Traditional Approaches to Psychotherapy

All psychotherapies move as directly, swiftly, and effectively to the heart of a problem as the validity of their explanations enables them to do. The manner of treating patients has always been derived from what made sense according to some understanding of the ailment. Most therapies, however, had blindly groped for solutions to problems that were partially or dimly illuminated, if at all, in their theoretical framework. A few therapies have developed from serendipitous discovery of something that seems to help people--without persuasive explanation of why or how it helped (as in eye movement desensitization). For these a rationale attempting to explain the process was usually developed later.Each school of psychology has devised treatment strategies relying largely on whatever they have posited as the key factors in the illness. The current major groups are listed below in a simplified outline:
1. Biological psychiatry supposes that psychological troubles have their source in brain chemistry
2. Psychoanalysis considers all psychological illness as based in origins of personality development (with exceptions such as inborn deficits)
3. Cognitive theory postulates the key element to be faulty thinking (although in that school, workers appear to concentrate more on attitudes than on idea)
4. Behaviorism postulates the key element in pathology to be faulty or unfortunate conditioning
5. Popular psychologies consider key issues to be such matters as stored emotion, faulty self-attitudes such as inferiority complex, or temperamental difficulties such as "over" or "under" assertiveness
In fact, all those suppositions are imperfect. The treatment results for the classic neuroses, by the approaches of each school, corroborate the impression of weaknesses and deficiencies entailed in those theories. This suggests we are at an early stage in the development of the science. It needs more work. Although some treatment approaches for psychological disorders had been presented with little theoretic basis, even in those atheoretic psychologies the techniques fit with some defined principle (such as the hopeful, religiously based, somewhat mystical but persuasive "built-in drive for health" posited earlier in the nondirective therapies and visible again more recently in Kohutian "self" theory). Occasionally specific techniques have been offered without substantial supporting theory, but by the influence of an authority declaring them to be of value, have acquired undeserved credence. Overall, however, therapy techniques are usually carefully delineated applications of elaborate theoretical formulations of mental process, psychological development, symptom formation, illness, or health. Let us make comparisons as we consider treatment processes. In the course of our examination, we will find that a new approach offers not only more efficient and effective treatment, but also the possibility of actual cure of the illness rather than of the episode.