Psychotherapy

I

Introduction

Psychotherapy, treatment of individuals with emotional problems, behavioral problems, or mental illness primarily through verbal communication. In most types of psychotherapy, a person discusses his or her problems one-on-one with a therapist. The therapist tries to understand the person’s problems and to help the individual change distressing thoughts, feelings, or behaviors.

People often seek psychotherapy when they have tried other approaches to solving a personal problem. For example, people who are depressed, anxious, or have drug or alcohol problems may find that talking to friends or family members is not enough to resolve their problems. Sometimes people may want to talk to a therapist about problems they would feel uncomfortable discussing with friends or family, such as being sexually abused as a child. Finding a therapist to talk to who is knowledgeable about emotional problems, has patients’ best interests at heart, and is relatively objective can be extremely helpful.

Psychotherapy differs in two ways from the informal help or advice that one person may give another. First, psychotherapy is conducted by a trained, certified, or licensed therapist. In addition, treatment methods in psychotherapy are guided by well-developed theories about the sources of personal problems.

At one time the term psychotherapy referred to a form of psychiatric treatment used with severely disturbed individuals, whereas counseling referred to the treatment of people with milder psychological problems or to advice given on vocational and educational matters. Today the distinction between psychotherapy and counseling is quite blurred, and many mental health professionals use the terms interchangeably. Psychotherapists and counselors often treat the same kinds of problems and use the same set of techniques.

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II

Problems Treated with Psychotherapy

Psychotherapy is an important form of treatment for many kinds of psychological problems. Two of the most common problems for which people seek help from a therapist are depression and persistent anxiety. People with depression may have low self-esteem, a sense of hopelessness about the future, and a lack of interest in people and activities once found pleasurable. People with anxiety disorders may feel anxious all the time or suffer from phobias, a fear of specific objects or situations. Psychotherapy, by itself or in combination with drug treatment, can often help people overcome or manage these problems.

People experiencing an emotional crisis due to marital problems, family disputes, problems at work, loneliness, or troubled social relationships may benefit from psychotherapy. Other problems often treated with psychotherapy include obsessive-compulsive disorder, personality disorders, alcoholism and other forms of drug dependence, problems stemming from child abuse, and behavioral problems, such as eating disorders and juvenile delinquency.

Mental health professionals do not rely on psychotherapy to treat schizophrenia, a severe mental illness. Drugs are used to treat this disorder. However, some psychotherapeutic techniques may help people with schizophrenia learn appropriate social skills and skills for managing anxiety. Another severe mental illness, bipolar disorder (popularly called manic depression), is treated with drugs or a combination of drugs and psychotherapy.

III

Trends in Psychotherapy

Before 1950 psychoanalysis was virtually the only form of psychotherapy available. In traditional psychoanalysis, patients met with a therapist several times a week. Patients would lie on a couch and talk about their childhood, their dreams, or whatever came to mind. The psychoanalyst interpreted these thoughts and helped patients resolve unconscious conflicts. This type of therapy often took years and was very expensive.

Over the next several decades the field of psychotherapy and counseling expanded enormously, both in the number of approaches available and in the number of people choosing to enter the profession. Variants of psychoanalysis emerged that focused more on the patient’s current level of functioning and required less time in therapy. In the 1950s and 1960s therapists began using behavioral and cognitive therapies that focused less on the inner world of the client and more on the client’s problem behaviors or thoughts.

As the number of approaches to therapy grew throughout the 1960s and 1970s, the practice of psychotherapy and counseling spread from hospitals and private psychiatric offices to new settings—elementary schools, high schools, colleges, prisons, mental health clinics, military bases, businesses, and churches and synagogues. With more opportunities for individuals to receive help for their problems, and with more affordable treatments, psychotherapy has become increasingly popular. Although a reliable count of the number of people who receive psychotherapy is difficult to obtain, researchers estimate that 3.5 percent of women and 2.5 percent of men in the United States receive psychotherapy in any given year.

A

Attitudes Toward Psychotherapy

The increased availability and use of psychotherapy has led to more positive attitudes toward mental health care among the general public. Before the 1960s, people often viewed the need for psychotherapy as a sign of personal weakness or a sign that the person was abnormal. Those who received therapy seldom told others about their treatment. Since then the stigma attached to psychotherapy has decreased significantly. It is now common for people to consider seeing a therapist for an emotional problem, and recipients of therapy are more willing to disclose their therapy to friends. Today psychotherapy is a topic of immense public interest. In the scientific community and in the media, people assess methods of therapy and debate which approaches are best for particular problems and disorders.

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