When people think of psychotherapy, they often visualize Dr. Sigmund Freud holding a note pad with his client lying on a couch facing away from him. While it is true that there are still some professionals who utilize Freud’s form of psychoanalysis, there are many different types of psychotherapy that exist to aid in the healing process.
In this article, we will examine together five different types of psychotherapeutic techniques and how they can help you heal.
Different Reasons for Seeking Help
As I indicated in the last article on psychotherapy, there are many reasons to seek help from a mental health professional. Some seek help for comparatively minor issues such as quitting smoking or weight loss, but a large majority look for assistance because of traumatic life events they cannot process on their own.
Traumatic memories and life experiences happen to everyone throughout the course of our lives, and most of these we can work through on our own. These events may include the death of a loved one or the loss of a job.
However, sometimes these seemingly ordinary losses create an internal reaction that causes huge problems and needs to be addressed professionally. These events may include the two reasons listed above, or rape in either childhood or adulthood, and other types of violence perpetrated against our person.
The consequences of these life experiences are sometimes followed by major depressive disorders, anxiety disorders, dissociative disorders, and a myriad of other problems. It is when these problems arise, and harm our quality of life, that it is vital to seek help.
Five of the Modalities Used to Aid Healing
Upon doing my research on the different types of psychotherapeutic treatments, I came across a plethora of listings. These treatments range from traditional talk therapy to using a model called Emotional Freedom Technique (EFT) where the therapist teaches their client how to use a tapping technique on their bodies to alleviate stress, anxiety, and give insights into cognitive dissonance.
(In case you might be wondering, cognitive dissonance is a theory first proposed by Dr. Leon Festinger, Ph.D. that describes how our beliefs and behaviors, if inconsistent or conflicting, often lead to humans using different coping strategies to reduce their inner turmoil. However, if these coping strategies are unhealthy, they cause problems throughout ones life.)
In the following paragraphs, we will explore five of these techniques of psychotherapy, how they help, their limitations, and where you can find them.
Classic Talk Therapy
Psychotherapy’s most recognized form is classic talk therapy. Unfortunately, it is also the most misunderstood.
Talk therapy, also known as psychoanalysis, was founded by Sigmund Freud in the late nineteenth century. In this technique, therapists listen to patients talk about their experiences, as well as their lives and pay close attention to the body language of the person speaking to them.
Through listening and observation, the psychotherapist looks for patterns and events hidden in their client’s words and movements to recognize and treat unconscious feelings, motivations, and thoughts contributing to the difficulties that forced their client into treatment.
Talk therapy works because we all need someone to express our deepest concerns and challenges with. Sitting with a mental health professional, we can tell them everything that is or has happened in our lives without fear of what we say spreading beyond the sanctity of the therapist’s office.
As we speak on the events in our life, the therapist asks leading questions and uses active listening skills to help us discover the ‘what’ that we must do to improve our existence. It is not the therapist’s job to tell us what to do or to give us advice. Both the therapy and its outcomes are dependent on what we want and progresses at the speed we desire.
Through using empathy, a nonjudgmental environment, and unconditional positive regard the therapist builds a strong therapeutic alliance with their client so they can help break down the strongholds prohibiting them from moving forward with their lives.
There is such a long list of disorders that are treated with talk therapy, that it would be undue to list them here.
While there is no doubt that talk therapy helps millions find relief from psychological disorders, it has many limitations.
Perhaps the largest of these limitations involves the fact that therapists are human beings who have their own life experiences. For this reason, there are many opponents to talk therapy whom believe that talk therapy is not effective and object to it based on their belief that the therapist’s humanity often colors how they see their client’s problems. They believe this can lead to dangerous and destructive misinterpretations of what is going on in their client’s minds.
A great platform to find a therapist in your area is the Find a Therapist resource from Psychology Today.
Eye Movement Desensitization and Reprocessing (EMDR)
EMDR is a technique involving an eight-phase treatment utilized by over 100,000 clinicians worldwide to successfully treat millions of people over the past twenty-five years.
EMDR was developed to treat post-traumatic stress disorder, but it also now used to treat a wide range of problems including but not limited to:
- Panic Attacks
- Complicated Grief
- Dissociative Disorders
- Disturbing Memories
- Pain Disorders
- Performance Anxiety
- Stress Reduction
- Sexual and Physical Abuse
- Body Dysmorphic Disorders
- Personality Disorders
EMDR was invented by Dr. Francine Shapiro Ph.D. in the 1980s after noticing that moving her eyes from side to side reduced the effects of distressing memories she was experiencing. Later she theorized that trauma causes us to store negative emotions in the memory regions of the brain, and that these eye movements can mitigate those effects.
(You can learn more about Dr. Shapiro and EMDR in her book, Eye Movement Desensitization and Reprocessing: Basic Principles, Protocols and Procedures 2nd edition, published by Guilford Press.)
EMDR involves attention to three time periods, the past, the present, and the future. The treatment focuses on past disturbing events, as well as any other related events, and how they influence situations in the present to cause distress. The technique helps people develop skills and attitudes to overcome the negative and instead focus on the future in a positive manner, causing the distress to lessen significantly.
Although Dr. Shapiro has laid out the technique she believes to be the most effective in treating clients with EMDR, the main limitation found in a study conducted in 2010 and others like it has been that there are inconsistencies in the way clinicians perform the technique.
To find a qualified Eye Movement Desensitization and Reprocessing therapist near you, check out the Find a Clinician page on the EMDR Institute website.
An extremely powerful method to help people living with the after-effects of trauma is drama therapy. First conceived by Dr. Jacob Moreno this type of treatment is meant to help clients explore their inner experiences and to free themselves from the way their inner conflicts limit them in their healing journey.
The North American Drama Therapy Association describes drama therapy as:
“An active, experiential approach to facilitating change. Through storytelling, projective play, purposeful improvisation, and performance, participants are invited to rehearse desired behaviors, practice being in a relationship, expand and find flexibility between life roles, and perform the change they wish to be and see in the world.”
Performed in a group setting, during drama therapy clients choose a disturbing memory or event, and people from the group to represent the people originally involved.
Drama therapy allows those using it to rewrite their own history and thus provides an extremely powerful way to express how they felt when the event happened and ways to resolve them.
I personally have taken part in drama therapy twice, and can attest to the powerful changes that have come about because of it. I chose a memory from my history where my mother would forget to feed my brother and I for days. During the drama therapy session, I reenacted the memory and went in with the police to rescue myself and my little brother.
The experience was life-changing. I had not only faced that event head-on, but had resolved it the way it should have been long ago. From drama therapy, I found a powerful ally in myself and received the closure I could not have accomplished otherwise.
Drama therapy is often used to treat the following conditions:
- Post-Traumatic Stress
- Relationship Issues
- Substance Abuse
- Behavior Issues
- Dissociative Disorders
- Eating Disorders
- Grief and Loss
It is important to note two things. First, the above list is certainly not all-inclusive and second, drama therapy is not acting. It is reenacting memories or events from the past.
There are few limitations to drama therapy, but the main one seems to be finding a drama therapist who is trained and qualified to perform it correctly.
If performed incorrectly, drama therapy is so powerful that reenacting past events can put clients at risk of self-harm.
The North American Drama Therapy Association (NADTA), was established in 1979 to teach and uphold rigorous standards for the competent use of drama therapy through the training and certification of drama therapists.
The NADTA has a page on their site to help you find a qualified drama therapist (you will need to scroll down to find the information).
Sand Tray Therapy
Developed by Margaret Lowenfeld, Goesta Harding, Charlotte Buhler, Hedda Bolgar, Losolette Fischer, Ruth Bowyer and Dora Kalff, sand tray therapy offers an expressive way for anyone, of any age, to construct their lives and experiences in a microcosm.
Sometimes called sand play therapy, sand tray therapy involves the client choosing objects, like small figurines, to represent people in their life to face and resolve conflicts that the client may not be aware they have towards them.
Although sand tray therapy sounds like a procedure that would only be effective for children, adults also benefit from its use.
The disorders most treated by sand tray therapy are those related to childhood sexual, physical, and emotional abuse and or neglect.
The method of sand tray therapy involves the therapist offering instructions for the client to choose from a collection of figurines and objects to represent the trauma they are working through and the people involved, then place them in a tray of colored sand.
The therapist is careful not to influence either the objects chosen or their placement in the sand.
The therapist then asks their client what each figurine or object represents and how they would interpret their placement in the sand. After hearing their client’s interpretation, the therapist then offers insights into the objects and asks their client to further describe the behavior of the people represented and their own behaviors.
It soon becomes apparent to the client why they subconsciously chose each figurine, and then they can begin to interpret the story represented in the sand.
I have also been involved in the use of sand tray therapy.
I was told by a therapist to choose different figurines from a long wall to represent my family. After I chose them, she told me to place them in the sand tray. After I had done so, she asked me to explain who each figure represented, and why I had placed them in the positions I had.
I had not had exposure to sand tray therapy before, and did not know that the positions I had placed each figure representing myself, my brothers, and my parents would offer me powerful insights into how I saw these important people in my life.
After I told the therapist why I thought I had chosen the figures and placed them where I had, she proceeded to explain what she saw.
I was totally amazed to find she was absolutely accurate, and I received validation that what I had experienced in childhood had actually happened, and the freedom I felt from the burden of those times was palpable.
Like any other type of therapy, there are limitations associated with sand art therapy. Some adults may consider playing in the sand as something that is childish, time-consuming, frustrating, and intrusive. Other adults resist sand tray therapy because they believe they lack the creative ability to do a good job and thus refuse to participate.
Another significant limitation, hotly debated in the mental health professional community, is that the interpretation of the symbols in the sand depend heavily upon the therapist’s own emotions and background.
The Sand Play Therapists of America website offers a page on its site to help you find a sand play therapist near you.
Art therapy is best defined as a technique using drawing, painting, collage, coloring, and or other artistic expressions to examine psychological disturbances and help resolve them. The art therapist database currently includes over 5,000 credentialed therapists.
Below, are some of the psychological disturbances treated by using art therapy:
- Emotional Dysregulation
- Low Self-Esteem
- Illness or Disability
- Post-Traumatic Stress Disorder
- Aging Issues
- Compassion Fatigue (burn-out)
- Heart Disease
- Eating Disorders
- Cognitive Impairments
- Relationship Issues
The places art therapy is performed vary widely and include private counseling, hospitals, wellness centers, correctional institutions, senior centers, and community centers.
Anyone at any age can utilize art therapy and can help clients make connections between their inner conflicts and help them move forward. Participating in art therapy, clients use art to reawaken memories and reveal messages or beliefs from their unconscious mind, that influence their choices in their lives today. By decoding the images with the guidance of a credentialed art therapist, the person can gain huge insights and healing.
Art Therapists are required to earn a master’s degree from an accredited educational institution and then to receive approval from the criteria set by The American Art Therapy Association (AATA), The Art Therapy Credentials Board (ATCB) offers three professional credentials to individuals who wish to practice as art therapists.
The credentials include:
Registered Art Therapist (ATR): This confirms the therapist has taken and satisfactorily completed graduate-level courses in art therapy and gained post-graduate clinical experience under the supervision of a qualified mentor.
Board Certified Art Therapist (ATR-BC): This is the highest credential an art therapist can earn. Applicants are required to successfully complete a national exam to highlight their total understanding of the clinical skills and theories associated with art therapy.
Art Therapy Certified Supervisor (ATCS): This advanced supervisory credential may be earned by an experienced board certified Art Therapists.
As with sand tray therapy, resistance by adults to participate is the biggest limitation of art therapy. Here also, adults may feel threatened by their own inner feelings that they are not talented enough to do a good job and may not be in touch enough with their emotions for art therapy to be effective.
To find a qualified art therapist, the AATA has on their a find a Therapist page.
Plainly, there are many choices when it comes to therapeutic approaches. However, the vital thing to remember about psychotherapy is that there is one out there to fit your needs. Whether you are working on changing a habit or finding ways to mitigate the effects of trauma, there is a therapy out there for you.
In our next article we will examine finding the therapist that will benefit you the most, what to and not to expect in therapy, and finding help to pay for it all.
In the meantime, keep your chin up and don’t forget to take advantage of the marvelous services offered by the CPTSD Foundation. While we are not therapists, we offer stop gaps to fill in the hours and days between your therapy sessions.
Please, always remember, we care deeply about you.