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.

The Woman with a Ph.D. in Anxiety

PhD anxiety woman story

Ana, a middle-aged woman, came to see me because of two problems that had severely limited the quality of her life for over 10 years. She told me that she had been diagnosed with depression and anxiety. And that she had, so far, spent seven years in psychotherapy to get to the root causes of her problems.

She knew all the details of why she was anxious and depressed. She had analyzed every corner of her subconscious mind with the help of a variety of psychotherapists belonging to different schools of therapy.

“I have a Ph.D. in my neurosis,” she said, “I know all about my depression and my anxiety.” However, despite her vast knowledge of all the reasons and causes of the problem, she was still anxious and depressed.

I saw Ana for the total of 8 sessions. After the first 5 sessions, her anxiety was completely gone. During three more sessions I helped her to learn how to handle future life challenges without any relapse.

I did not ask her anything about her past for two main reasons. First of all, she had already done this with the help of many therapists. She knew all her conflicts with her family, parents and herself. Of course this didn’t help her at all. Secondly, and most importantly, I did not investigate the genesis of her problem because it is unnecessary. You cannot change the past. Therapy should be focused on the present and the future.

The majority of the tasks and exercises I gave her were to help her feel anxiety differently. Ana, like all anxiety sufferers, had already done the thinking about her anxiety. What she needed wasn’t more thinking, but rather a specific way of feeling differently about her problems.

A year later, I touched base with her and was extremely satisfied to hear from Ana that, after so long, she was finally happy because anxiety was now a closed chapter in her life.