There talking side of therapy, whereby an individual

There are many different ways in which people may seek
guidance in overcoming their mental health struggles. These professions vary
from Psychiatrists, who are more medically trained and can prescribe an
individual with the suitable type of medication, to the works of a Counselor,
who is trained more into the talking side of therapy, whereby an individual is
encouraged to talk about their emotions and feelings, rather than being treated
with medication. These are just a few of the many professions out there in
treating mental illness, with different treatments being more suited to one
individual than the other. Throughout this essay, I will explore a few other
available sources of treatment including clinical psychologists, with also
comparing them with one another and showing how Counseling and Psychotherapy differentiates
itself from other mental health professions. Alongside this, I will also be
explaining three main approaches in the world of therapy and how they are used
in the therapeutic setting, comparing and evaluating them too, to show further
understanding, with focusing on one to provide my contextualised knowledge and
understanding of how the theory came to be developed via historical, cultural
and political possibilities.

According to the British
Association for Counselling and Psychotherapy (BACP), The role of a counsellor
and psychotherapist is to try and develop the overall health and security in
our society. Generally, Counselling and Psychotherapy are listening and
talking-based methods of understanding psychological issues (Feltham and Horton,
2012).

As a profession, psychotherapy involves all talking therapies, with the
objective being to try and help the client to overcome the negative aspects they’re
dealing with in their day-to-day lives. A few examples of these things may
include things from emotional struggles they’re presently dealing with, to traumatic
conditions they’re struggling to cope with. Usually, a Psychotherapist will
meet with their client or group, on a fixed routine, with once a week being the
most common depending on the circumstance. With this in mind, there are
different forms of therapy that can take place, including Cognitive Behavioral
Therapy (CBT) and even art therapies, which uses creative arts in a therapeutic
manner.

To help a client who is experiencing mental health problem, a counsellor
will use aspects of psychotherapy to try and overcome these. These two
professions often coincide with one another, however there are debates about
their differences, with some people believing that counselling works in a more
unstructured manner, dealing with shorter-term issues. With this being a
debate, it’s been seen that more counsellors are taking similar training to
psychotherapists, with also some using a certain approach in psychotherapy to
help support their client. Counsellors can work with a range of people,
including those who have suffered from addictions, bereavement, abuse and
eating disorders.

With that being said, there are many different areas and professions within
the world of mental health, all who help those who are struggling with their
mental well-being. One of these professions is Psychiatry. This profession
involves a medical doctor who has studied both physical and mental health problems,
with then going on to do further training in mental health. Due to this medical
background, they’re able to prescribe a patient with medication, unlike
psychotherapists or counsellors. They’re able to treat conditions such as
anxiety, post-traumatic stress disorder (PTSD) and schizophrenia, with also
being able to offer emotional support for those with long-term physical health
conditions through treatments such as talking therapies.

Another profession is
a clinical psychologist. Within this profession, just like a psychotherapist
and counselor, their main aim is to help those suffering from mental distress either
emotionally or psychologically, which has a negative impact on their daily
lives, making the differences between the professions very similar. However,
what makes psychotherapists and counsellors different from clinical
psychologists is the fact that they tend to look into individuals with less
extreme mental distress, whereas clinical psychologists look into clients with
more severe mental health disorders, including things such as psychosis. Just
like in counselling, they can work with groups or just and including, however a
clinical psychologist will tend to concentrate on a certain type of therapy,
including Cognitive Behavioral Therapy (CBT). 

 

Looking in depth into behavioural therapies, Cognitive
Behavioural Therapy (CBT) is a strand of cognitive and behavioural drives, with
the basic origin coming from the works of Pavlov and Skinner in classical and
operant conditioning. Looking into the behavioural aspects of it, Skinner
further developed the work of Pavlov, with also criticising his experiment for
being too simplistic to be able to reflect mundane realism, creating his own
theory which is known as operant conditioning. Within this he introduced the
concepts of punishment and reinforcement, explaining how behaviours can become
subdued, depending on the types consequences they may have, either positive or
negative.                                                                                                                                       In terms of the cognitive strand to CBT, this was brought to our
attention by the works of Beck and Ellis, whom were both interested in how our
thoughts are influenced by our feelings. Fundamentally, they believed that our
psychological issues are due to the way a person thinks and feels. This
approach is also bought upon on an individual’s interpretations, which are
thought to be based on their own experiences from past events, cognitive makeup
and beliefs about the world around them, others and themselves. This idea was
developed by Beck in the 1960’s and is most popular to treat people who suffer
with depression. This type of cognitive therapy helps clients to acknowledge
their negative thoughts which in turn, has guided them to their depression.

Also, the therapist aims to challenge the client’s negative ways of thinking,
trying to get them to ultimately change their way of thinking about their daily
lives in a dysfunctional way.  

With being the first person to use the term
‘psychoanalysis’, Sigmund Freud worked for years concentrating on clients who
had neurotic and hysterical conditions. Over time, this led him to the
conclusion that painful early life experiences produced these anxious symptoms
and, with the use of encouragement, talking about these events and buried
emotions would lead to them being cured (Feltham
& Horton 2012). This led to the origin of the “talking cures”.

Freud was born into a middle-class family and
originally trained as a neurologist at the University of Vienna.  This class position meant his primary focus
in his therapeutic practice led him to see clients from higher classes (or
people who could afford the therapy) especially young women who were supressed
by men.

Thinking about his family dynamic and how it
may have influenced his viewpoints and development of the psychodynamic
approach, his father, had already two children from a previous marriage and was
a wool merchant, earning the majority of his living from that. Amalia who was
Freud’s mother and also the third wife of Jacob, was younger than her husband
by twenty years, with also referring to Freud as “my golden Sigi”. From just
this, you can see that his relationship with his mother was close, and through
self-analysis found that when younger, he wanted to marry his mother but saw
his father being in the way, with having to compete for her love. He later
analysed this as the Oedipus Complex, becoming one of his most well-known
ideas.  

 

With being among one of the oldest
therapeutic models in the world of therapy, the psychodynamic approach roots
back to the nineteenth century. The basic philosophy of this approach is that
people are motivated by unconscious drives which are created and shaped by
unresolved childhood experiences. If these can then be talked about and brought
into consciousness, then the individuals’ life choices won’t be driven by the
unconscious too much, but rather by their present selves. In turn, the main
aims of psychodynamic therapy are to bring unconscious thoughts into
consciousness, by talking about them and figuring out coping strategies.

 

Looking further into the psychodynamic
approach, Freud developed his psychoanalytic perspective by breaking the
personality up into three different components, with the first being the id. The
id is thought to be fully unconscious according to Freud, meaning it affects
how we are as individuals without us even being aware of it, with working on a
pleasure principle by demanding immediate satisfaction. It does this by
avoiding pain, increasing pleasure and decreasing tension. Alongside this,
Freud also stated that that it’s the only personality trait that’s present at
birth. Moving onto the next component, the majority of the superego is thought
to be unconscious. The superego operates on the moral principle, with wanting
to do well for others. In order to gain gratification, a person must do, think
and feel no wrong. If we give into the id’s demands, the superego responds with
guilt. Finally, the ego, which is mostly conscious with this time operating on
the reality principle. The ego aims to satisfy both the superego and Id and is
essentially what we perceive ourselves to be. In order to protect an individual
from psychological pain such as trauma, the ego can unconsciously distort one’s
reality. This is referred to as defence mechanisms, with one being repression,
which involves an individual pushing anxious thoughts and memories into our
subconscious to avoid any previously threatening thoughts becoming conscious.

 

It’s been evident that this particular
approach has evolved over many years, creating multiple definitions. Focusing
on this approach, it integrates various theories that all view the interaction
of a person’s inner drives and forces, especially their unconscious, being
based on the numerous structures within their personality (Mcleod, 2007).

Traditionally, psychoanalysis
took place over several years, typically consisting of one session a week,
working with thorough and long-term sessions. However, more recently, this has
changed to the opposite, consisting of shorter sessions, with having a clear
focus and limited goal (Smith, Garforth, 2012).

 

The development of Freud’s “talking
cures” therapy attracted many people at the time, as many people were still
treating psychological symptoms in a medical manner. This led people who were
interested in psychoanalysis such as Adler and Jung, to develop and look more
into the approach. Due to Adler’s disagreement with Freud on psychanalysis, it led
him to resign from the Vienna Psychoanalytic society and thus form his own group
for Individual Psychology. Comparing societal
backgrounds with Freud, Adler was born into a lower class, witnessing economic
and political oppression from early on in his childhood years. He grew up in a
marginalised society whereby the majority of people around him often struggled
to put food on the table. Growing up with this particular background in
comparison to Freud led him to understand and see the unfairness in society.

Alongside this, Adler was part of a large family, with numerous siblings, just
like Freud. However, for him, it caused much sibling rivalry with a lack of
attention from his mother. This upbringing influenced his viewpoints and
development of his theories, playing a part in his disagreement with Freud’s
emphasis of sexual factors. Adler was also a socialist, meaning he was very
politically active, advocating healthier social welfare for the working class.

From knowing this, it makes sense that his theory and clinical work was largely
influenced by his political outlook and his empathy for the working class.

 

From Freud’s assumption being the main cause that neurotic
symptoms were due to unfulfilled sexual wishes, Adler criticised this by saying
that these symptoms were in fact caused by external, environmental factors. He
considered mental illnesses being the result of more broad, societal issues of
inequalities and groups who were socially marginalised and oppressed, such as
women and the working class. This doctrine later played a major role in psychology,
influencing many well-known psychologists, including Abraham Maslow; the
advocate of the Hierarchy of Needs. According
to Adler, he also believed an individual shouldn’t
be understood in regard to parts, like Freud referred to the personality as the
id, ego and superego, but rather as a complete and holistic being (Julita, 2011).

Adler believed our
social and cultural surrounding shapes our behaviour.  

Keeping this in mind, Adlerian therapy is partly
humanistic but also focuses on goals, linking greatly to the Humanistic
approach to therapy. This approach involves observing a person as a whole, looking
at how a person behaves through their own judgements, not just through someone
else observing them. The humanistic approach involves person-centred therapy
(PCT), which was created and developed by Carl Rodgers in the 1940’s. This
theory is seen as different from others due to it adopting a non-directive
approach, meaning that the client is there to figure own their own solutions to
their problems, resulting in them becoming aware of their thoughts and
feelings. Ultimately, the goal to this type of therapy is for the client to
become independent and confident in how to solve their negative view and
beliefs in themselves, with the therapist being the “facilitator” of the
practice (Twigg, 2012).

Fundamentally, Rogers believes that every
individual are innately pre-programmed to do the best to their ability, with
the central principle being that with the right psychological and social environment,
a person will reach their full potential (Twigg, 2012). If this has been reached, then a person will be known to have
reached “self-actualisation”, the top of the hierarchy of needs.

There are supposedly three main concepts within
the person-centred approach, with the first being congruence. According to
Rogers this is seen as the most important characteristic within counselling.

Meaning genuineness, it allows the client to act real and authentic, with the
therapist acting in a way that assures the client that their inner and outer
experiences are to an extent, the same.

The second core belief is unconditional
positive regard. This refers to the belief that in order for people to reach self-actualisation,
they need to be judged and valued as themselves. In therapy, this refers to the
therapist sustaining a positive relationship with the client by accepting them
for who they are, even if the carry out behaviours they may disapprove of.

Lastly, empathy. In therapy, this is the action
of being able to understand how the client is feeling and to show that they do,
in a sensitive and truthful manner by almost putting themselves in the client’s
frame of mind.

 

To conclude the
topics discussed above, it’s clear to see that there are different professions that
provide distinct treatment which suit certain kinds of people.  According to the National Institute for Health and Care Excellence
(NICE), the most common forms of mental health disorders including obsessive
compulsive disorder (OCD), Depression and Post-Traumatic Stress Disorder (PTSD)
can affect 15% of a population, however this doesn’t include those who have
been undiagnosed. With knowing these figures, it’s clear to understand why
there are so many professions that work around the subject of mental health having
a range of treatments, from talking therapies to using medication. Having a variety
of professions is good in my eyes, with different treatments being appropriate
to the different types of people. Also, the diverse professions have different knowledge
of treatments, with even different therapies having different strategies of dealing
with and overcoming mental health difficulties.

With also looking
into the approaches as well, I personally like how diverse each one is. It’s
clear to see that the upbringing of the founder has an influential factor and
impact on the type of theory they develop and also their views and beliefs.  I personally liked Freud’s theory, so looking
in depth at his work interested me to find out more about his history, political
and philosophical views altogether. 

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