Changes in psychotherapy
The aims of psychotherapy are manifold. The resolution of mental health problems is what it is best known for. But alongside that goal there are several others: self-understanding, personality change, healing, self-mastery, life-improvement, happiness and resilience to name a few more.
In this article the focus is on the three fundamental types of change that (nearly) all approaches to therapy encourage, Some therapies may focus on one or two types of change, but effective therapy generally entails the development of all three.
- Changing your relationship to thoughts
- Developing emotional intelligence
- Changing your behaviour
Changing your relationship to thoughts
Changing thoughts is especially prominent in Cognitive-behavior psychotherapy. Which addresses the cognitive distortions – thoughts that trigger anxiety and depression, to name the two most common mental health issues. These include worries about the future, catastrophic thoughts, black & white judgments, over-generalising and self-blaming. Distancing oneself from these thoughts – or challenging them directly – reduces their impact.
However, counselling and analytical therapies also encourage a change in thinking in a more general way; by examining how clients develop a self-concept in earlier life. Thereby taking in the thoughts they adopted from their family of origin, and from the culture they were raised in. For example, many clients hold the sub-conscious judgment that they are inadequate. By examining their experiences in earlier life clients come to see that thoughts like these arose from the expectations and demands from the people around them. Thus making it easier for to let go of them, and replace them with kinder thoughts.
Acceptance & Commitment therapy (ACT) takes another approach to thoughts altogether: teaching clients to change their relationship with them. Starting with the recognition that we habitually fuse with any and all thoughts without discrimination: dreamy thoughts, practical thoughts, anxious thoughts, trivial thoughts, depressing thoughts, creative thoughts. While some thoughts are helpful, the majority are not.
ACT therapists teach clients to be more mindful of what goes on inside consciousness: looking at thoughts rather than through them, Paying close attention to useful thoughts, while bypassing the rest. Thought defusion techniques are an integral part of the approach.
Developing emotional intelligence
In psychotherapy clients learn to recognise, label and understand their own emotions; empathise with the emotions of other people; and express the desires and hopes their emotions are pointing to. In this way they learn to become more appreciative, more loving, and more assertive.
In the 1950s Fritz Perls developed Gestalt therapy in order to help clients develop self-awareness, take ownership for their experiences in the moment, and to take action on situational needs (Gestalts) expressed through emotion. This approach has had a powerful influence on many other types of therapy.
In the 1960s Eugene Gendlin developed the Focusing approach, in which clients go into the body, connect to any emotions present, and ask self-questions to emotional states that reveal their emotional purposes. Such questions include:
What are you here for?
What are you alerting me to?
What do you want me to do about that?
Many therapists, from a wide variety of approaches, employ focusing techniques to assist clients in developing emotional intelligence.
Due to the fact that many life-problems that present in therapy have to do with other people: parents, children, partners, friends, and people in the work-place, work on empathetic communication has become standard in psychotherapy. A popular book on this subject: Non-Violent Communication by Marshall Rosenberg is now employed on therapy and counselling training courses worldwide.
Changing your behaviour
For many people symptom reduction is the main aim in psychotherapy. For example: in anxiety it is desirable to reduce over-thinking, agitation, worry, insomnia and panic attacks. However, these symptoms are largely addressed through learning new behaviours: mindfulness, calming techniques, thought defusion, sleep management and exposure therapy for example.
Evidence-based therapies such as CBT, ACT therapy and Solution-focused therapy measure success by counting the number of times clients successfully used a technique or a behavioural change program over a specified period of time, while also measuring symptom reduction. This ensures that standards of treatment are maintained and improved. The emphasis is always on concrete, measurable changes in action that make a difference to the outcome.
Here is a list of common behavioural changes in psychotherapy:
Increasing activity levels in clinical depression.
Daily mindfulness practice.
Extending time spent in phobic situations (exposure therapy).
Reducing time spent on obsessive-compulsive behaviour.
Using assertive communication to set personal boundaries.
Gradually reducing alcohol/drug usage.
Neutralising the impact of post-traumatic memories.
Replacing harmful habits with healthy ones.
Regular use of calming/grounding techniques in stress management.
Breaking comfort zones and developing resilience.