In the first therapy modalities blog, we covered three of the essential therapy modalities that are commonly used today, including cognitive behavioural therapy, dialectical behavioural therapy, and client-centred therapy. In the second series of therapy modalities explained we will cover three other modalities that are also widely used today, psychodynamic therapy, schema therapy, and acceptance and commitment therapy.
Originally derived from psychoanalysis, Psychodynamic Therapy focuses on clients’ perspectives and understanding their needs, urges, and desires. It places great importance on clients’ awareness of their unconscious thoughts and motivations that contribute to their difficult feelings and behaviours. It also emphasizes the role of one’s childhood experiences in shaping their personality and affecting their present behaviour, relationships, decisions, and experiences. It focuses on the psychological root of one’s emotional suffering.
One of the main goals of Psychodynamic Therapy is for clients to recognize their self-defeating patterns of emotions, thoughts, and beliefs, to be able to free themselves from the harmful elements of their past and their present symptoms. Psychodynamic Therapy assumes that the new-found awareness of one’s unconscious thoughts and feelings can help clients better understand their roots, and therefore, bring about a sense of empowerment and relief.
Psychodynamic Therapy utilizes self-reflection and self-examination, by encouraging clients to express themselves freely without any censoring or judgement. Clients are also encouraged to explore their fears, dreams, and repressed emotions.
“In contrast [to behavioural therapy], dynamic psychotherapy, which facilitates a patient’s rewriting of his life narrative, his picture of himself, his past, present, and future, seems uniquely positioned to address the depth of an individual’s experience".
Richard F. Summers
Psychodynamic Therapy, according to research, was proven to be successful in helping those suffering from depression, relationship difficulties, anxiety disorders, and anorexia nervosa, as well as numerous other disorders.
Schema Therapy is another therapy modality that focuses on how one’s childhood experiences affect our present behaviours, thoughts, and feelings. Schemas are essentially cognitive structures that help create a framework for the knowledge we have and will continue to gain through life about people, places, objects, events, and our subjective perception of the world. These mental shortcuts begin to form during our childhood years and help us understand and make sense of new information as we encounter new experiences.
During our childhood, there are certain needs that should be adequately fulfilled such as safety, stability, and autonomy, among others. These needs can be met with excessive fulfilment or too little of it, leading us to develop maladaptive schemas. These maladaptive schemas include our memories, emotions, cognitions, and bodily sensations, and they affect our ability to relate to others and form healthy relationships. Once our schemas are developed and become engrained, they act as the “lenses” which we use to view and perceive the world and understand interactions with those around us. A child may have excessively received the safety need and have been overprotected throughout his whole life which could affect his future level of autonomy, decision-making skills, or independent problem-solving.
When therapists utilize schema therapy in their treatment plans, they first start by assessing the client’s schemas and how they developed, as well work to identify their maladaptive coping styles. As clients begin to recognize and understand their maladaptive behaviours and where they originated from in terms of their unmet childhood core needs, they are then taught healthier and more adaptive methods of meeting those needs.
Acceptance and Commitment Therapy (ACT) helps clients to accept their thoughts and feelings as they are, rather than to attempt to modify them or fight them off, and to commit to engage in behaviours that are aligned with their core values, values that can enhance their lives.
ACT incorporates mindfulness with self-acceptance, and helps clients develop psychological flexibility. Mindfulness is how we are able to connect with the present moment without being distracted from external interferences and without jumping into “auto-pilot”. Being mindful allows us to become aware of our sensations, thoughts, and emotions, without judgement, as well as allowing ourselves to detach ourselves from our thoughts.
Psychological flexibility is one’s ability to effectively cope with the difficult situations they are put in. One is then able to handle daily life’s stresses by adapting to different circumstances or shifting his or her mindset and behaviour when needed.
ACT includes six core processes that are used throughout the therapy sessions:
Acceptance is allowing internal and external experiences to just be instead of trying to change or avoid them. Accepting our thoughts as they come and go is an example of that.
Cognitive defusion helps us separate ourselves from our thoughts, and merely view them as passing thoughts, and therefore decrease the emotional impact that they may cause. For example, “I’m a bad person” would then be turned into “I am having the thought that I’m a bad person”.
Being present involves using mindfulness in order to focus our attention away from distractions, including our thoughts and feelings, and intentionally choose to be aware of the present moment.
Self as context involves separating your thoughts from your behaviours, meaning that not every thought needs to have an action taken as a result, and thoughts exist without the need to entertain them.
Our values represent the things in our life that are the most important to us and consequently guide our behaviour. In ACT Therapy sessions, clients are encouraged to identify their values and would be guided on how to use these values as a “compas” that direct future effective behaviours.
Committed action involves actively dedicating time and effort in order to change our behaviour based on the concepts discussed during the therapy process.
