If you’re looking to start therapy, you’ve already done a lot of good work. You’ve identified a need and have committed to a potential solution. This is a big first step.
How to find the right therapist
Finding the right therapist is of the utmost importance, so finding the right kind of therapy is, too.
Under the umbrella category “psychotherapy,” there’s psychoanalysis, psychodynamic therapy, cognitive behavioral therapy, dialectical behavior therapy, mindfulness therapy, and too many others to list.
These approaches are distinct from one another, but many of them are built upon the same framework.
Patients may encounter several of these therapeutic methods to find the approach or blend of approaches that best help them and often find that one form or another is best for them. If you think therapy is right for you, the next step is to figure out which kind of therapy is right for you.
If all of this information feels a tad overwhelming, don’t worry. These approaches are distinct from one another, but many of them are built upon the same framework. Your therapist will most likely be able to test a variety of approaches and borrow solutions from related branches of therapy. If they need to, they will give you an excellent referral.
We’ve put together a breakdown of some of the most common therapeutic methods. There won’t be a pop quiz, but learning the basics can only help you end up in the right hands.
What it is: Talk therapy, often over a period of time
Who it’s for: People who want to understand themselves and their motivations better
Psychoanalytic therapy is the kind of therapy we always see on television—think the leather couch and the white-bearded doctor or the kindly woman on a chair taking notes. It is perhaps the most influential form of behavioral therapy there is, as it provided the blueprint for many of the branches that followed.
This form of talk therapy was developed by the famous neurologist and psychologist Sigmund Freud in the late 1800s. Freud postulated that our minds function on three different levels: the conscious, the preconscious, and the unconscious.
He argued that psychological problems are a result of tensions between these different parts of our minds. When unhealthy thoughts or motivations live in our unconscious and preconscious, our conscious mind suffers too.
Psychoanalysts challenge patients to dig into parts of their mind and life they haven’t yet explored, which can be rough.
Freud’s solution was to make our conscious minds aware of the issues lurking below by way of interrogation, conversation, free association, and the interpretation of dreams and memories. His methods were specifically designed to dredge up repressed trauma, hidden beliefs, and questionable desires so that they could be addressed by the better-behaved parts of our brains.
So what does this history lesson mean for you? Psychoanalysis still relies heavily on the methodology Freud laid out, but has certainly come a very long way since the 1800s. Psychologists make a distinction between Freudian, Jungian, and modern psychoanalysis for that very reason.
Patients undergoing psychoanalysis rely upon their therapists to steer discussion. Analysts will interpret or judge their life events, memories, beliefs, and dreams as they come up. Psychoanalysts challenge patients to dig into parts of their mind and life they haven’t yet explored, which can be rough.
They do so not to make patients uncomfortable, but to help them figure out what’s going on in the deeper parts of their minds where mental health issues are often born. Psychoanalysis is very common, and is often used in tandem with some of the therapeutic methods described below.
What it is: A “more streamlined” talk therapy
Who it’s for: It can be especially helpful for couples or groups
Psychodynamic therapy was developed with the idea of being a more efficient form of psychoanalysis. This type of therapy places a strong emphasis on recurring thought patterns. Patients are again asked to dig into their unconscious. However, the goal of this exploration is to catalog patterns in our responses to psychological challenges, not to interpret events.
By getting to know the patterns in their thinking, psychodynamic therapy patients learn to identify unhealthy coping strategies and defense mechanisms. For example, a patient may begin to notice that they always accept blame for problematic situations, even when others are responsible. Once these bad habits are observed, the idea is that one can address the symptoms directly without getting as caught up in the interpretation of root causes.
By getting to know the patterns in their thinking, psychodynamic therapy patients learn to identify unhealthy coping strategies and defense mechanisms.
In this way, psychodynamic therapy is more streamlined and less interpretative than psychoanalysis. It’s also more interactive and goal-oriented in nature. Treatment plans, with short- and longer-term goals are built to resolve specific issues.
Because psychodynamic therapists rely upon interaction to tease out underlying thought patterns, couples or groups may feel psychodynamic therapy is particularly well-suited for them.
Cognitive-behavioral therapy (CBT)
What it is: A proactive and assignment-heavy form of therapy
Who it’s for: Those who have specific issues they know they want to work on
Cognitive-behavioral therapy (CBT) is a group of therapies founded on the idea that our perceptions influence our behavior. How we perceive determines how we act.
The premise of CBT is that when we perceive events through a negative lens, we can end up letting every day events and occurrences cause emotional suffering.
“Cognitive errors”—like focusing on failure, or interpreting another person’s genuine mistake as a personal affront—create a cycle of negative reinforcement that can lead to distress or, in pronounced cases, even mental illness.
CB therapists have developed techniques that allow patients to adjust their perceptions through practice. Tools like journaling, thinking exercises, and relaxation enable patients to catch themselves interpreting their actions or the actions of others through a negative lens, to challenge that perception or belief with other logical conclusions, and eventually, to change their emotional response to it.
Over time, patients learn to correct their cognitive errors in perception, and in the process rid themselves of the undue emotional suffering that go hand in hand with them.
Psychoanalysts challenge patients to dig into parts of their mind and life they haven’t yet explored, which can be rough.
CBT is collaborative and designed to resolve specific issues that patients and practitioners identify as a team. Cognitive behavioral therapists give plenty of assignments and ask patients to monitor their thoughts and emotional responses to those thoughts on a daily basis.
An active commitment to the techniques your therapist shares is critical to the success of CBT. If you prefer practical, hands-on solutions and don’t mind doing some homework, CBT may be right for you.
Dialectical behavior therapy (DBT)
What it is: A modified and intensified variant of CBT
Who it’s for: Tends to be helpful for those with chronic mental health conditions like borderline personality disorder or schizophrenia
Dialectical behavior therapy (DBT) is an intensive form of cognitive behavioral therapy. It was developed for patients with severe and/or chronic mental health conditions. The goal of DBT is to improve quality of life for patients who haven’t had success with other forms of treatment.
DBT therapists work with patients to increase their motivation and to bolster their ability to handle triggers. The thinking is that difficult-to-treat conditions are more manageable when patients learn to accept their illness while simultaneously embracing the possibility of change.
This “dialect” or coming together of opposite concepts—is central to the approach. Unless you’re seeking treatment for a chronic and severe mental health condition, you’re probably not the prime candidate for DBT. And if you are, take heart in knowing that it is a safe and effective method.
What it is: A practice of detaching from the triggers that cause you distress
Who it’s for: Those who have difficulty coping with stress.
Proponents of mindfulness therapy believe that our minds function on two levels: “being” mode and “doing” mode. They argue that switching between these modes is the key to good mental health.
“Being” mode is a meditative state of simply existing that offers safe detachment from thoughts and actions. When we are engaged in only being, we afford ourselves a healthy distance from the things that make us anxious or depressed.
The goal of mindfulness therapy is to help patients practice this state of being through meditation and breathing and mindfulness exercises. Patients are taught to respond to triggers or heightened symptoms by breaking from “doing” mode and entering “being” mode, thus behaving in a less reactionary way.
“Being” mode is a meditative state of simply existing that offers safe detachment from thoughts and actions.
Mindfulness therapy is practical in nature and treatment is often no more than an eight-week course. This complement to CBT may be of particular interest to patients who practice or have an interest in meditation.
Eye Movement Desensitization and Reprocessing Therapy (EMDR)
What it is: A therapy that combines memory recall with tracking eyeball activity to re-imprint memories.
Who it’s for: People with post traumatic stress disorder
EMDR uses bilateral stimulation, directed eye movements and/or alternating left and right taps or vibrations on the knees, shoulders or hands, to help patients access unprocessed memories.
It’s primarily used to treat post-traumatic stress disorder. Advocates for EMDR believe that when humans experience trauma they are often unable to fully process the information they’re receiving. The result is an unprocessed memory that will continue to trigger negative responses until it is fully processed.
By recalling a traumatic event and opening neural networks simultaneously we pave new roads to these unprocessed memories.
Patients discuss their emotional history with their therapist, recall an “adverse life event,” and undergo bilateral stimulation.
This means that as the patient recalls the life event, therapists might alternate stimulation of the shoulders, knees, and hands between left and right sides of the body, play different tones at intervals, or direct specific eye movements back and forth. These movements, tones, and taps require patients to learn new, simple behaviors.
When we learn behaviors we form new pathways in our brains called neural networks. These pathways all connect to one another. By recalling a traumatic event and opening neural networks simultaneously we pave new roads to these unprocessed memories.
The combination of focused recollection and pathway building allows patients to reconnect sections of the brain, then use those connections to get to areas they had previously blocked off due to trauma.
Once processed, the traumatic event is far less likely to cause continued distress when triggers are encountered in the future.
EMDR is not your average talk therapy, and it does require patients to recall disturbing life events. However, it is also proven to be quite effective. One study showed that after six sessions, 100% of patients who experienced a single traumatic life event had eliminated PTSD.
Because it works quickly to alleviate symptoms, EMDR can be especially helpful when used in tandem with psychoanalysis or psychodynamic therapy.
What it is: A less formalized approach to self improvement
Who it’s for: Anyone with concrete goals, rather than serious mental illness
Let the record show that life coaches aren’t necessarily therapists at all. The role of a life coach is to help clients achieve particular concrete goals, like a promotion at work or a more healthful lifestyle. Coaches provide encouragement and strategies to help clients jump hurdles in their personal and professional lives.
If having a coach in your corner helps you achieve your goals, go for it. However, you should not seek out a life coach to do a therapist’s work.
While there is some overlap between coaching and therapy, it’s important to note that therapists must study, train, and become licensed to diagnose and treat mental illness. Coaching requires no license. There’s no formal course of study and no degree or training requirements.
If having a coach in your corner helps you achieve your goals, go for it. However, you should not seek out a life coach to do a therapist’s work. Coaches are not a replacement for a real therapist, nor are they a viable alternative, especially if you think you’re suffering from a mental health condition.
This is only a fraction of the many different kinds of therapy available to someone looking for help; no one expects you to be an expert. If you’re not sure what’s right for you, set up a consultation with a licensed therapist. They’ll know how to guide you.
American Psychological Association. (2017) What is cognitive behavioral therapy? Retrieved from: https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral
Amano, T., & Toichi, M. (2016). The Role of Alternating Bilateral Stimulation in Establishing Positive Cognition in EMDR Therapy: A Multi-Channel Near-Infrared Spectroscopy Study. PLOS ONE, 11(10), e0162735. https://doi.org/10.1371/journal.pone.0162735
GoodTherapy. (2017). Eye movement desensitization and reprocessing therapy. Retrieved from: https://www.goodtherapy.org/learn-about-therapy/types/eye-movement-desensitization-and-reprocessing
Freud, S. (1900). The Interpretation of Dreams. Standard Edition, vols. IV–V. London: Hogarth.
Good Therapy. (2017). Psychoanalysis. Retrieved from: https://www.goodtherapy.org/learn-about-therapy/types/psychoanalysis
Jung, C. G. (1921). Psychological types. The collected works of CG Jung, Vol. 6 Bollingen Series XX.
Lee, Gale K, R.N., M.N., Beaton, Randal D, PhD, E.M.T., & Ensign, Josephine, R.N., PhD. (2003). Eye movement desensitization & reprocessing. Journal of Psychosocial Nursing & Mental Health Services, 41(6), 22-31. Retrieved from: https://journals.healio.com/doi/full/10.3928/0279-3695-20030601-10
Mayo Clinic. (2019). Cognitive behavioral therapy. Retrieved from: https://www.mayoclinic.org/tests-procedures/cognitive-behavioral-therapy/about/pac-20384610
American Psychological Association. (2019). Mindfulness meditation: A research-proven way to reduce stress. Retrieved from: https://www.apa.org website: https://www.apa.org/topics/mindfulness-meditation
National Alliance on Mental Illness. (2020) Types of mental health professionals. (2020). Retrieved from: https://www.nami.org/About-Mental-Illness/Treatments/Types-of-Mental-Health-Professionals
Personalityresearch.org. (2020). Psychoanalysis: Freud’s revolutionary approach. Retrieved from: http://www.personalityresearch.org/papers/beystehner.html
Psych Central. (1999, May 17). Psychodynamic therapy. Retrieved from: https://psychcentral.com/lib/psychodynamic-therapy/
Psych Central. (2016, May 17). An overview of dialectical behavior therapy. Retrieved from: https://psychcentral.com/lib/an-overview-of-dialectical-behavior-therapy/
SimplePractice. (2019). What’s the difference between therapy, counseling, and coaching? Retrieved from: https://www.simplepractice.com/blog/whats-the-difference-between-therapy-counseling-coaching/