Problems that Usually Need Psychotherapy or Psychiatry Treatment

Psychotherapy for Anxiety and Depression

Anxiety and depression are very common, frequently occur together, and often have similar causes.  Several different approaches to psychotherapy have been developed to treat them, which are described here very briefly.

Psychodynamic (or psychoanalytic) treatment is the oldest.  It goes back to Sigmund Freud, but has developed and changed significantly since his day.  It is centered on two core ideas: that negative experiences early in life often cause psychological problems later in life, and that repressed (or blocked) emotions, impulses, and needs are often at the root of these problems.  Treatment centers on understanding early experience and removing these blockages, however, most psychodynamic therapists today also help clients with their current life problems and are much more active than psychoanalysts were in decades past.

Cognitive-behavioral treatment (as the name implies) focuses on thoughts and behavior, and works to change emotional states by changing thought patterns. Cognitive therapists would agree that negative thought patterns originated earlier in life, perhaps much earlier, but generally prefer to work in the present to change those patterns now. Cognitive- behavioral treatment originated to some degree as a reaction against psychoanalysis, but more recently clinicians in both camps have borrowed what seemed useful from the other camp.  Cognitive therapists nowadays often find it useful to discuss earlier life stages with their patients so they can see how negative thought patterns arose and how distorted those patterns are.

There are other approaches as well, notably including family systems therapy and client-centered therapy, but cognitive and psychodynamic treatment are the only two I feel qualified to write about.  My lack of knowledge about the other approaches should by no means be taken as criticism and I urge readers to look into other approaches besides the ones discussed here.

For anxiety and depression there are clinicians who recommend cognitive-behavioral treatment, and others who would recommend psychodynamic treatment.  Both have merit and there are excellent practitioners who get good results in both camps.  When choosing a therapist your own experience with the person is probably a better guide than the school of thought the person adheres to.  If you are comfortable and feel you are being helped, then you probably are.

Our approach here at the Integrative Therapy Institute is to use a model I developed that integrates psychodynamic and cognitive treatment for problems caused by early life experience, and also uses a counseling approach centered on interpersonal functioning to address current life problems.  Patients with depression or anxiety are assessed for thought patterns, blocked emotions, and current stressors, and a treatment plan is tailored to them based on the assessment.  Negative thought patterns are dealt with using cognitive restructuring, and blocked emotions are treated with a modified psychodynamic approach that includes directed questioning, encouragement, and reinforcement, instead of the continued open inquiry that a strict psychodynamic approach might recommend.  The counseling component identifies and addresses deficits in interpersonal functioning.

Thomas B. Hollenbach, Ph.D.

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