Psychology has three main schools of thought, with several
subgroups within them. In this essay, psychology is not being limited to specific areas of research, such as biopsychology,
psychophysics, or psycho-pharmacology. Psychology, broadly, is the study of mental processes, including consciousness,
and their relation to behavior. I will attempt to outline its different schools of thought and how they can all be viewed
as equally valid schools within a unified field.
Although philosophers have long written on the subject,
with Kant even denying that psychology could ever become a science – ironically, some of his ideas continue to
influence experimental psychology – it wasn’t until the physicist Gustav Fechner created a mathematical
formula, linking sensation to perception, a distinction made over 2,000 years ago by Aristotle, in the 19th
century that researchers attempted to measure the mind.
A few decades later, Wilhelm Wundt in Germany
and William James in America, who could be described as philosophers with a background in physiology
and biology, created laboratories to systematically experiment on these ideas.
For Wundt, the aim of psychology was, borrowing a metaphor from chemistry, to discover the molecules of the mind. His school
was known as “structuralism,” and also “volunteerism,” meaning that he defined “thought”
as conscious attention built upon perception and the deliberate attendance to sensation (which is an automatic
physiological response that occurs prior to intention). James, a physician by training, considered consciousness in an evolutionary
sense, in terms of what it does and how it helps the organism adapt to the environment. This view is called
“functionalism.” If consciousness can be compared to light photons, Wundt investigated its particle-like properties,
and James its wave-like properties, as he coined the term “stream of consciousness.”
A prominent physicist and physiologist, Hermann Helmholtz,
also did systematic investigations on the nervous system and on sensation/perception in the 19th century. Brucke,
who was one of his students, coined the term “psychodynamic theory” to applications of thermodynamic physics to
the study of the mind, that is, to psychological energy.
However, these approaches remained more or less theoretical.
Psychoanalytic therapy, based on psychodynamic theory, was created by the Viennese physician Sigmund Freud, who was a
student of Brucke. It is commonly thought that his influential ideas arose mostly out of pure speculation biased
by in-vogue medical and psychological ideas, but they also stemmed from observations of patients by him and his
colleagues, as there was a practical need to treat a problem, especially among upper class females, then
called “hysteria” that had no clear remedy.
Since there was no known physical cause of this perplexing
class of symptoms, Freud assumed it must have something to do with the mind. But unlike the earlier approaches to psychology,
which attempted to study the conscious mind, he came up with theories and methods that probed the un-conscious mind, based on the work of his colleague Breur and his success in treating his patient Anna O. (who
called it the “talking cure”).
Psychodynamic theory was really the first force
of psychology. Freud boiled human motivation down to two forces, named from Greek: thanatos
– the death instinct, which is the desire to return to a state of non-action and non-existence, manifesting in self-destructive
and aggressive acts, and eros – the creative principle, or life instinct.
His model of personality mostly focused on the latter, dividing childhood into stages of psycho-sexual development. This is
important because it catalogues the process by which the id, a biological impulse/drive (characterized by “primary
process” thinking, the demand for wish-fulfillment in the present, guided by fantasy and visual imagination) governed
by the “pleasure principle” begins to recede beneath our everyday awareness as we grow up and focus
on the world outside our own body and its immediate desires.
During the maturation process the id is opposed by the
superego (the authoritarian self) in regards to certain pleasure zones of the body, and to maintain a balance between the
two there is the ego (the mostly conscious self). The ego develops out of the id, rationally calculates how to gain pleasure
and avoid pain, engages in reality-testing (differentiating imagination from reality), finds ways of releasing of tension
and gratifying desires for outward objects in a way that does not violate taboos or thwart future goals. Too much fixation,
or cathexis, on an object of pleasure or too much repression of a desire both unbalance the personality. The conflict between the
id and the superego happens unconsciously.
To understand this hydraulic view, you must place Freud’s
theory in context. A common assumption in his time was that the energy in the body was like a dynamo or closed electrical
circuit. The brain was less understood than it is today, but it was known to be the source of mental processing. As the current
flows through the body it is purely biological, and when it goes into the brain it becomes psychic energy. Psychic energy
has to regulate physiological drives, and sometimes there is conflict. Anxiety occurs when the libido (sexual energy) cannot
express itself. Basically, neurosis (mental imbalance) is bottled up energy. Certain behaviors called “defense mechanisms”
diffuse this tension like an engine letting off steam.
However, defense mechanisms can themselves cause problems
and disrupt daily life. Freud thought that this inner conflict was the inevitable result of civilization. Since we have to
cooperate with others and delay physical gratification, we must gain control of our ids. Authoritarian pressure becomes internalized
as the superego. The ego has to find a way to satisfy id drives without breaking the rules of society.
The type of patient suited for psychoanalysis is someone
with an overdeveloped superego and underdeveloped ego strength, and the task of the psychotherapist analyst is to form
an alliance with the patient’s rational ego. It typically starts off with free-association (saying the first thing that
pops into awareness). Not only is the content of the conversation important, but the therapist has to pay careful attention
to what the patient does not say. The patient’s dreams also provide material for analysis (for Freud, dreams
are the “royal road to the unconscious” because they are a repository of id and superego interactions, largely
unmediated by the ego, which speak in the language of visual symbols). In subsequent sessions the therapist can gain a clear
sense of what issues the patient is avoiding.
Usually the patient recounts past traumas, often relating
to sex, with parents in childhood (real or imagined, fantasized about in a taboo way that is deliberately repressed).
For example, males are said to go through a conflict called the “Oedipus complex” in which boys develop
a sexual attraction to their mothers and jealousy of their fathers. Fearing punishment from the father, they suffer “castration
anxiety,” taking away their source of pleasure. (The anxiety is handled well if the boy can properly forget this
urge and eventually identify with his father. If not, both the sexual desire and the fear of its consequences boiling down
below will continually disturb the surface of his consciousness).
A problem at any stage of psycho-sexual development
causes a fixation at that stage of development, affecting the later adult personality. After going through certain stages,
where the pleasure of tension & release has its locus in the anus, mouth, and phallus (or a desire for one), the normal
child has a latency stage in which he or she identifies with the same sex parent and learns to fulfill social roles.
When puberty hits, sexual feelings reawaken, and if handled well one reaches the mature genital stage as an adult.
If there are no debilitating neurotic symptoms, the adult
can direct impulses into work and love (through marriage and family, of course). The healthy ego directs id drives into socially
acceptable, useful pursuits (“sublimation” - the healthiest defense mechanism) without having to think about their
selfish basis or worry too much about them. Otherwise, one will exhibit exaggerated behaviors resulting from defense mechanisms.
As the patient is unaware of the source of his anxiety,
and thus has no idea why he/she reacts the way they do to features in his/her environment that bother him/her so
much, there is a need for uncovering techniques in therapy. One common defense mechanism is “regression”
in which the person reacts to a stressful situation by returning to a mental state prior to inner conflicts. This can be observed
in a child-like affect or in childish behavior. A crucial task of the therapist is the analysis of “transference,”
remaining aloof as the patient eventually directs hostility (or affection, dependence, etc.) towards the therapist, treating
him like a parent figure. Then, the therapist interprets this behavior as it presents itself, and the patient can gain insight.
Traditionally, during sessions the analyst would remain
out of the patient’s view while they lie on a couch. This was done because, first, Freud, who had learned about hypnosis
(which led him to further investigate the unconscious), knew that relaxation was a key part of the process. Second, he believed
transference couldn’t occur unless the personality of the therapist faded into the background. Therapy is rarely done
like this today, as it is assumed that we can access material without having to go through an intensive free-association
Although Freud came from a medical background, this talking
cure was not like other procedures doctors engaged in. Initially the province of psychiatrists, medical training was eventually
dropped as a prerequisite to psychoanalytic training. In addition to learning the method in the textbook sense, training requires
the therapist to undergo the treatment him or herself. This is done to prevent “counter-transference,” which is
when the therapist interprets the patient’s situation in light of his or her own issues, interfering with the patient’s
ability to relive past events, urges, and feelings. (Interestingly, since Freud first systematized this technique, he himself
did not have another therapist to analyze him, so he analyzed himself.)
Psychoanalysis is not a cut and dry process and it lacks
a definite timetable. This can deplete one’s financial, physical, and emotional resources, so the patient must be very
dedicated in order for it to succeed. Furthermore, the problems addressed in psychoanalysis usually affect the upper-classes.
In this theory, only the well socialized can develop these defense mechanisms, so this therapy primarily benefits the “worried-well.”
Coincidentally, since this therapy was expensive, only the well-to-do can afford it.
For these reasons, some skeptics accuse psychoanalysis
of ignoring the plight of those who need real help. Freudians have two main counter-arguments. 1.) Psychotherapy can only
be done on those who can benefit from it. It is not the job of psychology to deal with larger social problems; most social
problems are best left for the law to handle. 2.) Psychotherapy won’t work if it isn’t done to the fullest
extent. If therapy stops before the needed insight occurs, all that money and time will be wasted without any benefit. It’s
not like the improvement comes in stages, insight either happens or it doesn’t. If the id is over-exposed too early,
the patient will be even worse than before the therapy started.
Besides its high costs and imprecision, another criticism
of psychodynamic theory is its negative and deterministic view of human nature. In evaluating the influences of 19th
century science, one cannot leave out the influence of Charles Darwin. With Darwin’s
discovery of biological evolution, we are confronted with the fact that the survival of an animal species depends on
its success in sexual reproduction, and therefore, many behaviors and rituals exhibited by organisms are merely adaptations
to meet that goal. In other words, the sexual drive, just like hunger, thirst, or aggression, is genetically hardwired
and controls us. Though there are instances of altruism, our motivation is always based on self-preservation or leveraging
an advantage in the environment (e.g. if I help someone now, I expect that person to return the favor in the future, and I
may gain other possible benefits afforded by a strong ally, status, etc.).
The incorporation of this view in the social sciences is
known as sociobiology and evolutionary psychology, which some theorists, though by no means all, have used to justify hierarchical
or authoritarian social structures. Politically, this philosophy is represented by the conservative
position that holds that humans are basically selfish and institutions need to keep order through strict punishment to
keep people disciplined. If we jeopardize institutional order, violent upheaval and anarchy will ensue. As for Freud,
he did have reservations about the unhealthy attitudes of Victorian bourgeois society towards sexuality, but he was not as
liberal as many of his successors or detractors in the social sciences.
Another problem is that psychoanalytic ideas seem
to be built on a pseudo-scientific foundation. We know that the brain is an organ that can conduct electrical impulses,
of course, and thus it can be analyzed in terms of electrodynamic physics, but why smuggle the mind into that electical field
as though it is some magical force operating in the body? It's reminscient of the dismissed idea of “phlogiston”
And what if biological determinism isn’t
the whole story? What if human behavior is not “driven” by inner forces at all, but is shaped by the environment,
and can be altered or redesigned? These concerns led to the development of learning theories and the school of behaviorism
- the second force of psychology.
One of the earliest theorists in experimental psychology,
and also the first to systematically use animal research, was Thorndike, who formulated a “law of effect” between
stimuli and response (the rate of response to a stimulus will likely increase if it is satisfying to the organism, and decrease
if it is not). Independently, a Russian physiologist named Ivan Pavlov had paired a salivating reflex in a dog to a ringing
bell, or “conditioned reflex.” If pairing two normally unrelated variables, such as meat powder with the tone
of a bell, can cause a reaction from one stimulus to another, then that means, with training, automatic reactions can
be shaped into different actions. John B. Watson took these developments and created a whole new direction for psychology
that dominated the field for decades.
Whereas Freud has been called a “biologist of
the mind,” Watson, an engineer by training, can be considered a “mechanic of the mind” (actually, a strict
behaviorist would consider the word “mind” to be nothing more than a verbal designation, rather than an empirical
reality that can be studied). While Freud's concept of the superego included the conscience, which pressures us to
fear punishment of bad behavior (or, operating through shame and guilt, punishes us after), and the ego ideal, which
is pride and self-esteem associated with good behavior, this is still interpretive. It is easier and more scientific,
to behaviorists, to simply study the environment and the organism's responses to it, directly observing how rewards
and punishments condition behavior.
Thus, behaviorists attempted to eliminate all the imprecise
methods they saw in the previous approaches to psychology. To this day, these hypotheses and theories are the easiest
to test, especially in animal experiments and controlled single case studies.
However, behaviorism is a very narrow approach. In scientific
procedure, behaviorism is elegantly simple and effective. Techniques from classical conditioning have been shown to be effective
in therapies targeting phobias. Operant conditioning, based on the reinforcement principles of B.F. Skinner, has been usefully
applied in a wide variety of settings, such as in schools, juvenile detention centers, with sports teams, business, animal
training, and for those with developmental disorders. As a theory of psychology, however, behaviorism is limited because there
is no understanding of underlying cognitive processes.
The problem is that behaviorism, with its own techniques, does
not necessarily describe all human activities or preferences. Even in some primate studies, certain behaviors have
been observed seemingly independent of external reinforcers (indicating the existence of intrinsic motivation).
Of course, behaviorists only sought very basic principles
of learning that apply to all organisms. However, the role of memory cannot be dismissed. For example, an experiment was done
in which mice were led through a maze and did not move or do anything except see where they were being pulled on a cart. When
left to roam around, they were able to follow the same path that they were led through, even though their behavior was not
shaped or reinforced. This shows that the mice internalized the information.
The study of memory gained traction with the publication
of the paper “The Magical Number Seven, Plus or Minus Two” by George Miller in the 1950’s, a study
on the capacity of working memory and short-term storage. This marks the era of the cognitive revolution in
psychology, which later led to the independent branch of cognitive science, a multi-disciplinary field comprising psychology,
computer programming, neuroscience, anthropology, and linguistics that studies intelligence and internal learning systems.
This research has cross-pollinated with the field of AI (artificial intelligence). Further, there was revived interest in
researching the problems of perception and pattern recognition, influenced by “gestalt” (whole-field) psychologists
several decades earlier, who argued that we innately perceive figures/objects as wholes and patterns prior to its individual
parts (that is, mental or “top-down” processing).
Pure behaviorists argue that if researchers kept pursuing
traditional methods it would eventually yield better information. Currently, most theorists combine both approaches for a
more complete picture of learning and memory, called Cognitive-Behaviorism. In therapy, it is especially effective to reinforce
both adaptive behavior and positive schemata (mental representations) of the world in order to counter self-defeating emotional/behavioral
Many of these later developments in psychology led researchers such as Abraham
Maslow, who started by working with more traditional psychological models in primate research, to conclude that not only
is there such a thing as human nature, but the good in human nature is just as influential as the bad, if not more so. As
in psychodynamic theory, intentionality was emphasized. But instead of giving primary importance to our pathological
traits, a much larger role was given to generosity, creativity, authenticity, curiosity, and love.
Freudian techniques are focused on the past, and neo-Freudians, who expanded the role of the ego, with the present, this approach
helps the client look forward to a fuller life in the future. This school became known as humanistic psychology, the
Another influential philosophy called “existentialism” focuses on
human freedom, and the problems that result from alienation and a sense of the absurdity and purposelessness
of life. To heal one must be committed to one's values, take ownership of one's life, prioritize and make definite choices, accept personal responsibility for those choices, and create our
Despite obvious hurdles, psychologists
have managed to find creative ways of investigating the subjective (i.e. what it's like) aspects of the mind and experience,
or phenomenology. Carl Jung, who was early on one of Freud’s biggest supporters, eventually broke away from his circle.
Based on his clinical observations and his study of mythology in different cultures, he theorized that the unconscious, which
Freud considered private and teeming with hostility and chaos, is collectively inherited across all cultures. This collective
unconscious forms certain patterns he called “archetypes,” symbols found in dreams,
myths, stories, and religion. Another psychologist who broke from Freud was Alfred Adler, who theorized that humans have a
social drive for superiority. He coined the terms “superiority complex” and “inferiority
complex.” He found that our birth order, sense of mastery over the environment, and sense of self in relation
to others, plays a large role in the development of our personalities. Berne, the founder of transactional analysis,
looked at ego and elaborated on it in terms of an inner “child,” “adult,”
and “parent.” Each aspect of the personality carries with it a script, like continuously playing tapes
in our psyche, which influences our emotional responses to situations and other people.
There have been many other
important theorists who contributed the study of the mind in cognitive, neo-Freudian, and humanistic thought, such
as Perls, Rogers, Horney, Ellis, Beck, Kohut, Vygotsky, Kelly, Piaget, and Assaglioli. There is also the related field
of positive psychology, coined in 1998 in the journal American Psychologist by Seligman and Csikszentmihalyi
as the study of what exactly makes people happy and analyzes what it means for a person to thrive and experience well-being.
Maslow himself was primarily
interested in motivation. He found that everyone has the same essential needs, but
life conditions demand different priorities. There are deficiency needs based on getting
what we lack that keeps up alive, and being needs (meta-needs), conceptualized
as a hierarchy from purely physical, to psychological/social, to intellectual, to spiritual. At the bottom are basic physiological
needs: food, water, air, shelter, etc. The second level constitutes safety needs: structure, order, routine, etc. The third
level constitutes affiliative needs for affection and belongingness. The fourth level constitutes esteem needs, the desire
to be needed, respected, and valued by others. The last level is self-actualization: the need to understand the world and
oneself, thereby actualizing our full potential as a person.
The top of the pyramid also constitutes spirituality – the transcendence of felt personal limitations
and the integration of life’s dualities such as: self/other, high/low, beginning/ending, success/failure, satisfaction/disappointment,
etc. an acceptance that you can’t have one without the other..
Maslow realized that this
latter aspect required another category for research, the fourth force of transpersonal psychology. One phenomenon
studied by transpersonal psychology, originally written about by William James, is what Maslow termed “peak
experiences.” These are transcendent experiences of oneness – with
nature, spirit, or the universe – that are non-egoic but are not attributable to psychosis.
Transpersonal psychology has
gained some insights in the last 30 years that have changed how many of us view religion. Especially important is the work
of psychiatrist Stanislav Grof, who did pioneering research on chemically induced states of consciousness and later, for legal
reasons, psychosomatic responses through breath-work. Working from a medical model, he initially thought alternate states
of consciousness resulted from diminished brain functioning, but later changed his view.
He found in his experiments
that controlled doses of the drug LSD were marginally useful in treating depression and substance abuse. However, the sessions
were unpredictable. There is no single set of physical reactions a person will have when ingesting psychotropic or psychodelic
drugs like LSD, much less psychological, though general patterns can be ascertained. He called such drugs “amplifiers of experience,” meaning that they expose and exaggerate what
is already in our minds, similar to the way dreams, in psychodynamic theory, reveal the unconscious.
To sum up, the forces of psychology
are: psychodynamic (focusing on biological and personal drives, urges, and desires), behaviorism (focusing
on learned behavior), humanistic (focusing on our unique potentials and positive, adaptive human traits),
and to a lesser extent the offshoot transpersonal (focusing on spirituality) school. Another force of psychology could
be called “integral,” although it is more of an orientation rather than a separate
force per se. This approach attempts to honor all of the forces in a way that incorporates every known aspects of personhood.
The philosopher Ken Wilber
has come up with what he calls “the four quadrants” of
consciousness.[i] Consciousness is divided into: social versus individual, and inner (subjective/intentional/mental) versus
outer (objective/physical).[ii] We are an “I,” a “we,” and an “it.”
The body is a material it
and the mind encompasses our personal identity. Behavior is reinforced by physical rewards/punishments offered by the social
system, as well as a general social cognition resulting from growing up in a particular cultural environment. A
crude analogy is that of a computer. The body is the physical hardware, and the mind is the software within the computer.
Society, including material culture, is the network the individual computer interacts with. Non-material culture is comprised
of shared software programs. Higher (or deeper) consciousness would be the electricity, or programmers, powering
the whole system.
This integral model can help
one make sense of the different findings in psychological research. The crucial thing to recognize is that a human being is
a nest of systems within systems (each generating multiple perspectives). Health requires a coordination of biological, ecological,
social, and mental systems working in harmony. Problems in one area can and do affect others. Rather than asking whether
we should rely on medication, or social work, or talking cures, or political-economic solutions, etc. perhaps we should look
at how all of these approaches can work together to further our individual and collective well-being.
For a more detailed description of Wilber’s views on an integral theory of consciousness, see
this article from the “Journal of Consciousnes Studies”www.imprint.co.uk/Wilber.htm
[i] In this presentation of Wilber’s
theory, I’m leaving out the issue of levels of consciousness. The four quadrants represent a flat map showing
the horizontal distribution of consciousness: an individual body, an individual identity, the society the body is situated
in, and the culture the identity is situated in.
If you add depth, then that map becomes
3-dimensional and shows a “transcend and include”
evolution. (Think of Russian dolls - a doll inside a bigger one, which is inside a bigger one, etc.) The sequence
of consciousness evolution goes from body-based awareness to personal mind to transpersonal consciousness (soul) - sensation/perception
emerges, then emotions, symbols, concepts, rationality, mind-body holism, intuition, etc. A spiral metaphor is probably
the most accurate portrayal of development. Recently there has been collusion between Wilber and Beck on the Spiral Dynamics
theory which expands the work of Clare Graves on his theory of “value
[ii] The four quadrants is an in-depth concept that requires further explanation of its ontological categories
in order to understand its relevance to an integral perspective vis-à-vis psychology.
The “I” -- individual interior consciousness -- is stressed
throughout much of the essay in its outline of psychodynamic and humanistic thought.
Behaviorism touches upon “its” - the collective exterior in which
action and communication take place. The field of sociology -- the study of social life and society as a whole -- can shed
more light on the complexities of relationships than either behaviorist (except for Homans in his reciprocal reinforcement
model) or social-cognitive models alone, and overlaps with psychology in the school of social psychology. While
the former tends to analyze the unit of a social group as a social group, the latter looks more at the behavior/thinking
patterns of the individual within social groups.
But this cannot be fully understood without ethnographic research and anthropological knowledge,
and this is where we get into the “we”- the collective interior of consciousness. The non-material culture (language,
ideals, taboos, norms/mores, religion, ideology, cosmology, etc.) that we inherit and acquire, depending on where
we're born and raised, is the context in which all individuals express their ideas, relationships, status,
and identities. One particular subgroup that warrants attention is the family, where neo-Freudian and systems theories
meet. (I could go on further about the creativity of interdisciplinary connections, for example Lacan, who combined linguistics
Finally, the “it”
is our individual physical body. In this area, psychiatry uses a battery of drug interventions, and sometimes even psychosurgery, to
alter behavior and mood by tinkering with the chemistry and physiology of the central nervous system.
Many people are suspicious, in some cases, rightfully so, of the wealthy pharmaceutical industry, with its increasing
political clout. For example, Thomas Szasz, a physician involved in the anti-psychiatry movement, believed that science
cannot measure a disease that is mental, as the mind is a vague construct, unlike the brain, and not open to empirical
research methods. To him, mental illnesses are just “problems
in living” and should not be treated by a dogmatic system that he called “mono-medicine.”
While some critics regard behavioral medicine as a dangerous tool of social control, the fact that psychotropic
drugs can and do affect behavior or emotional states is difficult to dispute. This is why doctors are trained to notice psychological
problems in their patients, and clinical psychology generally uses a combined approach of talk-therapy with medication (some
clinicians are pushing for changes in the law to allow them prescribe meds without having to refer to a doctor).
The view in contemporary mainstream
psychiatry and clinical psychology is that drugs, in the short-term, can help the patient function well enough until the psychotherapist
eventually gets to the root of the problem. However, insurance companies often favor medication because the long-term evidence
for the efficacy of talk therapy can take too long to come in (the addendum on systems therapies addresses the influence of
managed care in therapeutic practice).
Both conventional and alternative medicine
have recognized a link between mind and body. Mind-altering chemicals have long been ingested by humans throughout our history
as a species for both practical and recreational purposes, and it’s unlikely to change any time soon. Ideally,
we should do unbiased research into the most effective options, not criminalize drug use, and promote informed choice and
Addendum - The 6th “Force”
Michael Probert, LCSW
An integral model of psychology makes the most sense in a world where time is
not a precious commodity. In this world, enough time could be taken to adequately assess a client’s situation and apply
the most effective technique. However, the reality of this world is that time is viewed as a precious commodity (consumerism
affects even our values of time). Because of this fact, and the increased involvement of insurance companies in setting the
length of time allowable for treatment, the 6th “force” of psychology could rightly
be said to be Insurance Based Treatment Modalities.
Insurance Based Treatment Modalities are all brief models, lasting 10 sessions
or less. Some therapists have even crunched the therapeutic process into one session (see Single Session Therapy: Maximizing
the Effect of the First [and Often Only] Therapeutic Encounter by Moshe Talmon). The positive side to brief treatment
is that there some people who have little or no mental illness, and may just be having a simple life-stage crisis, are not
allowed to become dependent upon an otherwise lengthy therapeutic process. The downside is that deeper level problems are
not dealt with but simply worked around and justification of continued therapy can be difficult. Two specific types of Brief
Treatment Modalities are Narrative Therapies and Brief Solution Focused Therapies.
In Narrative Therapies, the focus is upon how the clients define themselves.
The person is assisted in changing how they tell their life’s story. The core belief of this theory is that all views
of the world are relative and that a situation viewed as “negative”
can be made to be “positive” by
shifting one’s cognitive framework. While this can be a powerful change agent when used to assist the client in making
a change in their life (a woman in a controlling relationships learns to define herself as independent and begins to assert
her needs with her husband) it could potentially be used by a therapist rushing to force the client to accept their plight
(the person in poverty changes their view that poverty is depressing to one of acceptance because it’s “all they’ll ever amount to”).
Brief Solution Focused Therapies (BSFT) are less dependent upon a person’s
cognitive framework. The theory behind these therapies is that people already possess all that they need to manage their stressors
and/or mental illness and that the role of the therapist is to point the client to the skills they already possess. BSFT’s
are highly focused on the present and rarely discuss a person’s past or investigate the unconscious except to discuss
how the client handled their problems before (e.g. “When you were previously depressed, what did
you do to make yourself feel better? Can you do that now?”).
BSFT’s have a group of techniques that are rarely strayed from and as
such can appear somewhat gimmicky to the client (such as “The Miracle
Question” e.g. “Suppose tonight, while you slept, a miracle occurred. When you awake tomorrow, what would
be some of the things you would notice that would tell you life had suddenly gotten better?”).
However, with people with non-chronic mental illness, BSFT
often can work very well. With chronic mental illness, in which a client’s sense of self is greatly distorted (as in
psychosis or personality disorders) BSFT may not work at all. Self-awareness must exist in some fashion for this therapeutic
modality to work (of course BSFT have techniques designed to elicit self-awareness in those who don’t have it - their
bag of tricks just covers everything, doesn’t it?) While brief therapies may not be the most effective treatment modalities,
as long as the current insurance system exists, brief treatments will continue to dominate. Luckily, however, well-trained
therapists should be schooled in different techniques and be able to mix and match where appropriate.