As a therapist, even I get overwhelmed by the abundant amount of different therapies out there. CBT, DBT, ACT…so many acronyms, oh my! In this blog, I’ll offer an overview of some more common therapy modalities that you’ll see offered on sites like Psychology Today or Good Therapy as well as what conditions each type tends to be best for.
Cognitive Behavioral Therapy (CBT) is one of the most known modes of therapy and centers around how you relate to your thoughts. CBT looks at distorted thinking patterns and helps identify how our thinking (cognition) propels negative behaviors. CBT is highly structured by the therapist and is time limited, typically 20 sessions or less. If you are engaging in formal CBT therapy and the strategy isn’t work well for you, your therapist should help you with a referral. The prior statement is the case with any type of therapy, really. Remember, you are the boss, your therapist is your employee!
CBT can be particularly helpful for: chronic pain, insomnia, anxiety disorders, including hair pulling or skin picking, & phobias
Dialectical Behavioral Therapy (DBT) was originally created by psychologist Marsha Linehan for the treatment of borderline personality disorder (BPD). DBT focuses on changing self destructive patterns of behavior, as opposed to changing thoughts or feelings. DBT is a skills based therapy, with many of the skills focused on effective communication (DEAR MAN acronym) and balancing rational and emotional parts of your mind (Wise Mind).
DBT can be helpful in the treatment of BPD, but also individual behaviors like impulsivity, self harm, substance use. It is also helpful to people who are addicted to fiery, dependent relationships.
Somatic psychotherapy is one of the newer modalities I’ve added to my repertoire. While mind/body integration is well used in the Eastern world, these ideas are slowly gaining momentum across the USA. Somatic psychotherapy is a broad holistic approach that looks at the mind-body connection, particularly as it relates to trauma. Within this modality, we also draw on Polyvagal Theory, which explains how the nervous system shuts down when trauma takes over our body. In my work with somatic therapy, we also draw on more traditional psychotherapy, uncovering the root causes of of some of our maladaptive behavioral strategies. We then discuss how to try a new behavior, with an emphasis on calming through the breath, movement and identifying emotions in the body.
Somatic psychotherapy can help those struggling with eating disorders, people who struggle to connect with their emotions and/or bodies, and those who experience high stress, as well as trauma.
Psychoanalysis is based on the work of a man you’ve all at least heard of– Sigmund Freud. Freud’s classical psychoanalysis delves deeply into unconscious problems, including identifying id, ego, and superego drives. Because of the nature of taking a deep dive into aspects of the mind that aren’t in your awareness, classical psychoanalysis is long term, at minimum one to two years. However, modern talk therapy, including some of the work I do in my practice, draws on specific aspects of psychoanalysis to aid resolution of long term concerns.
Psychoanalytic therapy can be helpful for chronic neurosis, repressed memories and deep seated self esteem issues.
Ego state therapy is a less common modality, but one I use often and love. Ego state therapy serves to understand and modify conflicts between stuck parts of ourselves. We identify our most healthy, adult states while restoring a level of safety to parts that feel dysfunctional. As adults we can take responsibility and help heal hurt child parts of self. A similar type of parts therapy is called Internal Family Systems (IFS). Although I am not formally trained in IFS, I draw on simple tenants of this type of parts work in my practice.
Ego state therapy can be helpful with those of us whose childhood caregivers did not meet our attachment needs or inflicted trauma, resulting in a lack of self soothing skills. Ego state therapy is also helpful for people who identify with strong personality types, like “control freak.”
Eye Movement Desensitization and Reprocessing Therapy (EMDR) is one of the most popular modalities in treating symptoms of post traumatic stress disorder (PTSD) and other trauma. Sessions are longer, 60-90 minutes in order to work with the brain to reprocess trauma. Therapists use tapping, buzzing, or finger following side to side to engage in bilateral stimulation. Bilateral stimulation is meant to reduce the emotional intensity associated with traumatic experiences. Over the course of EMDR, traumatic memories should become less intense and your ability to get unstuck should increase. ALL therapists practicing EMDR should be certified and I’d encourage you to ask about your potential therapists certification.
EMDR is a trauma based therapy designed to treat traumatic memories or extremely stressful events that are causing intense anxiety.
Acceptance and Commitment Therapy (ACT) is one of my very favorites! It’s a form of therapy I refer to often in my personal life, especially when I’m feeling unmotivated to change something which needs to change. When I explain the purpose of ACT to people, building a meaningful, value driven life versus focusing on being happy all the time, it tends to make intuitive sense to them. ACT focuses on the ‘caveman brain,’ understanding that our impulses are still driven by the survival techniques (i.e: comparing, constant dissatisfaction) of our Stone Age ancestors. The goal of ACT is not reducing stress, but encouraging people to learn how to live with stress. In other words, act in alignment to what is meaningful for them, even when this is accompanied by difficult thoughts or feelings.
ACT can be helpful for those who suffer from chronic depression, anxiety, and obsessive compulsive disorder. I also find ACT helpful for those who are seeking recovery from substance use disorders.
Other current popular therapy styles are Humanistic Therapy, Gestalt Therapy, Gottman style, Narrative Therapy, Motivational Interviewing, and Biofeedback. If you have questions about the basis of these and other styles of therapy, I’ll be happy to try to answer. While the specific therapeutic modality is far less important than an authentic, trusting relationship with your therapist, seeking skilled treatment that resonates with your journey is also crucial.