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Psychotherapy 101

What Is Psychotherapy?

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Updated November 29, 2012

Psychotherapy is a process in which a trained professional enters a relationship with a patient for the purpose of helping the patient with symptoms of mental illness, behavioral problems or personal growth. The process involves the patient and therapist sitting in a room talking, which is why it is often called "talk therapy".

The History of Psychotherapy

The first recorded instance of psychotherapy is the case of Anna O. in the early 1880's. Anna, whose real name was Bertha Pappenheim, developed severe symptoms, such as paralysis, loss of sensation, the inability to drink even though thirsty and a greatly reduced ability to speak or understand language. She also experienced periods of delusions.

Dr. Josef Breuer, who was treating Anna, observed that during the periods of delusions, she would repeatedly mutter a few words which seemed to be related to her train of thought. He had the idea to put her into a state of hypnosis while she was not in a state of delusion and repeat the words to her. By doing so, he was able to get at the root cause of her symptoms, which were previous events in her life, such as a vivid nightmare she experienced while caring for her ill father. This process caused her symptoms to disappear.

Later Sigmund Freud began employing this "talking cure" on his own patients, which lead to the development of psychoanalysis.

Types of Psychotherapy

There are now a variety of therapeutic approaches, in addition to psychoanalysis, which are available. These include: cognitive behavioral therapy, behavioral therapy, interpersonal therapy, rational emotive therapy and family approaches.

Both individual and group modalities are commonly used, depending upon the severity of the symptoms, the person's financial resources and the local resources which are available.

Best Types of Psychotherapy for Depression

Although psychoanalysis was the first form of psychotherapy to be developed, there is little research to support its use in depression treatment. Some therapists may make use of psychodynamic theory to help conceptualize an individual's personality, however.

Cognitive-behavioral therapy is the most popular and commonly used therapy for depression treatment. Hundreds of research studies have been conducted which verify its safety and effectiveness in treating this disorder. It consists of simple techniques which focus on the negative thought patterns, called cognitive distortions, which the depressed person may habitually use.

Therapy begins by establishing a supportive environment for the patient. Educating the patient about how depression may be caused by cognitive distortions is the next step. The types of faulty thinking are discussed (e.g., "all or nothing thinking," "misattribution of blame," "overgeneralization," etc.) and the patient is encouraged to begin noting his or her thoughts as they occur throughout the day. This is done so that the individual may understand how common and often these thoughts are occurring.

In cognitive-behavioral therapy, emphasis is placed on discussing the thoughts and the behaviors associated with depression rather than the emotions themselves. The rationale for this is that it is believed that by changing thoughts and behaviors the emotions will also change. Because of this approach, cognitive-behavioral therapy is short-term and works best for people experiencing a large amount of distress. Individuals who are able to approach a problem from a unique perspective and who are more cognitively-oriented will to do best with this approach.

Interpersonal therapy is another short-term therapy used in the treatment of depression. The focus of this approach is on improving an individual's social relationships. It is thought that good, stable social support is essential to a person's overall well-being. This therapy seeks to improve a person's relationship skills, communication skills, expression of emotions, and assertiveness. It is usually conducted on an individual basis, but can also be used in a group therapy setting.

Most individual approaches will emphasize the importance of the patient being actively involved in his own recovery. Patients are usually encouraged to do homework assignments between sessions. If the patient is not yet able to participate actively in therapy, then the therapist may provide a supportive environment until medication begins to improve the patient's state of mind.

Sources:

Freud, Sigmund. Five Lectures on Psycho-Analysis. New York: W.W Norton & Company, 1910.

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