There is a tendency for us all in the 21st century to think that by changing certain aspects of our lives it will make us happier (e.g. a new job, new relationship, a pay rise). This may work in some cases, but research has shown that one year after major life changing events many people revert to their pre-event level of happiness. This suggests that happiness is more to do with how we perceive things around us, how we respond to what happens to us in life and the significance we attach to our experiences.
The term ‘therapy’ can be applied to any activity from listening and advice, to life coaching and to the kind of therapy that focuses on helping someone make internal changes often over a longer period of time. A common rule of thumb is that if you are in the midst of a crisis or have a problem in one are of your life (e.g. phobia or stress) short-term solution-focussed counselling/therapy could be the best option. If the issues are more ingrained you may want a more reflective approach. Therapy cannot necessarily make you happier but it may help you find a way to manage your emotions and the uncertainties of life instead of using work, food, drink, sex, fear or denial to cope with or divert away from your feelings. In most cases it is someone’s coping skills that are not working when no amount of holidays, fresh air, exercise and new ventures help us overcome the uncomfortable emotional states we may find ourselves in.
If you are considering therapy however, it seems like you are faced with even more confusion when grappling with the difference between cognitive behavioural therapists, psychotherapists, psychoanalysts, psychologists and counsellors etc etc. To make matters worse the number of different models of therapy on offer has significantly increased recently. Similarly the private therapy sector has grown which means there are hundreds of practitioners listed on a multitude of websites so we find ourselves bombarded with an often confusing array of information. The following may help things become a little clearer.
Counsellor – The term ‘counsellor’ (and indeed ‘therapist’) can be equally adopted by those who have undergone a thorough training to someone who has done a short course and to a person who feels they are a good at listener. The government are currently regulating the use of these terms in an attempt to halt their misuse. The main bodies that regulate counsellors in the UK are Relate and the British Association of Counselling & Psychotherapy. When it comes to the choice about counselling or psychotherapy and whether the process is the same or different there are firmly held views either way depending on whom you ask. The solution is not as simple as it appears. What is clear is that the practices of counselling, a particular model of therapy (e.g. CBT), psychology and psychotherapy all have the potential to be valuable and effective provided that person, problem and therapist are well matched. A common somewhat simplistic rule of thumb is that if part of your life is a problem see a counsellor, if your whole life is a problem see another kind of therapist. Counselling is ideal for problems with bereavement and loss, relationship break-up, some types of depression and stress.
Cognitive behavioural therapist/psychotherapist (CBT) – CBT is based on the idea that a lot of emotional problems are due to cognitive distortions or faulty thinking. For example people with panic disorder often interpret anxiety signals as life threatening. CBT teaches people to identify automatic thoughts and to challenge them. It aims to relieve symptoms by changing unhelpful thoughts, beliefs and behaviour. Treatment is often short and in most cases between 6 -8 sessions. CBT has a good evidence base and is the therapy most widely offered in the NHS. An argument against CBT is that we are more than just thinking beings. We have bodies (obviously connected to our psyche), creative capacities and an unconscious as well as a conscious mind. However research shows there can be benefit for people with obsessive compulsive disorder, anxiety, phobias and bulimia.
Eye movement desensitization and reprocessing (EMDR)
Is a fairly new type of therapy that has proved to be effective in treating post-traumatic stress disorder (PTSD). PTSD often occurs after experiences such as military combat, physical assault, rape, or car accidents. Usually during EMDR therapy sessions a client relives traumatic or triggering experiences in brief doses while the therapist directs their eye movements. These eye movements dampen the power of emotionally charged memories of past traumatic events.
Psychiatrists – focus on medical mental health rather than on talking therapy. Psychiatrists are doctors who have specialised in mental illness (some psychiatrists are also trained psychotherapists). They may partly think of mental distress in terms of disordered brain chemistry and will often prescribe drugs. Mental health problems that might need drug treatment include schizophrenia, obsessive compulsive disorder, clinical depression and manic depression. Some disorders are treated with drugs and psychotherapy.
Psychotherapist – The main schools of psychotherapy are psychoanalytic, psychodynamic, humanistic, gestalt, integrative, group, family and systemic. Traditionally most psychotherapy has been psychodynamic – which looks at links between someone’s past history and present problems. This kind of therapy tends to attract people who are curious about themselves and how they operate on a deeper and more subtle level. The aim is to liberate the person from childhood patterns or traumas by understanding the way these are affecting their life now, so they have a choice about how they think, feel and behave in the future. Psychotherapy can help a person gain insight into their behaviour and cope better with their emotions. It is good for helping someone explore patterns of behaviour that are more ingrained and is designed to facilitate sustained change. Psychotherapy is good for relationship difficulties, anxiety, eating disorders, depression, trauma and PTSD, mood disorders, addiction, tendency towards self-defeating behaviours and lack of meaning in life. This kind of therapy can be either short or long term.
CBT could be regarded as a ‘top-down’ approach (changing thought patterns = transforming behaviour) and psychotherapy as a ‘bottom-up’ approach (transforming internal dynamics and thought patterns = changing behaviour). Some psychotherapists have had years of therapy themselves and most are required to undergo continuing professional development (a requirement for membership to the main accrediting organisations).
Psychoanalysis which is based on classical Freudian theory (and some of his later proponents) is a more intensive approach and sessions can be up to 5 times a week. The client lies on a couch and there is an emphasis on free association (speaking whatever comes into the person’s mind). Freud alluded to potential gains ‘this big investment in one’s life can produce significant rewards in terms of the ability ‘to love and to work’. People can find themselves freed up to live life more to the full, to be more creative and to relate and care for others better’.
Clinical psychologists – have been trained scientifically and apply psychological principles to understand, prevent and relieve psychological based distress or dysfunctions. They will often use psychological testing to help establish and measure the nature and extent of this distress and are generally trained in different modalities of therapy. The aim is to promote psychological well-being and personal development.
For more information about all of the above therapies there are some very useful fact-sheets on the MIND website. The main accrediting body for therapists from each category are listed at the end of this article.
To conclude then – you may need to shop around and to ask lots of questions. If you are considering paying for therapy its important you do as much research beforehand as you can. Don’t be frightened to ask about a particular therapist’s qualifications and experience beforehand or in your initial assessment session.
List of accrediting bodies:-
British Association for Counselling and Psychotherapy
United Kingdom Council for Psychotherapy
British Association for Behavioural & Cognitive Psychotherapy
British Psychological Society
British Psychoanalytic Council