In an odd way, this is a very simple question yet deceptively difficult to answer. Since the birth of 'modern' psychotherapy, throughout the decades there has been a constant debate as to which modality of therapy is superior to another. This is a huge error that 'misses the target' that continues to today. As society is becoming more technological, segregated and isolated this accentuates the importance and significance for the 'practice' of therapy to return to its 'practical roots.' Therapy [Therapeia in Greek] means to attend the healing and witness as a kind of birthing similar to that of a midwife that attends, witnesses and partakes a birth of creation. Healing practices have existed from the beginning of time back to Shamanism. This is a process, a journey that takes time, sometimes a long time. Healing implies there is suffering, a 'sickness' and this is a story. There is a beginning, a middle and an end. This is a journey that involves delving and unpacking layers of experiences. This trilogy is of immense significance in therapy. In this light, 'The Therapeutic Arena,' can also be said to be a microcosm of the rest of existence. This sense of process or processing is gradually being lost more and more, seeking more 'efficient' and 'effective' ways to 'heal' that only serves to tranquilise the human instead of giving the time and energy that is needed to untangle and unknot and process experiences. Howe [1965] stated a contributing 'factor' to healing is that there is a 'giving' of time. Of course, the quality of time given cannot be overemphasised.
In short, the practice of therapy is healing that in a person which is suffering from. Different schools of thought have complementary vs contradictory insights, nuancing and accentuating different phenomena that reflect the particular theorists wrestling with 'the therapy arena' at their particular time.
Below is a synopsis of some of the main approaches. The practice of therapy is immense and wide, just as there are a number of practitioners, there are individual styles. However, there are frameworks that practitioners practice from according to their training and accrediting bodies. It is the whats, whys and how that is often the debate.
Behavioural Therapies including CBT and its offsprings emphasis a direct link between thoughts and behaviours. In short, CBT states that changing thought patterns will lead to behaviour change. Core beliefs/limiting beliefs, over-exaggeration, perspective taking, overcoming fears and phobias by immersion and strategies to calm the central nervous system are seen of primary importance. A common critique of short-term CBT particularly in mainstream services does not do full justice to the complexity of untangling human experience, it is important to wrestle and grapple with what is practically achievable within 6-12 sessions. It is often seen as a 'shortcut' to bypass the processing and delving of deeper layers within the self. However, the insights that they hold of primary importance are on point. This is not to say their strategies are not effective - breathing techniques, mindfulness. However, if a person wants to understand, explore and unpick their experiences, 'to dig deep,' CBT may not be appropriate for what a person may be seeking. Nonetheless, this may provide an initial 'holding' that may pave the way for deeper work later on. However this also depends on the way an individual practitioner practices.
Psychodynamic/Object Relations believe that past experiences, not always from childhood [formative years] influence not only how the present and future is interpreted but how the present and future is also experienced. In short, the present and future are seen through the lens of the past. 'Ways' of relating [learned/internalised usually from primary caregivers] become repeated patterns of behaviours. This implies which is picked up explicitly within the Jungian approach that unresolved trauma gets passed on to the next generation. Why do we do the jobs we do? why do we attract a particular 'type' of partners? This approach is a very different way of working compared to CBT. Far less directive and open to exploration. The 'freeness' and openness to explore may not be suited for everyone. A critique of this approach is that everything becomes interpretable, and therefore, when does therapy end? However, Freud [1920] also stated 'Sometimes a cigar is just a cigar.' [Although it is debated if Freud ever said this]. Nonetheless, ambivalence, and wrestling with ambivalence is the bread and butter of this approach.
Bioenergetics [Body Therapy] shares many overlaps and similarities with psychodynamic theory, however, the primary focus is utilising and involving the body physically. Freud began the conversation on psychosomatics and body therapies have developed from it. In short, trauma, wounds, scars, character armour, unresolved and repressed experiences and feelings are 'stored' in bodily tissue, muscles and organs. Through physically utilising the body, this evokes the body to begin to 'release,' sometimes as 'forgotten' memories. As these dynamics are being 'released' they can be worked through and processed.
Humanistic/Existential starts by giving power back to the client. There is always a power imbalance between therapist and client. However, compared to psychodynamic stance - their position of power and authority is undeniable. Humanistic/Existential approaches believe that the answers to the questions clients seek are within the person. In this light, therapy is an uncovering of the veil that exposes and reveals the truth beneath. Emphasis on honing in on 'lived-experience' in the here and now is of primary focus. This implies there is latent wisdom within laying dormant waiting to be evoked, woken, lived and perhaps ultimately to die for. Existential approaches are considered the more 'adult' forms of therapy, wrestling with 'adult' themes of meaning-making, purpose, death, absurdity, the unknown, angst, heroism [not the false hero of rescuing or co-dependancy], truth, tragedy, responsibility and others.
Transpersonal [Spiritual] links the mysterious reality of existing in nature with spirits and Spirit. Also concerned with adult themes, this bridges the beginning of the human linking with the divine, nature, spirits and Spirit. Think of Bubers [1923] I-Thou, he states 'the world is not divine play, it is divine fate.' However, most humans interaction and relating is I-It. The I-Thou is a journeying towards something deeper internally and externally. This suggests that much of humanities dysfunction has spiritual roots.
Implicit in all of this is, all therapeutic modalities are singing from the same songbook, emphasising different melodies, rhythmic structures, baselines, accents, instruments etc. So the conversation of which modality is superior to another is meaningless. The undertone is always healing, growth maturity from 'the inward parts' but the way this is approached, the angles adopted, that healing, growth, change mean different things to different modalities and practitioners. But the messages oddly still share similar ground. There is a considerable amount of research notably Wampold & Imel [2015] support that all modalities achieve about the same results. Rather, 'results' achieved is complex and seems to come down to common [situated] factors, a vein that flows through all approaches. Thus, a dance between what the therapist beings as a person and what the person seeking therapy brings as a person.
This blog originates and is inspired by Jamie Moran