Psychoanalytic therapy vs cognitive behavioral

In this post we will highlight the differences between these two types of psychotherapy and help you identify which is the best for you.

Psychoanalytic therapy vs cognitive behavioral

Cognitive therapy and psychoanalytic therapy are often opposed without delving into their points of agreement or their differences. However, psychoanalytic therapy has been, and continues to be, a cognitive therapy insofar as it modifies beliefs and ideas.

From the beginning, Freud argued that it was essential to undo the work of repression so that what was subject to unconscious processing became the object of what he explicitly called “associative correction”, that is, once in consciousness it was contrasted with other ideas that could rectify it.

In other words, a two-stage process: lifting the repression and then cognitive restructuring (the contrast between ideas), the latter being the decisive factor.

What’s psychoanalytic therapy?

Psychoanalytic therapy is characterized, among other things, by being adapting to circumstances without following a very rigid structure. This is so because, from the theoretical perspective from which psychoanalysis starts, each patient experiences a unique form of discomfort, based on their past experiences and that is part of her identity as an individual.

To know what this type of psychotherapy consists of, it is relevant that we review some of the principles and foundations of applied psychoanalysis. It is true that each psychoanalyst will address the needs of their patients in a unique and personalized way, but most of these therapists follow these elementary principles:

• Psychological conflicts are the consequence of problems in the unconscious
• Symptoms are externalized by latent conditions
• The origin of these unconscious conflicts is usually found in unresolved problems during childhood, or in traumas that have been repressed
• Therapy makes these repressed thoughts aware, and it is at this time that the patient can treat and overcome her fears and conditions.

Bases of intervention of Psychoanalytic Therapy

Psychoanalytic Therapy inquires about the drives and impulses that every human being keeps in his unconscious, and its goal is to provide a situation of rediscovery of oneself in order to promote an improvement of the current mental state.

In this process, the patient must better understand his past and the different life events that have affected his life, being able to recompose his beliefs and memories to overcome the conflicts that he drags.

The therapy is spread over several sessions, which can vary depending on multiple factors and circumstances. In any case, the environment of trust between patient and therapist (the “rapport”) should enable the latter to speak openly about their latent thoughts, memories and emotions.

The psychoanalyst therapist will limit himself to listening to the patient’s stories and concerns, being attentive to patterns of thoughts or memories that may be of clinical interest. Throughout the therapeutic sessions, the repressed feelings will flourish and the patient will achieve that his anxiety and fears dissipate.

What’s cognitive behavioral therapy?

Cognitive-behavioural therapy thus appears as a combination of two streams, behaviorism and cognitivism, relating thoughts and behavior. It affirms that there is an intrinsic relationship between thought, emotion and behavior, and that changes in some of the components will have consequences on the others.

In this way, it uses very diverse techniques aimed at modifying one of the three elements, knowing that in this way it will be extended to the human being as a whole. For example:

• Cognitive restructuring is a technique that is based on helping the person to modify their beliefs or thoughts. 

To do this, invite the person to evaluate the veracity of what he thinks and to look for more adaptive thinking alternatives. Once you change the way you interpret reality, change the way you feel and act.

• Exposure is a technique aimed at modifying behavior. The person is encouraged to stop avoiding and escape what he fears and cope with it. By changing his behavior and facing the dreaded situation, he checks that it is harmless and his beliefs and emotions about it immediately change.
• Relaxation techniques focus on modifying emotions. Specifically, they help the person to self-regulate their emotions and their level of activation. 

If your emotions change, your thoughts become less catastrophic and your behavior changes from fleeing to coping.

Bases of intervention of cognitive behavioral therapy

Cognitive-behavioral therapy works by teaching to recognize thinking styles that predispose to reaching conclusions that are not very useful for the patient, or dysfunctional thoughts.

For this, it is necessary to train the person to be able to reflect on their own way of thinking and consider which points are conflicting and which are not. In this way, it is intended that the client has more capacity to question the categories with which she works (such as “success and failure”) and detect typical patterns of thought that cause problems.

The process by which it is achieved that the patient recognizes the cognitive aspects that cause him discomfort and can act on them is based on a model of action inspired by Socratic dialogue.

This implies that during a part of the cognitive-behavioral therapy sessions, the professional will return the necessary feedback to the patient so that he, by himself, detects the contradictions or unwanted conclusions to which his thinking styles and his cognitive schemas.

The therapist does not guide the patient in this process, but rather poses questions and remarks statements that the client himself has made so that the latter can go deeper into the study of his own thinking.

The second part of cognitive-behavioral therapy involves intervening on the cognitive and material foci that have been detected. This entails, on the one hand, setting specific objectives to be met, and on the other, training the patient to be able to determine, from his own criteria, the strategies that bring him closer to and away from these goals.

In addition, as the objectives have been defined in such a way that it can be impartially verified whether they have been met or not, it is easy to measure the progress that is being made and the pace at which it is happening to take note of it and, if it occurs the case, introduce changes in the intervention program.

Differences between Cognitive Behavioral Therapy and Psychoanalysis

Next, we will go through the differences between Cognitive Behavioral Therapy and Psychoanalysis with respect to three key aspects: treatment modality, empirical research support, and information provided to the patient.

Treatment modality

The psychoanalyst predominantly uses the technique of “free association”; It does not apply procedures aimed at behavioral change, since it starts from the idea (which is widely questioned today from other approaches) that authentic “cure” occurs only when the patient “discovers” aspects of the “unconscious” that were “hidden.”

The cognitive-behavioral therapist implements therapeutic techniques whose objective is to change the behaviors, thoughts and emotions that cause suffering to the patient. In other words, the patient’s problem is addressed directly.

Empirical support of treatments

The origin of Psychoanalysis is located in the theoretical system initially developed by Sigmund Freud between 1885 and 1938.

The practice of current Psychoanalysis is based on theories and hypotheses of various authors that make compatible and complement the original proposals of its creator to varying degrees.

This results in a wide set of divergent currents within Psychoanalysis itself. To be more precise, there are approximately 200 schools of Psychoanalysis. Regardless of the empirical support that he has in controlled studies, the analyst applies the theory that he believes or convinces him.

Regardless of whether he likes a certain theory or not, the cognitive-behavioral therapist must give priority to those approaches that have passed the empirical test through previous studies that verify the effectiveness of a technique in certain disorders.

In several countries, scientific research has been stimulated in the clinical field, trying to establish precise criteria on which are effective treatments for different pathologies.

Thus, the professional who works in Cognitive Behavioral Therapy must consider such criteria when choosing which techniques to apply to help their patients.

Information about the techniques to the patient

In Psychoanalysis, the patient is not usually informed that the analyst will not directly address their problems or reasons for consultation.

Moreover, according to Freudo-Lacanian psychoanalysis, the patient must “suppose” that the analyst possesses a “knowledge”; In general, he cannot respond directly to the patient’s request for help by modifying the symptom, since in this way he “blocks” or “interferes” with free association.

For example, if the patient suffers from anxiety, the analyst does not apply relaxation techniques, as it would involve working on the “surface” and not on the supposed “conflict.”

Naturally, the resulting ethical problem is that the lack of accurate information about the characteristics of the psychoanalytic approach leads to the patient spending months, even years, believing that the analyst implements techniques to change his problem.

In Cognitive Behavioral Therapy the therapist must clearly inform the patient which procedures he will apply. Psychoeducation, that is, explaining basic theoretical notions and technical steps, constitutes one of the unavoidable components in therapeutic programs for most psychological disorders.

In this way, the patient is allowed to choose, from the fact that he is informed in a transparent way about the intervention strategies that will be implemented and about the reason for them.

Cognitive behavioral therapy is a very comprehensive, flexible, and effective approach. It achieves very important improvements in a short time and in a wide variety of disorders and conditions.

Furthermore, it is the psychological orientation with the most experimental evidence of its efficacy. However, when going to therapy it is advisable to find out about the available alternatives and choose the approach with which you feel most identified.

FAQS: Psychoanalytic therapy vs cognitive behavioral

What is the difference between psychoanalysis and cognitive therapy?

In psychoanalysis, the goal is mainly to interact with the feelings that are the genesis of the emotions that sabotage relationships and mess with the growth of marriage and potentially endanger the performance of one’s job. CBT is a linear approach focused on logical analysis that is mechanistic.

What are the main differences between psychodynamic and cognitive Behaviour therapies?

So, if you try to look at a longer-term approach to the issues you are facing, psychodynamic psychotherapy can be beneficial. CBT, on the other hand, is a short, time-limited treatment with 6 to 12 sessions concentrating on personal interests, but not the historical background.

Is CBT psychoanalytic?

Cognitive behavioural therapy, like most techniques such as psychoanalytic psychotherapy, does not appear to rely on latent implicit aversion to transition.

Is psychotherapy and cognitive behavioral therapy the same?

A common kind of talk therapy is cognitive behavioral therapy (CBT) (psychotherapy). You communicate in a formal manner with a mental health specialist (psychotherapist or therapist), attending a limited number of sessions.

What is the difference between a counselor and a therapist?

Counseling is an intense and personal process focused on helping people with normal problems and opportunities. … Active therapy is one in which the therapist performs some type of personal intervention that is not limited to collecting and interpreting the information provided by the patient.

In this post we will highlighted the differences between these two types of psychotherapy and help you identify which is the best for you.

If you have any questions or comments please let us know!

References

Field, T.A., Beeson, E.T., Jones, L.K. (2015), The New ABCs: A Practitioner’s Guide to Neuroscience-Informed Cognitive-Behavior Therapy, Journal of Mental Health Counseling, 37 (3): pp. 206 – 220.

Froggett, L. y Richards, B. (2002). Exploring the Bio-psychosocial. European Journal of Psychotherapy & Counselling, Vol. 5 (3). pp. 321 – 326.