The Iceberg Model of Human Behavior

In a previous post (Symptom Removal Vs. Psychodynamic Therapy), I explained the two major streams of thought in psychotherapy. In the first group that primarily focuses on working on the system, Cognitive Behavioral Therapy (CBT) stands out as the most well known approach. Psychodynamic approach, instead tries to get to the root causes of the problem hidden in the unconscious mind.

Symptom oriented therapists try to help people overcome their fears and anxiety in 10 to 20 sessions. However, psychodynamic schools criticize CBT as being a Band-Aid approach because the root causes have not been addressed properly. They argue that if you don’t solve the underlying issues, another symptom could appear in the future.

The unconscious oriented therapists; on the other hand, need several years to be able to explore all the deep root causes before helping the clients overcome their problems. They get criticized for their long therapy process because the clients keep suffering from the symptom until they are able to understand all the deep-rooted issues.

These two approaches have their strengths and their weaknesses. The first one may be faster but risks to be short lived. The second approach may help eradicate the cause but it takes a long time.

Is There a Better Approach? Yes! It is possible to combine these two streams of thoughts in order to get the best of each. For the last decades I have used an alternative method that combines these two approaches so you can get long lasting results in a short time. To explain it I will use the well-known iceberg model.

The Iceberg Model

Sigmund Freud (1856 – 1939), the most prominent figure of psychodynamic school, believed that much of the observable human behavior is caused by inner impulses beneath the conscious awareness of the individual. To explain this model Freud used the analogy of the iceberg. What we see is just a very small part of the iceberg; meanwhile, a giant portion is hidden beneath the surface of water.

According to this model, a symptom, like anxiety, is the tip of the iceberg. The psychotherapists that rely on the unconscious use the iceberg-model to split the human mind into two parts:

The conscious part includes what the individual is aware of. The person with phobia of flying would be conscious of certain thoughts (“What if the plane crashes and I die”), emotions (intense fear) and bodily reactions (perspiration, racing heart, muscle tension, dry mouth, et.).

2) The unconscious part includes images, forgotten or repressed memories, deep urges and existential fears and desires.

The approach I use has the power to address all the deep unconscious root causes. I seek this result working in a special way from top down: focusing on a apparently trivial portion of the symptom that can have a ripple effect downward toward all the deep unconscious issues. (Fig. 2)

All the cases you can read in my blog come from my private practice and my online sessions. For example when you read Katie’s story (I get anxious when my sister insults me) you realize that all I asked her was to do one apparently small and insignificant action. It looks as if what Katie did was not related to her problem. She didn’t have to talk with her sister; fight back; avoid her; etc. She had tried all of these solutions but none worked.

Katie’s small action started a ripple effect that in a very short time stopped her sister to insult her. As if by magic, her relationship with her sister improved and the older one began respecting her.

Although these changes may appear magical, there is a scientific explanation to them. You can easily call to mind the chaos theory or the butterfly effect that argues that a small cause can have large effects. This branch of mathematics has been applied to other fields such as biology, robotics and human behavior. It has proven useful to understand and predict phenomena such as abrupt climate changes, evolution, chemistry and other areas.

In summary, the iceberg model tells us that we have to take into consideration deep issues that are connected to the visible problem or symptom. However, none of the two extreme are efficient ways to solve human problems. Focusing primarily or exclusively on the tip of the iceberg or embarking on a long journey of deep unconscious issues, are both inefficient ways to help people solve their problems. An alternative method is to know exactly where to apply a small change that will have major positive consequences at a deep level.

Symptom Removal Vs. Psychodynamic Therapy

The field of psychotherapy offers a plethora of different and often opposing approaches. Hundreds of diverse schools of thoughts with their own techniques claim to have the solution to human suffering.

This fragmented and chaotic field appears to offer a vast selection of therapeutic approaches to choose from. However, when you observe them carefully, you realize that there are only two major categories, namely Symptom-Oriented Therapies and Psychodynamic Therapies. All schools of therapies fall under these two big umbrellas.

Cognitive Behavioral Therapy (CBT)

The most well known school of therapy belonging to the first category is Cognitive Behavioral Therapy (CBT). This approach overshadows the others mainly because it is dominant in the university setting, and also CBT-oriented research projects receive more funding. For these reasons, most professionals in the filed of clinical psychology receive their training in CBT or a modern version of it such as Acceptance and Commitment Therapy (ACT).

The main goal of CBT, whether in its classical form or its modern versions, is to reduce the symptoms. CBT therapists use techniques to help their clients gain control over their symptom. For example if you were afraid of flying, they would teach you how to control your physical reactions using relaxation techniques. They would also challenge your beliefs and irrational thinking that flying is dangerous, and teach you a technique to cancel your negative self-talk.

Psychodynamic Therapy

On the opposite side, you find Psychodynamic Therapies. The representative of this stream of thought is Psychoanalysis. This approach seeks ways to help the person to gain an insight into their core identity and unconscious desires. Psychoanalysts believe that you need to address the underlying causes of your problem before you can get rid of your problematic symptom. If the clients gain a deep understanding about themselves, they could overcome the symptom.

The chief goal of dynamic therapy is to gain insight first. This is accomplished through a long process of analyzing the unconscious defense mechanisms rooted in the first childhood experiences and exploring one’s neurotic traits and the relationships with one’s parents.

For example, if you sought their help for the fear of flying, they would investigate your past, seeking the root causes of your problem. They would ask you about childhood memories, your relationship with your parents, your fear of death, and other aspects of your core self.

To summarize, if the symptom-oriented therapists see the observable irrational fear as the problem, the unconscious-oriented therapists consider the underlying causes that are below your conscious awareness as the problem. I must also admit that in the past few decades the gap between these two opposing streams of thought has become less wide.

Which Approach is Better?

It is tempting to simplify a complex field such as psychotherapy. Nowadays, most therapists are eclectic and use a combination of approaches. So maybe this is not a good question to ask. A better question is: which therapist is most competent?

When you want to assess the effectiveness of a school of therapy, you must keep an important detail in mind. A therapeutic approach, including all its techniques, is like a toolbox. Simply owning a set of tools does not guarantee that you are a competent craftsman. Craftsmanship requires not only the most sophisticated state of the art tools but also the skills to use them. Thus, you can find exceptional therapists in either category.

As we said, the competency of a therapist is the key to make or break the effectiveness of a specific approach. Next to this ability comes the usefulness of the tools. Therefore, when you look for a therapist, you are better off focusing on their competency as a professional rather on their school of therapy.