Psychoanalytic and Cognitive Behavioral Therapies

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It is believed that much can be said about how a person reacts to a situation. In times of successes and positive moments, most people celebrate with joyous reactions. However, in troubled times, people react with different shades of negative emotions. Some spring back right away and take positive action while others dwell in doom and even fall into a dark depressive state. For these people, how do they find their way back to the light?

The Psychoanalytic or Psychodynamic theory is premised on the belief that human nature is greatly affected by a person’s early childhood experiences and conflicts between impulses and prohibitions (Myers, 1995). Its founder, Sigmund Freud’s idea of the three systems of personality, the id, ego and superego being in constant battle within a person is likened to a person’s continual debate of what is right and wrong, and then behaves according to his moral decisions. Such decisions are affected by what society dictates as well as what the person truly desires for himself.

Freud views human behavior as determined by irrational forces, unconscious motivations and biological and instinctual drives evolving in the first six years of life (Corey, 2005). He has associated each life stage to a body fixation and namely the Oral, Anal, Phallic, Latency and Genital stages. He theorized that if a traumatic experience has happened in a particular psychosexual stage, an individual gets fixated on that stage, thereby retaining the characteristic of behavior associated with that stage.

To survive living with negative experiences that may have marred a person’s personality or life views, he develops “defense mechanisms” that aim to keep those traumatic experiences repressed in the unconscious (Pervin, Cervone & John, 2005). These defense mechanisms are usually practiced by everyone in their daily life not knowing that they are applications of Freudian thought. An example of a defense mechanism commonly used is ‘rationalization’. If a person has strived hard to reach a goal like applying for a certain job position and does not get it, he would rationalize to his family that he was not so interested in it after all. It is much like the fabled fox “sour-graping”. This is an attempt to mask his utter disappointment and maintain an “unaffected” façade to the people around him.

Defense mechanisms is one aspect of the Psychoanalytic theory that this author thinks would find useful counseling, as the patterned use of whichever kind already says a lot about the coping style and personality of the client. The goals of Psychodynamic therapy are settling unresolved conflicts in a person’s past that deeply affect his current patterns of behavior and personality. It may involve bringing repressed painful memories to resurface to be dealt with consciously through the techniques of free association, dream analysis, hypnosis, transference, and analysis of resistance handled by a skilled psychoanalyst (Corey, 2005). This tedious process intends for the client to reach a level of self-understanding for him to be able to move on with his life without the heavy emotional baggage he has been carrying all his life. This understanding is necessary for an eventual change in views, personality and character.

The psychodynamic therapist should be adept and very patient in coaxing the client to unearth his repressions. The ability to listen and be alert and sensitive to what the client tries to communicate (verbally or non-verbally) is crucial to her valid interpretations about the client. She must also possess maturity and maintain her professional objectivity especially when the client undergoes “transference” of remembered feelings towards a significant person in his life to the therapist. A deep level of trust must have been established between the therapist and the client to be able to achieve this feat.

In order for the therapy to be successful, the client must be committed to being cooperative and ready to discover truths about himself, no matter how ugly it may be. In the course of the therapy, the client is expected not to make any drastic life changes that may affect the analysis of his problems (Corey, 2005).

Psychodynamic therapy ends when both client and therapist mutually agree that they have reached the goals of therapy, that of the client reaching self-understanding, and being able to use uncovered information in confronting present conflicts and future possibilities of repetition of patterns of unwanted behavior.

Cognitive Behavior Therapy views human nature as full of innate potentials and flaws. Clients suffering from psychological problems are assumed to focus more on their flaws that pull them down than on their potentials that may spur them up to success. The basic premise of Cognitive Behavior Therapy is the clients’ erratic or exaggerated beliefs that it is their fault why they came to such a dreadful state. The goal of therapy is to help the client realize that reorganizing the way they view situations will call for a corresponding reorganization in behavior – sort of marrying the concepts of “mind over matter” and “self-fulfilling prophecy”. As an example, a recovering alcoholic will think that he has mustered enough discipline over alcohol. (mind over matter), hence, he strives to be strong and sober enough to resist a drink offered to him at a party (self-fulfilling prophecy).

The focus of Cognitive Behavior Therapy is more on thinking and acting more than just expressing feelings (Corey, 2005), which was more of the concentration of other kinds of therapies like the Psychoanalytic one discussed beforehand. It deals with the client’s present and not his past, although it acknowledges that his irrational thinking might have come from past negative experiences. The duration of the therapy process is usually short, as it immediately cuts to the core and does away with useless preliminaries.

The therapist uses a variety of therapeutic strategies depending on what he decides will work on his particular client. He also delegates responsibility to his client by expecting him to do homework outside the therapy sessions. Homework is aimed at positive behavior that brings about emotional and attitudinal change.

Ellis’ Rational Emotive Behavior Therapy (REBT) is considered to be the forerunner of Cognitive Behavior therapies. Its basic hypothesis is that our emotions stem mainly from our beliefs, evaluations, interpretations and reactions to life situations. Ellis believes that we have an inborn tendency towards growth and actualization but we often sabotage our movement toward growth due to self-defeating patterns we have learned. Through therapeutic processes, the client learns skills to isolate and dispute their irrational views which were mostly self-constructed and maintained by self-indoctrination (Corey, 2005). REBT helps clients replace such irrational views with rational and constructive ones, thus resulting in more productive change in behavior and reactions to situations.

Although Ellis believes that therapists maintain unconditional regard for the client, he also warns against giving too much warmth to the point of coddling, as it encourages clients’ dependence for approval from the therapist (Corey, 2005). Maturity is expected of the client as great faith is placed on him that he can change his irrational ways of thinking.

Another proponent of Cognitive therapy is Aaron Beck who agrees that much of our psychological problems are caused by “cognitive distortions” due to our acknowledged human fallibility (Beck, 1976). Therapists engage in Socratic dialogues with the clients, throwing questions that encourage introspection with the goal of the client arriving at his own conclusions.

Still another alternative to REBT is Donald Meichenbaum’s Cognitive Behavior Modification. It features client’s self-verbalizations that involve a heightened sensitivity to his thoughts, feelings, actions, physiological reactions and ways of reacting to others (Corey, 2005). Clients are also taught more effective coping skills practiced in real-life situations. He may be considered his own coach because his self-talk reminds him of how he should restructure his thinking and behavior. Meichenbaum also puts emphasis on stress management which can be very helpful to clients when faced with stressful situations not unlike those that caused their flawed thinking (Corey, 2005).

The Psychoanalytic and Cognitive Behavior Therapies are similar in that in both, a deep level of trust is established between the therapist and the client. If the trust is not established, then there is no point in continuing the sessions, as it requires a client to divulge his deepest fears and emotions and the therapist to maintain the confidentiality of the situation. The client is helped to analyze his circumstances and made to come up with his own conclusions with the support of the therapist. In both, the client’s awareness of his contribution to his current situation is addressed and is empowered to believe that he has the capability to take charge of his life (Huffman, K., Vernoy, M. & Williams, B., 1987).

Another similarity of the two counseling approaches is the use of a variety of strategies to involve the client’s participation in his treatment. Psychoanalysis makes use of free association, dream analysis, hypnosis, transference, and analysis of resistance while Cognitive Behavior Therapy makes use of thought catching, homework or task assignment, socratic dialogues, reality testing, cognitive rehearsal and dealing with underlying fears and beliefs (Beck, 1987). All the techniques urge the clients to confront a part of themselves that may be too painful or uncomfortable to do so otherwise.

Psychoanalytic therapy may take a long period of time before a client is finally treated, as it involves deep processing of his past experiences that contributed to his current problems. On the other hand, Cognitive behavior therapy intends for the therapy process to be short, and it deals more with the person’s present rather than his past.

Like in all the other counseling approaches, the goal of the therapy sessions is change in the client. After undergoing either Psychoanalytic or Cognitive Behavior therapy, the client is expected to be more self-aware of his thoughts, behavior and feelings and is equipped with skills to cope with life’s challenges better.

My personal evaluation of Psychoanalytic therapy is that it is too heavy for my taste. Although the Freudian view of psychosexual stages of development coincides with other contemporary theories on human growth and development, I believe that it is degrading to the human spirit. It demeans a person’s capacity to make sound judgments because he is viewed as enslaved by his biological fixations and primal needs. It is as if it implies that a person is imprisoned by his past experiences and that his horrible past determines his woeful future.

Requiring a client to undergo such a challenging journey to his past in order to gain enlightenment may have its advantages, and I believe in its goals of self-understanding. However, dwelling too much in the past may also be a waste of time, as what is more essential upon gaining such awareness is the process of moving forward.

I am more partial to the Cognitive Behavior Therapy approach. It is considerate of one’s perspective in life. One’s viewpoint of facts, ideas or situations colors everything one does, says and thinks. The therapist’s efforts in helping an individual correct his erroneous self-defeating beliefs into a more positive and empowering one is laudable. My personal situation being married with four children, living in a country that is not my original homeland may stir in me feelings of self-doubt and fears of not being capable of success in my own right. The many challenges of being a spouse and parent are already daunting in itself, how much more adapting to a culture which is not my own, and having multiple roles at that! The theories advocated by Cognitive Behavior Therapy (CBT) motivate me to be more positive in my outlook, as dwelling on fears and insecurities will only bring me gloom and doom. Somehow, as a normal, pretty well-adjusted person, I believe I may be able to follow the counseling techniques prescribed by CBT on my own. Training myself to look on the bright side may be difficult at first, being besieged by a number of challenges and life’s petty annoyances, however, it is not as difficult as the techniques proposed by Psychoanalytic therapy which should only be done by trained professionals.

In applying the counseling approaches to others, and to prospective clients in therapy, I believe I would be more effective as a CBT practitioner as my personality shows that I am a good encourager. Although I am not consistent in thinking positively for myself, I am aware that I always coax others to strive to be the best they can be and to acknowledge all the good qualities and skills they possess.

Life springs up a lot of surprises and tragic events on people. It is to test our mettle in the face of both glory and adversity. People can be vulnerable and at that state, would need a helping hand to support them towards the right direction. The counseling approaches covered so far have given me hope that there are people who make an effort to reach out to those in need of their expertise in propping up the down and desperate. With that thought, I rest assured that life, indeed, goes on.

References

Beck, A. T. (1976). Cognitive therapy and the emotional disorders. Madison, CT: International Universities Press.

Beck, A. T. (1987). Cognitive models of depression. Journal of Cognitive Psychotherapy: An International Quarterly, 1, 5-57.

Corey, G. (2005) Theory and Practice of Counseling and Psychotherapy, 7^th ed. Brooks/Cole, a division of Thomson Learning Inc.

Huffman, K., Vernoy, M. & Williams, B. (1987) Psychology in Action. New York: John Wiley & Sons, Inc.

Myers, D.G. (1995) Psychology, 4^th Ed., New York: Worth Publishers.

Pervin, Cervone & John (2005) Personality: Theory & Research, 9th Edition Wiley.

Schultz, D. & Schultz, S. (2005) Theories of Personality, 8^th ed Thomson-Wadsworth.

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Psychoanalytic and Cognitive Behavioral Therapies

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