Are you looking for psychological treatment, but not quite sure where to start? With many new types of therapy available, under many umbrellas of psychological services, we’re here to try and offer some light on a somewhat ‘historical split.’
In 2016, the Guardian published an article discussing the many differences between psychoanalysis and Cognitive Behavioural Therapy (CBT).
CBT became the dominant form of therapy available in the NHS, largely due to it’s short-term treatment time, and therefore overall cheaper cost. CBT focuses on the present, rather than the past, which can be favourable to some patients. It has a down-to-earth technique, which focuses not on the mysterious inner workings of the ‘unconscious,’ but rather conscious thought patterns. Flowcharts, diagrams and drawings are made use of to provide visual aids and colourful assistance.
Psychoanalysis on the contrary, was originally developed by Freud in the nineteenth century, as a form of long-term, intensive treatment for patients. His theory encompasses notions of the unconscious, resistance and symptom formation, neurosis and psychosis, and transference / counter-transference between patient and therapist. Patients are asked to ‘free-associate’ and speak whatever comes to mind, often on a couch, and with a warm neutrality the analyst can infer what this reveals about their unconscious wishes and desires.
CBT has experienced criticism, primarily due to the suspiciousness around it’s cheapness appealing to cost-cutting politicians wanting patients back in work.
Historically, psychoanalysis has also fallen out of favour, due to it’s high consulting fees, and often misinterpreted yet uncomfortable formulations around infant development. Critics have ridiculed notions that little boy’s are in love with their mothers, and fear their father’s castration, claiming that psychoanalysis is largely a ‘con.’
CBT as a model typically views negative or painful emotions as something to be eliminated. Life and your happiness is relatively simple, and it’s within your power and control to challenge or change your beliefs.
Conversely, psychoanalysts contend that things are more complicated. Psychological pain needs not to be eliminated, but understood, in order to enrich your understanding of yourself, and have a truly meaningful life. Pain can therefore often be interpreted as a signal for action; action to find out something you may not want to face. Humans are complicated, and we often wish for contradictory things, see our lives through the lens of our first relationships, and change can be slow and hard.
A study in May 2015 revealed that CBT was becoming less effective as a treatment for depression over time, despite its previous impressive results. Furthermore, the London Tavistock’s clinic in October published its results from an NHS study that long-term 18-month treatment of psychoanalysis for depression was much more long-lasting than CBT.
It is sadly true that many senior psychotherapy posts in the NHS have over the past few years been replaced with CBT junior therapists. We hope for a balanced view to be promoted, in which CBT can be recognised as a valid brief intervention, with psychoanalytic treatments being used for more complex mental health issues addressing more deep-seated problems.
Please note, the London Clinic of Psychoanalysis continues to provide a low-fee service supported by charitable means.