, and change those patterns that contribute to our existing symptoms.

The last main type of therapy is the humanistic approach. Humanists look at a patient’s worldview and how it affects the choices we make in our daily lives. Rather than having a therapist tell you what your problems are and how you can fix them, humanists believe that you are the best person to understand what you’re experiencing. Therefore, a humanistic approach serves to guide you through that understanding, rather than interpret it for you. A staple of humanistic therapy is unconditional positive regard, in which a therapist supports whatever choices their patients make without imposing their own feelings. Generally, you will be the one directing the session, and the therapist will just be there to support you, occasionally asking questions to guide you through the session.

While all of these therapeutic approaches are markedly different, neither one is inherently “better” or “worse” than the others. It all depends on your own needs. None of these treatments focus on a diagnosis, but rather alleviating individual symptoms that any person could experience. In other words, as I’ve said week after week, you don’t need a diagnosis to seek treatment because the treatment itself focuses on you, not your diagnosis. 

Mental health is a journey, and like any journey, it is important to be prepared. Understanding how therapy works will help you choose the right kind of therapy for you.

With all this in mind, it can feel overwhelming to seek help. How do you know which is the best option? Well, start by asking yourself some questions: What issues do I want to address? What traits do I want in my therapy sessions and in my therapist? How long do I want to be in therapy and how much time do I want to commit to my sessions? Figuring out the answers to these questions will aid you in choosing the right kind of therapeutic treatment. 

The internet can also be a great resource, so it may be helpful to consider conducting a quick search about the different types of treatments and read about them! After all, there are hundreds of different forms of therapy.