Psychology 101: The 101 Ideas, Concepts and Theories that Have Shaped Our World - Adrian Furnham 2021

Psychotherapy

Kinship is healing: we are physicians to one another. (Oliver Sacks, Awakenings, 1973)

Why waste money on psychotherapy when you can listen to the B Minor Mass. (Michael Torke, The Observer, 1990)

People go into counselling and never emerge. I wonder if counselling isn’t the new religion. (Raj Persaud, The Independent, 1997)

Most people know about, and many have sought out, ’the talking cure’, which goes under the wide umbrella term of psychotherapy. There are, however, very different branches and types of the talking cure as well as other very different types of psychological intervention.

Consider the range of therapies available; and this is far from a complete list:

1 Chemotherapy — prescribing drugs to achieve a therapeutic purpose.

2 Electroconvulsive therapy — electric shock treatment to cause convulsion.

3 Psychosurgery — destruction of specific brain tissue to control behaviour and emotions.

4 Megavitamin therapy — administering large dosages of specific vitamins.

5 Psychotherapy — a talking cure aimed at changing feelings, attitudes and behaviour.

6 Psychodynamic theory — often based on Freudian ideas and stressing unconscious processes and early relationships.

7 Systematic desensitization — people are helped to relax in situations that cause them great anxiety.

8 Implosion therapy — exposing people to situations and things that cause them most fear.

9 Aversion therapy — pairing an unpleasant event (shock) with an undesirable habit (drinking).

10 Token economies — rewarding and fining people for desirable and undesirable behaviour.

11 Behaviour contracting — establishing a written contract/ promise of appropriate behaviour patterns.

12 Modelling/ Role playing — watching and then imitating a therapist showing an appropriate behaviour pattern.

13 Assertiveness training — helping clients to express in various social contexts more effectively their needs and emotions.

14 Rational emotive therapy — helping people to think more rationally and be less magic-orientated or superstitious.

15 Thought stopping therapy — helping people stop obsessive or compulsive thoughts.

16 Non-directive therapy — therapist encourages talking but does not give advice, reassure or ask direct questions but does clarify, reflect and emphasize the positive.

17 Existential therapy — helping people to be more aware and responsible for the choices in all areas of life experience.

18 Gestalt therapy — helping people who internalize their problems by forcing them to confront conflicts and express emotion.

19 Hypnosis — getting people into an altered state of consciousness and suggesting behavioural or attitudinal changes and helping them recall experiences.

20 Biofeedback — helping people to relax and reduce anxiety by monitoring their physiological responses (heart rate).

21 Group therapy — getting groups of fellow sufferers to provide support and feedback.

22 Primal scream (Rebirth) therapy — attempting to get people to relive the trauma of their birth.

COGNITIVE THERAPY

It is often assumed that cognitive therapy began in the 1960s. The father figure of this form of psychotherapy is unusually recognized to be Aaron Beck who wrote Depression: Causes and Treatment in 1967 and Cognitive Therapy and the Emotional Disorders in 1976. He talked of the ABC of irrational beliefs: the activating event, the belief associated with it and the consequences (emotional and behavioural) of that approach. His technique was called reframing or reinterpreting which encourages a reinterpretation of events and the development of healthy coping strategies. As a therapy it has proved particularly effective with those who set themselves high standards or who ruminate and feel guilty about their own perceived inadequacies.

Cognitive therapy was preceded by behaviour therapy and is sometimes called behaviour modification. Thus a phobic person may slowly but deliberately be exposed to the very situations that cause fear to provide evidence that these fears have no objective basis. They also used aversive therapy, which pairs an unpleasant experience with a particular activity. Giving an alcoholic a drug that makes them vomit every time they drink; painting nail-biters’ nails with very bitter paint. They particularly used token-economies, mainly in institutions. Here people receive a token (exchangeable for goods or privileges) if they behave in clearly prescribed ways. You encourage good behaviour like smiling and talking by giving a person a token every time they voluntarily manifest the behaviour.

Cognitive therapists talked of schemas, which are ways or filters through which we see the world. People develop cognitive biases, which are selective ways in which they see and interpret events. Thus they may remember their total schooling as highly selective, generalized memories of bullying, failure and unhappiness or achievement, friendship and fulfilment. People seem arbitrary, selective and often prone to generalization in their memory of the past, as well as their current and future view.

Cognitive therapy aims to break and then change a pattern of behaviour through changes in thinking. The aim is to replace vicious cycles with virtuous cycles through the interpretation of events. Thus a person may attend a party (situation) but fail to talk to people; this makes them think they must be boring or unattractive, which leads them to feel depressed and thus avoid future parties or turn down requests which, in turn, leads to fewer invitations — and the resulting feeling is that they are socially unskilled, inept or ugly. The therapy would start by considering other reasons why few people spoke to them at the particular party in the first place and changes in the so-called ’logic’ that follow from it.

REFERENCES

Furnham, A., Wardley, Z., & Lillie, F. (1992). Lay theories of Psychotherapy III: Comparing the ratings of Laypersons and Clinical psychologists. Human Relations, 45, 839—58.

Furnham A. (2009). Psychiatric and psychotherapeutic literacy: Attitudes to, and knowledge of, psychotherapy. International Journal of Social Psychiatry 55: 525—37.