The Combination Approach to Psychotherapy

After having recently listened to this Invisibilia Podcast titled Entanglement, I thought it would be a good idea to share my thoughts on where the major schools of thought on psychotherapy have been and perhaps where the field may be headed...

A portion of this Podcast neatly outlines the three major schools of thought on thinking and feeling, the first being Freud's theory of the unconscious. In part, this theory posits that most, if not all, of our thoughts and feelings in life stem from our childhood experiences. The predominant change occurs when we can get in touch with the origin of these thoughts and feelings and begin to understand that the circumstances that may have governed their formation way back when, may no longer apply to our daily lives.

The second major school of thought on therapeutic change is Albert Beck's theory of Cognitive Behavioral Therapy, which states that our behaviors and emotions are very much connected to our thoughts. The theory posits that if we are able to notice, change and/or retrain our thinking patterns, our feelings and actions will follow suit.

The third major school of thought on therapeutic change is generally referred to as Mindfulness Based Approaches, and is currently receiving a lot of attention and research. Such practices focus on teaching individuals to become aware of all thoughts and feelings that may come up and help us learn to accepting them without judgment, hence letting go of ensuing reactions and assumptions.

All three schools of thought mentioned above are widely viewed as helping bring about therapeutic change in different ways. The first school of thought focuses on understanding where the uncomfortable thoughts and feelings come from, in hopes that this insight will update the unconscious thoughts and feelings and make them conscious, thus making them amenable to change. The second and third schools of thought on therapeutic change focus instead on deauthorizing the power of thoughts. Namely that by actively changing thinking patterns, or by accepting our thoughts and suspending judgment, our cognitions will have less power to affect our feelings and behaviors. 

In my experience, there is no one correct way to enact therapeutic change, but instead there is a combination of techniques and methods that can be used in order to help each individual achieve long-lasting change. This I believe, is largely based on where (with thoughts, behaviors, acceptance practices or feelings) the individual feels more comfortable starting their therapy. I do, however, feel strongly that feelings are more basic than thoughts (feelings are preverbal, thoughts are contingent on language), and hence when thoroughly understood and updated, can lead more directly to a more holistic and sustainable change. However, meditation and mindfulness practices as well as retraining one's thoughts and behaviors are wonderful ways to appease certain symptoms and contribute to greater comfort in achieving the insight and understanding that will lead to a come comprehensive paradigm shift.

If you would like to learn more about modern psychotherapy concepts please visit this blog of my dear friend and colleague, Dr. Richard Kestenbaum.