Lesson 2 Definitions
When dealing with mental health, one quickly encounters different technical terms: For example, different professional titles for doctors and therapists, but also different therapy methods. In this unit we want to introduce you to the differences based on the individual definitions and help you to find the appropriate forms for you individually.
Therapeutic Professionals
There are different therapeutic approaches. These are defined and presented in more detail hereafter in order to gain a better understanding.
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Psychiatrist |
Psychiatrist: physician for the psyche (diagnosis, treatment and research of diseases or disorders of the mind and soul of humans); medical studies and specialist training; can also treat or exclude organic disorders; prescribe medication; psychosomatics; focus on treatment with medication; When to see a psychiatrist:
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Psychologist |
Psychologist: Studies psychology; knowledge of the psyche and how perception, thinking, will, motivation, and emotions function and interact, and is able to challenge this behavior |
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Psychotherapist |
Psychotherapist: psychological means: treatment procedures whose therapeutic effect is based on conversation, action, and relationship between patient and psychotherapist.
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- A psychiatrist will ask you clearly structured questions to record a diagnosis.
- A psychotherapist is creating an open conversation, building a relationship and trust with his patient to record a diagnosis.
- Therapy discontinuation includes the risk of missing follow-up treatment; before stopping the treatment yourself signal your thoughts during conversation with the therapist and follow your desire to change together with him or her.
Therapeutic Treatments
There are several professional treatments for mental disorders. These are defined and presented in more detail in the following to provide a better overview.
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Psychoanalysis (S. Freud)/ Depth psychologie
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Depth psychology points to the fundamental assumption: theory and therapy do not remain on the surface of the psyche. The goal of depth psychology is to recognize and understand a person's motives in the depths beneath conscious experience, thinking, feeling and behavior. The therapy goes over a time of 3-5 years (2-3 settings in a week - each 50 min.). |
In psychoanalysis, one goes in search of motives: Desires, fantasies and smoldering conflicts that had to disappear from the conscious experience at an early age for various reasons. Also traces of memories of experiences that have been deeply imprinted in the soul of a person are explored. These motives determine our image of ourselves and of the world around us. Not infrequently, we experience current situations and events as a replay of old stories. Our past thus determines our present. This form helps to understand the disorder and thus to be able to react differently in situations. often the roots of the symptoms already lie in childhood.
Psychoanalysis includes not only classical psychoanalysis but also other methods, such as:
- depth psychologically based psychotherapy
- the depth psychology based short-term therapy
- the depth psychology based group therapy
The patient is encouraged to express thoughts, fantasies, feelings and sensations without regard to logic, meaning or morality. The analyst behaves rather passively in order to allow the patient to develop on his own. Psychoanalysis leads to change via a return to old memories and feelings hidden in the depths of the soul’s life.
Goal: to uncover early conflicts and traumas and to identify the core of the respective problem. Conflicts are worked through and understood. Not necessarily healing the symptoms but rather gaining fundamental insight, personality change and maturation.
This form is useful when it seems advisable to start therapy with the current conflicts and stresses of a patient. The relationship between patient and therapist is worked on as a model for relationships and experiences in the patient’s real life.
Goal: Elimination or improvement of the current complaints. Further-reaching changes in the personality structure are not sought.
Short-term therapies work on a specific problem, focus, or conflict that emerges in the initial sessions.
The number of hours is limited to about 10-40 hours. This form is often used for the preparation of expert reports, or in cases of severe suffering/crisis intervention, when a longer approval process seems unreasonable. Often followed by longer-term psychotherapy.
Group therapy arose from the need to provide psychotherapeutic care for as many patients as possible and is specifically directed at certain problems and disorders. The therapist treats the whole group and talks mainly about the group events. Only in exceptional cases is the experience of the individual discussed. Often the groups consist of 5-10 participants and the sessions take place weekly for about 1.5 hours.
All depth psychological therapy methods make use of the factor of transference. In the relationship with his therapist, the patient thereby re-experiences old relationships. In the process, he transfers the feelings, thoughts, fantasies and sensations he associates with them to the therapist (or the group and individual group members).
Through this, the therapist can gain insight into the old stories and the triggered feelings and change the current psychological situation.
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Behavioral therapy
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Important models of behavioral psychology are:
- the reinforcer loss model (Lewinsohn)
- the learned helplessness model (Seligman)
- the cognitive model (Beck)
In all approaches, as in the depth psychological approach, the individual’s life history is considered to play an important role in the development of mental illness. Behavioral psychology assumes that the disorder is an expression of misguided learning processes. These guided processes make the person vulnerable to the symptoms. Innate vulnerability and vulnerability increased by learning processes complement each other.
Learning through reinforcement: every person organizes his or her behavior in such a way that it is successful for him or her and therefore creates an incentive to repeat the behavioral patterns that have already been practiced once. The reinforcer model makes use of this assumption. New behaviors are tried out in order to escape a negative vicious circle and to gain positive experience again.
This model is also about learning: The person with the disease has learned in his life history – whether through a bad experience or through many events that remained uncontrollable and inscrutable for him – to be helplessly at the mercy of situations, people and events. He has experienced that no matter what he does, the consequences of his actions are beyond his control. This model wants to break through this way of thinking and experience and show situations in which the person concerned can very well exert influence.
Cognitive behavioral therapy assumes that negative thoughts are the cause of negative feelings. So: I think I am incapable and inferior, so I feel worthless, incapable and inferior. This is the way people have learned to think, and this image determines the way they see things. Typical thinking errors are: False generalization, False conclusions, Selective perception, Personalization, Maximization/ minimization, Thinking in black and white patterns.
This model aims to change and break the thinking patterns.
Which treatment for whom?
In general, based on today’s research results, it can be said that specifically developed procedures are best suited for the treatment of a specific disease. For example, cognitive behavioral therapy was developed specifically for depressive disorders and has been very successful. Nevertheless, the appropriate method of therapy and its success always depend on individual factors. The most important factors are the patient’s trust in the chosen method and his or her ability to cooperate. There are also other methods added to the ones presented above. We wanted just to give you an idea about the most common ones.
- Do I need a personal relationship, eye contact and empathy in the therapist in order to feel accepted?
- Do I want to achieve a deep self-knowledge that is sought through a long term analysis?
- Do I need a counselor to tell me “where to go”, such as in the directive approach of a behavioral therapist?
- Pay attention to your gut feeling during the initial consultation.
- Sometimes a certain type of treatment is recommended for certain mental disorders, discuss this with your therapist.