The Mental Health Industry has, as much as I hate to say it, done a terrible job at helping the public understand how to find the right therapist.
I read recently that there are currently over 1400 types of therapy. Some styles are household names, like CBT, others, like 'Imago Therapy' and even 'Horticultural Therapy' are not so common. This leaves a lot of confusion and uncertainty around how to find the right therapist, who practices the type of therapy that will be most useful to you.
With so many types, and little to guide us, it's sometimes overwhelming to know where to begin looking for a psychotherapy style. I have found that a brief understanding of how therapy evolved to be helpful in guiding people to understand what type of therapist they might want to work with.
The Origins Of Psychotherapy:
Psychotherapy started over 100 years ago with the work of Freud who contributed the notion of the ‘unconscious’. His view of the unconscious included unaccepted sexual thoughts and impulses which, most often, remain out of conscious awareness by ‘defenses' such as repression and denial. His ideas have evolved significantly from this idea to to include a broader range of processes like breathing and heart rate - things we just don't think about that go on automatically.
Freud's original views essentially provided us with an understanding of our unexplained actions. For example we might rationally want one thing:
"I REALLY want to give up sugar !"
But often end up blocked, stuck or in somewhere completely different:
"I can’t believe I just ate all that ice-cream just now -
Freud realized that through the process of free association, and in the presence of a non-judgmental analyst, a lot of unconscious memories, desires and thoughts were revealed. The analysts helped the client integrate these unconscious thoughts into conscious awareness, which, he found, gave the client more options and an increased amount of awareness. In psychotherapy, we often talk about making 'the unconscious, become conscious', because he realized clients gained some insight, understanding and space around choices that were previously automatic:
"Hmmm - do I really want to eat that ice cream right now?
I just said I wanted to give up sugar...’"
Freud also noted that in their work, his clients tended to act or behave towards him in a way that was somewhat reminiscent of the client's early life relationships. This 'transference' of earlier emotional patterns onto the therapist could be analyzed to bring even more awareness into the client’s conscious life.
His thinking, which is sadly often criticized as being flawed today, helped future generations see that our first experiences in the world, the first relationships we have with others - our family - informs much of who we are and how related to others in the present day.
His ideas were the principles of psychoanalysis that have been incredibly impactful in the current world of mental health services. As people thought about his contributions, and as society changed, the number of types of therapy has grown. All of them, I believe, are influenced to some degree by Freud.
Changes in our culture, such as the introduction of psychopharmacology to the public in 1954, and the first mentions of family therapy in 1957, created a need to modify the original theory. Subsequently new schools of thought branched off from psychoanalysis. Similarly, the training requirements of therapists shifted since psychoanalysis was introduced, which allowed a greater number of therapists to become qualified in any number of therapeutic styles.
Currently there are over 1400 different types of therapy available and without understanding all the variations, it might seem impossible to know how to pick the right person.
When people ask to see me in my private practice I often ask them what type of therapist they’re looking for. Sometimes people very clearly want a therapist who will give homework to help around a specific problem. They want structured assignments around a specific problem and to deal with things quickly -in which case I might refer them to a cognitive behavioral therapist.
Other times they are less specific and want to explore and understand themselves better, particularly when it comes to relationships, in which case, a psychodynamically trained therapist like myself might be a better match.
I created a quick infographic guide with some of the more common types of therapy to help - or at least point you in the right direction if you're reading this and looking for a therapist. It's important also to know what to ask the therapist when you call so I included some pointers.
Most importantly, we have found from over a hundred years of doing therapy, that the relationship between you and your therapist is the most important healing factor there is. Ultimately, if you like your therapist, if you feel safe and secure - you've got the right person.
If you're reading this and need some more direction, shoot me an email at Oliver@OliverDrakeford.com and I'll be happy to see if I can help.
Oliver Drakeford is a therapist in Los Angeles and Beverly Hills. He is psychodynamically trained, and loves helping clients make the unconscious, more conscious.