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The Difference Between Behavioral Therapy and Psychoanalysis

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The first time I went to therapy, I was a college student who just thought I needed someone to talk to. And I genuinely did. I wasn’t talking to anyone about what was going on with my family, the anxiety and dissociation I was hiding with overworking, and the passive suicidal thoughts that were creeping into my head when I was walking to class or faking it at a party. For me, therapy meant talking to someone about all the things I felt like I couldn’t tell my friends. A place to tell my secrets. A place to finally be honest. A place to go when I truly felt like I had nowhere to turn. 

Therapy is, and should be, all of these things. It should be a place where you can be honest, let out whatever you’ve been carrying in your head, and talk about issues that are hard to discuss with your family and friends. When I was younger, I didn’t realize there were different types of therapy available, or that depending on what I was struggling with, I might have to “shop around” for a therapist (and therapy style) that was right for me. 

Depending on what’s available in your area or what your insurance will cover, you might not have the luxury of shopping around. But, if you are in a position to choose between a few or multiple therapists, it can be nice to know what you’re looking for. While this article won’t go into all the specific acronyms you might run into when scrolling through online listings of mental health professionals (CBT, DBT, and EMDR, oh my!), we are going to zoom back to understand two different therapeutic approaches you might encounter. 

It’s important to note that many therapists nowadays have a more eclectic style, meaning they may pull knowledge from multiple ways of practicing. But, especially if you’re interested in specific kinds of behavioral therapy, it is important to find someone who is certified and experienced in the type of therapy you’re interested in receiving. Instead of searching through individual therapists, you might also try going through a mental health clinic or agency in your area that offers specialized group or individual therapy around a specific type of therapy. 

To get you started, here are the basics on two schools of therapy you might run into: psychoanalysis and behavioral therapy. 

What Is Psychoanalysis?

For many, the word “psychoanalysis” brings to mind images of a person lying on a couch, interpreting ink blots, and describing their dreams to an old white man as he sits in a chair and takes notes. While this isn’t what psychoanalysis necessarily looks like today, it’s honestly not that far off from how it started. Austrian neurologist Sigmund Freud, the father of psychoanalysis, was, indeed, an old white man, who did have his clients share their dreams and deepest desires as he helped them uncover what was beneath the surface. 

Today, we understand that many of Freud’s theories and beliefs about human behavior are outdated and frankly sexist — do yourself a favor and Google: penis envy – but, he did contribute to our modern understanding of the subconscious. Think of that classic iceberg metaphor. Above the water is what we’re conscious of – our current thoughts, what we can observe in our world, what we remember, and (sometimes) how we feel. Underneath the surface, though, is an entire subconscious part of our mind that still influences our behaviors, thoughts, and feelings. The idea is that by exploring that subconscious part of our mind, and breaking down the defense mechanisms that prevent us from accessing it, we can gain a deeper understanding of ourselves and our behavior, which can in turn improve how we show up in our lives.

Therapists who take a psychoanalytic or psychodynamic approach, then, are interested in helping people discover what’s underneath the surface. As you work with a psychoanalytic therapist, they can help you make sense of what’s happening in your life now, how your current behavior might relate to past experiences, what mental blocks might be getting in your way, and how you can use this information to ultimately create a better life for yourself. 

Many modern therapists use a combination of approaches.

When You Might Want Psychoanalysis

Psychoanalysis is used to support people with a range of mental health concerns such as low self-esteem, general emotional distress, anxiety disorders, and depression. You might benefit from this therapeutic approach if you enjoy talking things out, exploring your past, and getting to the root cause of your issues. (Childhood trauma, fun!) The therapeutic relationship is also really important in this type of therapy, and sometimes just knowing you have someone to talk to every week about what’s going on in your life can have a positive benefit. 

Potential Downsides of Psychoanalysis

While no therapy is a quick fix, psychoanalysis is known for being a longer or slower process. It’s not as solution-focused as other types of therapy, and might be frustrating if you have a specific issue you’re hoping to tackle now

What Is Behavioral Therapy? 

Behavioral therapy is less concerned about the subconscious mind. Instead, it focuses on aspects of self that are observable – namely, our behaviors, our environment, and the thoughts we have about our behaviors and our environment.

If you’ve taken a psychology class, you’ve likely heard of Ivan Pavlov and his dogs; this experiment, which basically trained dogs to salivate at the sound of a bell using a concept called classical conditioning, is the most simple way to think of behavioral therapy. Behavioralists believe that just a dog can be trained to salivate when he hears a bell, most of our behavior – both positive and negative – is learned from external stimuli. Therefore, we can be “trained” to rewire these patterns of behavior using different skills. There are specific types of behavioral therapy that each add their own flair and set of acronyms (if you know, you know) to this general concept of “retraining” your brain.  

  • Cognitive behavioral therapy (CBT): Focuses on how our thoughts, feelings, and behaviors interact with each other, offering strategies that help us challenge negative thinking patterns and resist negative behavioral patterns. It is often used for people with anxiety and depression.
  • Dialectical behavior therapy (DBT): A modified form of CBT, it was created specifically for people who struggle with intense emotions and interpersonal relationships. It’s most commonly used to treat people with borderline personality disorder.
  • Acceptance and commitment therapy (ACT): A mindfulness-based approach, ACT emphasizes acceptance strategies and psychological flexibility. It’s a great option for people with anxiety and depression who want to focus on their values. 
  • Exposure therapy: This type of therapy slowly exposes you to a trigger to help you become desensitized to it. It’s mostly used for people with specific phobias, obsessive-compulsive disorder, and trauma.

When you might want behavioral therapy:

Behavior therapy can be a great tool when there are specific behaviors or thought patterns you’re trying to tackle. This especially might be a good option for people who like structure, want specific skills to help them tackle their problems, and who care less about exploring the subconscious motivation behind their behaviors. 

Potential downsides of behavioral therapy:

As previously mentioned, much of the theory behind behavioral therapy has its roots in studies on animals, but alas, humans are more complicated than Pavlov’s dogs. If it’s not practiced with nuance, behavioral therapy can feel a little rigid and might not flow with your personality type if you don’t like being told what to do. Like with any type of therapy, there’s cultural considerations, and it’s important to acknowledge you can’t “retrain” your brain to solve problems caused by factors like racism, poverty, and other societal forces. 

The most important thing is that you’re getting the emotional support you deserve.

Which One Is Right for You? 

The great news is you are not doomed to choose one over the other. There might be points in your life when you’ll benefit from a talk therapist with a more psychodynamic approach, and other points when you’ll crave a more structured, behavioral approach. It’s also important to consider what type of challenge you’re facing. For example, for those with OCD, exposure and response prevention (ERP), a type of behavioral therapy, is typically recommended over psychoanalytic therapy. Your trauma history is also a consideration, and here you can find a list of therapies recommended for people with trauma. 

And if you’re someone who wants a therapist simply because you need someone to talk to, there is nothing wrong with that. As I mentioned before, many modern therapists use a combination of approaches, so even your talk therapist who seems more psychoanalytic on the surface might offer coping skills and behavioral interventions for you to try. The most important thing is that you’re getting the emotional support you deserve, even if that means looking for something entirely different. Either way, we’re rooting for you! 

Getty Images illustration via PrettyVectors

Originally published: April 29, 2022
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