Hello professor and classmates,
The approaches to psychotherapy have been always a good topic of debate among professionals and people in general interested in the subject of psychology, psychiatry, and mental health in general. I believe is fundamental for professionals to know the main theories and learn from their different perspectives, but none of the theories are definitive nor are they exclusive in my opinion, in fact, science supports the idea that the conscious cannot function without the unconscious that is why most therapists tend to mix approaches to get better results with the patients depending on the condition the client present, their level of consciousness, the ability of reasoning, their thought process and the environmental, social, and biological factors that may be influencing in their mental health.
According to the APA, Psychoanalysis and psychodynamic therapies focus on changing problematic behaviors, feelings, and thoughts by discovering their unconscious meanings and motivations. Psychoanalytically oriented therapies are characterized by a close working partnership between therapist and patient. In those therapies, patients learn about themselves by exploring their interactions in the therapeutic relationship. While psychoanalysis is closely identified with Sigmund Freud, it has been extended and modified since his early formulations. Humanistic therapy, on the other hand, emphasizes people’s capacity to make rational choices and respect for others are also important themes, this type of therapy is more positive and holistic, the therapist shows him/herself as a nonjudgmental and seeks help the client to develop a healthier sense of self. Its key concept is that humans have an intake to grow and develop and that people will do good if they can, and only become destructive when external forces override their sense of goodness, but what are those external forces and how much external can they be? Furthermore, Client-centered therapy rejects the idea of therapists as authorities on their clients’ inner experiences. Instead, therapists help clients change by emphasizing their concerns, care, and interest. Gestalt therapy emphasizes what it calls “organismic holism,” the importance of being aware of the here and now and accepting responsibility for yourself. This approach is characterized by being holistic, and interactive and being focused on existentialism and presenting life challenges rather than delving into past experiences with the goal of assisting the client to restore their natural state of self-regulation.
Because of the characteristic of the presentation of our client James, his level of self-care, consciousness, and reasoning I would consider using humanistic therapy or integrative therapy that blend elements from different approaches and tailor their treatment according to my clients needs. A specific technique that I would like to use on the client is the empty chair dialogue since most of his symptoms are psychological rather than physical (palpitations, nausea, dizziness, nausea, etc..) and have been proven to be linked directly to anxiety disorders.
American Psychological Association. (n.d.). Different approaches to psychotherapy. American Psychological Association. Retrieved November 7, 2022, from https://www.apa.org/topics/psychotherapy/approache…
Humanistic psychology is a holistic approach that focuses on the whole person, as humanists believe that a person is in the process of becoming. Additionally, the focus is on the person and their search for self-actualization, aiming to help the individual develop a strong and healthy sense of self, explore their feelings, find meaning in life, and focus on the individuals strengths. Using empathy, the therapist seeks to understand the patient and allows the therapist to relate to the patients experiences from their perspective. The therapist shows warmth, is non-judgmental, and is receptive to what the patient is saying, avoiding coming across as an authority figure (Sauber Millacci, 2022).
Gestalt therapy is one of the 3 types of Humanistic therapy. This form of therapy focuses on what the patient and the therapist experience and how they make meaning on the co-created therapeutic situation. Symptoms are seen as products of the creative self and are unique; psychopathology simply represents an originally unique creative adjustment in a difficult situation. Gestalt therapy aims to support the human growth of the patients in the unique context of their lives as opposed to focusing on the patients psychosomatic symptoms so that they become aware of significant sensations within themselves and respond reasonably to them (Roubal, Hytych, Cevelicek, & Rihacek, 2021).
Freudian psychodynamic therapy is known for techniques such as free association, dream analysis, and hypnosis, as well as practices used today, such as talk therapy and the beliefs that emotions can impact the body. Psychodynamic therapy is the psychological interpretation of mental and emotional processes (Fulmer, 2018). It is rooted in traditional psychoanalysis (Freudian) and is developed as a simpler, less-lengthy alternative. It aims to reduce symptoms and improve the patients life by addressing the foundation and formation of psychological processes (i.e. reviewing emotions, thoughts, early life experiences, and beliefs of the patient).
Because James has been suffering from anxiety for years and has developed a sense of panic, he may have Panic Disorder (F41.0). Panic Disorder is an anxiety disorder based on the occurrence of panic attacks which are recurrent and often unexplained. Additionally, at least one panic attack should be followed by one month or more of the person fearing that they will have more attacks, causing them to change their behaviors, including avoiding situations that might induce an attack. A panic attack is defined as the presence of 4 or more of the following symptoms:
- Sensations of SOB or smothering
- Chest pain/discomfort
- Nausea or abdominal distress
- Feeling of choking
- Chills/hot flashes, numbness
- Fear of dying
- Fear of losing control
- Derealization or depersonalization
James will benefit the most from what is known as Panic-focused psychodynamic psychotherapy, a treatment plan 12-weeks in length, meeting twice weekly, with a total of 24 sessions. This form of psychodynamic therapy targets dynamic factors that contribute to anxiety and panic onset, persistence, and recurrence, including intrapsychic conflicts with separation, autonomy, anger, ambivalent attachment, and guilt, and further shows patients the meaning of their anxiety and panic attacks through identifying their feelings and circumstances surrounding their symptoms (Busch & Milrod, 2019).
Busch, F.N., Milrod, B.L. (2019). Panic-focused psychodynamic psychotherapy extended range. Contemporary Psychodynamic Psychotherapy. Retrieved from Links to an external site.“>https://doi.org/10.1016/B978-0-12-813373-6.00008-8
Fulmer, R. (2018). The evolution of the psychodynamic approach and system. International Journal of Psychological Studies 10(3):1. DOI:Links to an external site.“>10.5539/ijps.v10n3p1
Roubal, J., Hytych, R., Cevelicek, M., Rihacek, T. (2021). Personal therapeutic approach in Gestalt therapists working with clients suffering from medically unexplained psychosomatic symptoms. Research in Psychotherapy 24(3): 535. doi: Links to an external site.“>10.4081/ripppo.2021.535
Sauber Millacci, T. (2022). Humanistic psychologys approach to wellbeing: 3 theories. Positive Psychology. Retrieved from https://positivepsychology.com/humanistic-psycholo…