Our understanding of psychology has been developing since as long ago as 400 BC, but the professional practice of therapy as we know it today is as recent as the mid 1900’s. In all of that time, a lot of theories have been explored to understand the human mind! Some theories have been debunked, while others have remained strong. To effectively help people through mental health struggles, therapists need to have an idea about how the brain works.

Not so surprisingly, there are a few different angles to look at when considering the brain, starting with four over-arching theories: psychodynamic, behavioral, humanistic, and cognitive. Another not-so-surprising fact is that all four of these theories hold some truth about how human brains function, and what can go right or wrong over the course of life.

• Psychodynamic— Childhood Trauma Messed Up Your Unconsciousness
• Humanistic— People Are Good, and They Will Do Their Best When They Have What They Need
• Behavioral— We Do What We’re Rewarded For
• Cognitive— It’s Not the Problem That’s the Problem, It’s What You Tell Yourself About It

It’s common that depending on the issue you come to therapy with, a theory is chosen that is thought to be the best fit for the problem. If someone comes to therapy wanting to resolve childhood trauma, a psychodynamic approach might be best. Someone dealing with grief and loss may like a humanistic approach. Someone with an alcohol addiction may benefit most from a behavioral approach.. If the person is dealing with insecurity and invasive thoughts, then a cognitive approach may be chosen.

In reality, therapists often use elements of all four theories in order to help solve client issues, because often psychological problems are not so simple as to have only one cause. Mental health struggles usually have multiple causes and therefore need a flexible approach. 

However, it is still helpful to look at the different ways the human brain works, because finding something that resonates may help you reframe the issue so you can more clearly see the way out.

Seeing a problem through the lens of each of these approaches informs a therapist’s choice on how it should be treated.

So, what are these four approaches?

The Psychodynamic Approach

This approach is a fun one, because it is all about personality and childhood development. Sigmund Freud was the first to come up with the idea that people have an unconscious mind, and that this unconsciousness can influence our feelings and decisions. You are probably familiar with a few terms he has come up with, such as the ego and defense mechanisms (I will be sure to write more about these in the near future!).

According to Freud, our unconscious is made up of three parts: the id, ego, and superego. The id is the part of us that wants to pursue pleasure and avoid pain. The ego is the part of us that is logical and based in reality, so it tries to help the id get what it wants in realistic ways. The superego is our morality, which is often based on societal messages and what our parents taught us growing up. Theoretically, by understanding the arguments these three pieces of ourselves have with each other, we can better navigate the solution and treat all three perspectives as valid.

The psychodynamic approach also assumes that childhood experiences unconsciously influence who we are in the present. If we have learned a way to cope with struggles as a child, then we may continue to try to cope in the same way as an adult, even if it no longer works for the situation we’re in.

For example, if you were afraid of your parents’ anger growing up and coped with that by withdrawing, then maybe in your grown-up marital relationship you continue to withdraw at signs of conflict. This is an example of a defense mechanism, but one that is no longer applied to a fitting situation. Imagine how much better you might feel if you acted out other ways to cope with conflict that can result in problem-solving (such as communicating).

Carl Jung (pronounced Yung) built on Freud’s theories by creating an even more elaborate explanation of our unconscious with a personality system that you may already be familiar with, because it is the system behind the Meyer’s Brigg’s Personality Test. Although this test is often used for matching personality to job options, the system is much deeper than that. Jung identified four ways that our brains function: with thinking, feeling, sensing, and intuition. Our personalities differ from each other when we use these functions in a different order of priority, hence the sixteen personality types.

Jung also believed that what we hate in others is what we repress in ourselves. If your personality values having logical justification for emotion, then you may have a hard time dealing with decisions in others that prioritize feeling-based values over logic.

In this personality system, personality is a coping mechanism that is often not flexible enough to be what it needs to be in every situation. To be healthy, Jung believes we must balance all of our functions to become whole, or individuated, as he would call it. Working on expressing what you repress in yourself is called Shadow Work. Jung believes the only reason there are “bad” parts of our personality is because they are repressed, so working on expressing those repressed parts will bring out the healthy aspect of that side of ourselves.

The last perspective I will bring up related to psychodynamic theory is from Alfred Adler, who focuses on social theory. Adler focused on a person’s relationship with himself, others, and the environment, rather than just focusing on the self. Adler claimed that we form these relationships to self, others, and world at a young age of five or six, and that by becoming aware of these relationships we can intentionally question the messages we learned. Once again, this perspective is about making unconscious understandings conscious so that we can adjust them to be more accurate and useful.

Adler believed it is important to think about your earliest childhood memories to explore what messages you may have learned during that critical period. Adler also focused on birth order, familial patterns, and inferiority complexes as well.

Overall, the psychodynamic approach shows the impact of early childhood experiences on our personalities and coping mechanisms. The therapeutic goal, then, is to bring these unconscious needs and messages to light so they can be corrected and channeled into something more true and all-encompassing.

2. The Humanistic Approach

The Humanistic approach is all about the belief that people are good and genuinely want to solve their problems. People only become bad if they have obstacles or unhealthy situations. Therefore, the method used under this belief system involves building a healthy relationship with the client and giving them support as they sort through their problems.

Existential therapy is a type of humanistic approach that helps people sort out how to find meaning in their lives. This type of therapy is great for people who feel they have questions that run too deep, and have significant internal conflicts because of them. One big difference between the humanistic approaches and the psychodynamic approaches is that the humanistic ones focus on the present, and are less concerned with past experience.

Existential therapists want to know what the struggle is NOW, not then. They want the client to understand that they are supposed to be naturally free, and that they can take control of their fate if they decide to.

Another humanistic approach is called person-centered, or Rogerian therapy. This approach has a strong focus on the counselor-client relationship. A popular term called “unconditional positive regard” is used to refer to the counselor’s attitude towards their client. The counselor should have faith that their client is innately good and doing their best with the tools they have.

Person-centered therapy also has a strong emphasis on accurate empathy and authenticity. The counselor needs to be congruent with the client, showing that their personal beliefs and what they say in counseling are in line with each other. Person-centered therapists believe that when a client has a positive relationship with the therapist, they are inspired to change.

This approach does not prefer to use techniques or interventions to try to change anyone—instead, being with the client in this positive relationship is believed to inspire all the change that is needed.

During this type of counseling session, the counselor aims to help the client feel understood and heard so that they are ready to move on to further processing. The client leads the session by deciding what to talk about and what bothers them. The therapist serves to reflect the person’s feelings and meanings back to them to allow opportunities for insight.

Gestalt therapy, another humanistic approach, is very similar. This therapy focuses on getting the client to accept where they are at instead of thinking about where they should be at. There is a striving for balance here between making the environment better for the client and getting the client to work better with the environment. For example, if someone has social anxiety, instead of focusing on why they have it and why they believe it isn’t justified or rational, a gestalt therapist may encourage the client to try to change their environment to be more soothing (maybe by playing calm music and finding calming candle scents) and then also to try to adapt to their environment as well (through deep breathing when a situation is stressful, for example).

All three of these therapies (existential, person-centered, and gestalt) have a huge emphasis on the client relationship and prefer to allow the client the freedom to pursue their goals in a natural fashion, true to their nature.

3. The Behavioristic Approach

The behavioristic approach to therapy is one that works only on behaviors that can be measured and observed. The premise is that we are all subconsciously trained to do what we get a reward out of, such as crying in order to get support, or eating in order to feel comfort.

The behavioristic therapist is going to look at what is happening to cause the problem, and then how the person solves that problem. If we use the eating example, let’s say a person eats unhealthy snacks throughout the day and they want to stop. According to behavioristic theory, this behavior is resulting in a reward, which is why the person is doing it in the first place.

The act of chewing actually releases comforting neurotransmitters such as dopamine and oxytocin, so eating is often used as a stress-reliever. In that case, the therapist may say that when the trigger (or stimulus), of stress is present, this stress gets resolved through eating.

The therapist would then consider what other ways stress can be resolved, by maybe first transitioning to lower calorie snacks like celery or gum, and then to considering ways to remove the person from the stress or help them manage it through deep breathing or progressive muscle relaxation.

The ultimate goal is to replace the unhealthy way to get the reward (eating to feel comfort) to healthy ways to get the reward (muscle relaxation to feel comfort).

Behavioristic approaches are often used for addictions and behavior problems, but the theory can be applied to so much more. It is useful for family therapy, since people perform behaviors often to get responses from others, thereby enforcing that behavior when someone responds the way they want. Even certain feelings like helplessness or anxiety can be seen as ways to achieve reward, such as a sense of acceptance or protection. Behavioristic therapy can get deep!

4. Cognitive Approach

The cognitive approach is currently one of the leading frameworks in understanding mental health, and it integrates aspects of the other frameworks as this one expands into many variations such as CBT, DBT, and ACT. The premise of the cognitive approach is that problematic behaviors and emotions result from inaccurate thoughts or beliefs. These beliefs then trigger the brain to produce the emotions that those thoughts warrant. 

This premise is simplified into an A-B-C framework:

A. Activating event

B. Belief about A

C. Consequence

So, if someone is depressed, for example, their sadness is likely fueled by automatic negative thoughts. For some people, it may be hard to detect the thoughts at first, but that is what therapy is for, to help dissect beliefs and emotions to figure out what those are. So let’s say this depressed person doesn’t know why they are depressed, but when they go into therapy and talk about their sadness they say they don’t like to walk around town because they see functioning, happy people everywhere.

In this case, the activating event (A) is noticing other people.  The belief (B) is that those people are happy, but this person is not, so something is wrong with them. Therefore, the result is (C), sadness, because they maybe feel that they “should” be happy if they were “normal.” The feeling of being left out is valid, but if the thoughts are held to a logical standard they often do not hold up.

When these thoughts start to come to the surface, that’s when cognitive therapy really shines. Cognitive therapists believe that when people think more logically, the result is more effective problem-solving and more adaptive emotions. First, the core belief needs to be identified. In this example there could be a few core negative beliefs, such as “I am broken,” “I am being punished,” “I will never feel that way,” or many other options, depending on the person.

Often, the core negative belief is something that we started to believe in childhood, and have learned to detect throughout our lives, even if it is untrue or not a fair thought.

There are lists of logical fallacies one could go through to check on the accuracy of the thought: all-or-nothing thinking, catastrophizing, overgeneralizing, “shoulds”, jumping to conclusions, magnification, personalization, and many more.

By focusing on correcting these negative thoughts, the resulting emotion will not be nearly as damaging, and allow for a healthier response to scary feelings. Hence, cognitive-behavioral therapy, or CBT (the combination of cognition and behavioral theory to resolve a problem).

There are even cognitive-behavioral therapy apps, such as MoodTools and Clarity that help you do CBT on your own!

Through the lens of psychodynamic, humanistic, behavioral, and cognitive therapies, the process of therapy helps in different ways. Because all of us have different personalities, different proportions of each theory affects us. Some people are much more held back by their past than others. Some people struggle more with addiction (behavior). Others struggle with over-thinking while others don’t have much of an internal dialogue. Despite all of these differences, all four of these approaches, especially when combined, are proven to be effective on a myriad of mental health struggles.

Hopefully this summary helps you understand how counseling theories help therapists walk people through their problems. You may even have an idea of the framework that would be the most powerful for you!

References

Simmons, R. T., & Kuhnley, A. M. K. (2019). Introduction to counseling: Integration of Faith Professional Identity and Clinical Practice.