What is Psychotherapy
Psychotherapies, which aim to make the client happy by creating a change in his life, to achieve inner peace, to increase his awareness, to live in peace with himself and his environment, to use his capacity and potential at the maximum level, to be harmonious, productive and productive, and to treat psychopathologies, were born from theories expressing different perspectives on people.
There are two “psychotherapies.” The first, very close to psychoanalysis, may be defined as that mental treatment whose central focus is the analysis of the patient’s experience of the relationship with the therapist in the here and now, and whose goal is insight. This is psychoanalytic psychotherapy. The second is nonpsychoanalytic psychotherapy, which bypasses the patient’s experience of the relationship with the therapist, and by so doing may be defined as that mental treatment based on suggestion, with the goal of subjective improvement or symptom relief. Each therapy has its appropriate role in human experience. The basis of nonanalytic therapy, suggestion, is antithetical to both the means (analysis) and ends (insight) of analytic therapy. J E Lifschutz
Each theory can have strengths and weaknesses. The most successful results can be achieved when theories are handled with a holistic approach and a synthesis suitable for the client is made, knowing that human beings are a complex entity with cognitive, affective and behavioral aspects without limiting the client to a theory.
Although there are more than 400 psychotherapy systems today, all psychotherapy methods have arisen from 3-5 main theories that we will summarize in this article.
Psychoanalytic Theory and Psychoanalytic Psychotherapy (Psychoanalysis)
It is the most basic theory of personality and a psychotherapy method that preserves its value today as the first cognitive and psychopathology approach. All other theories have emerged either to support or criticize this theory.
The founder of the psychoanalytic theory is Sigmund Freud, who lived between 1856 and 1939. His attitude towards human beings is negative and he regards the individual as a mentally problematic (neurotic) being who cannot get rid of the incapable, impulsive, selfish and demanding nature of infancy, who constantly needs care, attention and love from the opposite side, who suffers internal conflicts due to his incompetence. It ties the basis of behavior to innate, unconscious sexual (pleasure-directed) and aggressive (anger-directed) urges.
The aim of psychoanalytic psychotherapy is to make the client become aware of the unconscious features in his / her personality and to resolve their conflicts and thus to overcome the obstacles to self-development.
Freud, in the development of psychopathology indicates that the most sensitive period for the first 6 years of age. Notes that adolescence is a second chance and restructuring period. He argues that if there is no improvement in this period, mental health can only be improved by psychotherapy.
In psychoanalytic therapy, the therapist takes an active role and guides the client. Transference (conveying unconscious positive or negative feelings of the client to the therapist), opposing transference (the therapist’s deep emotional reactions to the client), resistance (all kinds of factors that prevent the progress of the treatment, point to the problem) and slips, name and All kinds of erroneous actions such as forgetting the place, being clumsy, confusing the session time (giving valuable information as the manifestation of unconscious requests or impulses) constitute the main lines of the therapeutic process.
Motive theory (the individual’s basic life energy and acting with sexuality and aggression impulses arising from the basic death instinct), mental process consisting of consciousness-preconscious-unconscious, structural personality theory including id-ego-superego concepts, ego defense mechanisms, oral-anal Psychosexual developmental periods classified as phallency-latency and genital periods are the basic concepts of psychoanalytic theory.
If we summarize the approaches that we can deal with in psychoanalytic theory, that diverge or contribute to Freud in some places;
1) The object and relations approach of Heinz Kohut, Melaine Klein and Margaret Mahler: The individual begins life psychologically in a position integrated with the mother, perceiving himself as parts instead of seeing himself as a whole.
2) Erik H. Erikson’s psychosocial personality development theory: It extended Freud’s developmental periods to the end of life and added the effects of environment and learning to early child sexuality. Saying that personality development is a lifelong psychosocial process, Erikson argues that people are trying to balance themselves and their social environment.
3) Karen Horney’s personality theory: Emphasizes having a positive and inner nature, the effects of culture and the environment. Believes in the importance of childhood experiences and sociocultural conditions.
4) Carl Gustav Jung’s analytical psychology: Defending that human behavior emerges as a product of individual experiences, racial past, goals and ideals, Jung says how man’s attitudes and functions perceive himself and the world.
Adlerian Psychotherapy (Individual Psychology)
Defending that subjective emotions are more important than biological impulses, Alfred Adler says that human beings are a social being and that conscious aspects are more effective in the development of personality. Behavior has the goal and purpose, and the person desires to be successful, grow and develop. In addition, every person has a tendency to feel inferiority, and when he cannot overcome this, he develops an inferiority complex. By experiencing the opposite, the superiority complex can also be developed. Both are neurotic problems that debilitate the individual.
The client’s insight is supported by the belief that social interest is an inner potential and can be developed consciously in adolescent therapy. The individual should consider himself valuable in essence despite his human flaws. Behavioral disorders develop when one feels weak and inferior to life and society. In the psychotherapy process, trust, hope and love are studied.
Adler attached importance to the birth order and elaborated on their roles in personal development. The first child is a sultan who reigns by gathering all the attention of the family on him, well socialized, successful, harmonious and responsible. When the second child is born, he will either be resentful of losing his throne, or he will understand the importance of power and authority better.
The second children are extroverted, free, creative and not interested in rules, do not take on the roles of the older sibling and often have opposite characteristics. Middle children, on the other hand, feel stuck in the family and may think that they are not treated fairly. However, they are effective individuals in making and making their own wishes.
The youngest children experience challenges and opportunities at the same time. While there is a high risk of being spoiled children, they are likely to be very successful. Single children mature quickly and become very successful. They have a great potential to have a rich imagination. However, they can be spoiled, selfish, and weak in socializing.
Transactional Analysis Approach
It is a cognitive-behavioral approach developed by Eric Berne. It is based on the human potential to choose, reorient and reshape their own destiny.
Stating that normal personality structure will develop in the hands of healthy parents, Berne has described three states of ego. These are child state, parental state and adult state. The most changeable one of these ego states is the adult state, and people direct their lives by learning the appropriate uses of their ego states. During the therapy process, the perception of “I am fine” is worked on.
It is accepted that there are four basic positions in human life positions.
1) I’m fine, you’re fine.
2) I am fine, you are not.
3) I’m not okay, you’re okay.
4) I’m not okay, you’re not okay.
A healthy individual should be able to fully express feelings of fear, satisfaction, sadness and anger. For example, the manifestation of anger in the form of resentment or aggression is pathological.
Throughout psychotherapy, the client tries to review and evaluate his old decisions and make more appropriate choices.
The ancestor of the behavioral approach is B.F.Skinner, who lived between 1904-1990. Defending that it is possible to develop the desired behavior, Skinner says that humans consist of certain innate abilities, structures and reflexes, and that the differences between individuals arise from different conditioning.
emotional aspects of human behavior and no insight into Skinner, appropriate learning situations satisfies showed inappropriate behavior can be changed when exercised. In behavioral theory, it is assumed that all compatible or incompatible behaviors are learned.
Classical conditioning, bond theory (trial-and-error way) and operant conditioning are the main concepts of behavioral therapy. Consolidation, forming, suppression, punishment, environmental planning, systematic desensitization, imitation, stop thinking techniques like behavioral therapy used in the process.
Person-centered therapy, which is also described as the approach that gets speed from the client, was developed by Carl Rogers. According to Rogers, who says that every person is unique and good in essence, if an environment is provided where people are accepted as they are and are not judged, they have the opportunity to know, express and develop themselves correctly.
In individual-centered therapy, it is aimed to ensure the harmony between the individual’s own concept of reality and the self concept perceived. The person will have a healthy mood when he / she recognizes and integrates his / her own resources and potential and feels realistic, safe and mature in his self-perceptions. Accepting oneself and others as they are and having positive thoughts is a state of being mentally healthy.
Self-confidence is when an individual finds himself strong and competent. Self-respect is the individual’s appreciation of what he / she has, valuing himself / herself in terms of his / her possession and position, liking and caring. If we are to describe positive self-esteem, we can say that the individual has good feelings about his or her self regardless of other people’s attitudes.
At the root of the psychological disturbances of the person, there is an adjustment disorder caused by the unintegration of the experiences and the self. Present interpretation of past experiences and subjective understanding of the person is the primary factor affecting current behaviors.
In individual-centered therapy, the emphasis is on how people perceive reality rather than what the event is.
Leslie S. Greenberg, who argues that emotions have a natural adaptation potential when they are activated, thus unwanted self-structure can be improved and emotional problems can be solved, is the founder of emotion-focused therapy.
According to Greenberg, we first feel, then we think. Therefore, many problems will be solved if the individual is provided to better know, experience, accept, examine, interpret, and manage their emotions in a flexible way.
Emotions are the primary factor driving our behavior. Behavioral disorders are inevitable if the individual is not aware of their primary emotions and is unable to recognize primary functional feelings and needs that are not avoided or symbolized. Under every emotion there is a need and every need turns into a behavior. We should see emotion not as an outcome, but as the cause of the current situation.
In conclusion, emotion-focused therapy is a psychotherapy method that tries to achieve mental health by using techniques such as emotional awareness, expression of emotions, regulation of emotions, and transformation of emotions. It is one of the most preferred types of psychotherapy in individual and couple therapies today.
Existential theory and existential therapy, shaped by the contributions of Rollo May, Victor Frankl, and Irvin Yalom, were born from the assumption that people are the architects of their own lives. People are free creatures and can direct their lives in whatever way they want. He makes his humanity himself and exists as he does. Existential anxiety develops in people who feel this responsibility.
The main purpose of existential therapy is to enable the individual to accept the risks of their freedom and responsibility to act and to gain awareness of what they are doing. The individual who gains self-awareness will be so free. We must know that our lifestyle and the position we have come from is a result of our choices, we must accept the responsibility of this. Psychopathology is the failure of people to make meaningful choices and to use their potential.
If the individual denies his potential, he is committing the crime of existence. If a person who cannot activate the power inside and cannot evaluate the possibilities that confronts him escapes from the existential guilt feeling he must experience, neurotic guilt may occur and the individual may fall into meaninglessness in life.
Existential theory states that the meaning of life will be discovered in three ways.
1) By doing something, creating something or accomplishing something.
2) By experiencing a value, an experience, a love or contributing in areas such as nature, culture, environment.
3) By developing an appropriate attitude towards the unchangeable fate in the pain and difficulties to be experienced and by being able to endure the pain and grief
According to Frederick Perls’s gestalt theory, the human being is a part of his environment and cannot be understood separately from his environment. Body, emotions, sensations and perceptions are parts of human integrity. Man becomes able to function in a systematic unity.
In Gestalt therapy, according to the here and now principle, it is aimed to be in integrity. The aim is to ensure the integrity of the individual. The completion of unfinished or unfinished parts of life and work is in this context. Incomplete works will create negative feelings such as resentment, anger, pain, guilt, and when these cannot be fully expressed, they will emerge in the person’s relationships with himself or others, and will return to a fixed course of action over time.
One of the most important contributions the Gestalt approach makes to the world of psychology is the importance it places on understanding the value of the present moment and living it fully.
Rational Emotional Behavioral Therapy
The main idea in Albert Ellis’ rational emotional behavioral therapy is the assumption that “people will be what they think”. One can develop irrational beliefs by instilling thoughts on himself. There is no such thing as good and bad. We create them with our thoughts.
If we can change the way people think, we can change their feelings and behavior. The main purpose of this psychotherapy method is to teach clients how to replace dysfunctional feelings and thoughts with healthy and useful ones.
His irrational thoughts underlie man’s emotional problems. Irrational behavior causes unhappiness and non-productive behavior.
If we accept that we are responsible for the creation of our own emotional problems, we believe that we can change these ailments, we understand that our emotional problems are largely caused by irrational irrational beliefs, and if we work with the belief of change, we can change the dysfunctional personality structure.
Cognitive Theory and Cognitive Therapy
Stating that depression is not an affective disorder but a cognitive disorder, stating that the mental health of the individual will deteriorate when the mental health of the individual deteriorates, and stated that emotional reactions occur depending on the meanings attributed to events, Aaron Beck is the ancestor of cognitive therapy.
Cognitive therapy aims to change the mentality of the client and the behaviors that occur accordingly. Problem behaviors are handled with an experimental approach, a hypothesis is established and a formulation is created. The individual’s thoughts and beliefs are approached in the context of the here and now and a solution is reached.
Mind-reading (not assuming what people think), reading the future (bad things will happen), disastrous (if I can’t, it will be terrible), labeling (like that corrupt person), ignoring the positive (like that was easy, that’s the way to go), focusing only on the negative , overgeneralization (like my failure in many issues), thinking all or nothing style, thinking should-do (like I shouldn’t fail, I should always be loved), personalization (connecting things disproportionately to yourself), blame (by saying my family is the source of all my problems and getting out of it. not taking responsibility), unfair comparisons (evaluating others to unrealistic standards), tendency to regret (like I shouldn’t have said this), dissatisfaction with answers (what if it goes wrong, etc.), emotional inference (my depression means that my business life and marriage are unsuccessful), judgment Focus (stigmatizing yourself and others with adjectives such as good, bad, superior, inferior) is one of the cognitive distortions that are frequently made. The essence of these distortions lies in the individual’s negative and erroneous perception of himself, his world and his future.
To illustrate a cognitive model;
1) Basic belief: I am incapable.
2) Intermediate belief: If I do not understand mathematics, I am stupid.
3) Situation: While studying.
4) Automatic thoughts: Math is very difficult, I will never understand.
5) Reactions: Sadness, stopping studying, headache, heartburn.
Being mentally healthy is to be able to listen, support, encourage, love, to be friends, trust, tolerant and self-confident, while being unhealthy is to force, punish, direct, criticize, blame, act with prejudice, complain, withdraw and direct others. William Glasser, who defined it as working, created the theory of reality therapy.
The goal of reality therapy is to help people meet their psychological needs for belonging, power, freedom and fun in responsible and satisfying ways.
Glasser says that the basis of unhappiness is that the people we encounter early in our lives are discovering what is true not only for themselves, but also for us.
It emphasizes the selection of action and action for psychological health. The only person whose behavior we can control is ourselves. The individual should say that I prefer depression instead of saying I am depressed.
Belonging and loving, strength, freedom, fun and creativity, encoded in human genes, constitute the four main requirements.
In reality therapy, we try to erase our belief that others feel or cause us to do what we do. Of course, drug use in psychiatry has great importance and value. However, we should know that no medication will eliminate the problem that leads us to choose unhappiness. In order to regain our mental health, we must break the outer control chains and avoid being helpless against forces Postmodern psychotherapy theories:
The Theory of Social Structuralism
Everything that the individual calls a problem is really a problem. Every individual lives with important dilemmas. The personal structure matures according to the way of perceiving dilemmas such as smart-stupid, rich-poor, honest-dishonest, beautiful-ugly, hard-working-less. There is no single or true way in life. In the therapy process, there is a transition from a single language or a single meaning-based dialogue system related to the problem to another speech system that solves the problem.
Solution-Focused Short-Term Therapy
It is a theory and method of psychotherapy that believes that a person who takes action by taking responsibility for change and can try new behaviors can produce his own goals and solutions.
Based on the view that there is no relationship between the cause of the problem and its solution, the solution of the problem is dealt with directly. Do not fix it if it is not broken, first understand what works and then do it more, if it doesn’t work, try the same thing again rule constitutes the basic philosophy of solution-oriented approach.
Focusing on the solution instead of the problem, looking at the past instead of the past, focusing on the desired goal, knowing that every solution will be different because each individual is unique, believing that small changes can produce great results are the main lines of this therapy method.
According to narrative therapy, people make sense of the world they live in with their own special perceptions and stories shaped by these perceptions. Humans are the only experts in their lives and have the skills and potential to solve their problems. The need for therapy arises if the person realizes that their story is meaningless or inconsistent.
Support and approval from the environment is the main factor in creating a healthy identity. The life story of the individual is shaped by factors such as family structure, child-rearing styles, interpersonal interactions, historical time, culture, religion, group needs, and economic situation.
According to the narrative therapy approach, human life consists of a series of stories and people question their own existence by inferring specific meanings from the events they experience.
Apart from all these psychotherapy theories and methods, it is possible to count hundreds of psychotherapy methods such as cognitive analytical therapy, dialectical behavioral therapy, acceptance and commitment theory, culture-centered psychological counseling, relational cultural theory.
Last Updated on January 4, 2021 by Marilyn Walker