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.
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.