Psychodynamic and Cognitive-Behavioral Approaches (Essay Sample)

Psychodynamic and Cognitive-Behavioral Approaches
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Abstract
Depression is a condition that causes acute symptoms, which affect your mood, thinking, behavior and just any of the essential daily activities. According to ADAA (Anxiety and Depression Association of America), depression is one of the most frequent mental disorders in the United States. The core symptoms of the severe depression are a loss of interest or pleasure and depressed mood. However, according to DSM-IV (American Psychiatric Association, 1994), the depression as a diagnosis can only be appointed after experiencing five or more symptoms for more than two weeks. The issue has been carefully studied by the two principal schools of psychiatry and clinical psychology for more than half a century. Both psychodynamic and cognitive-behavioral approaches have major strengths and limitations in curing the symptoms of depression.
Keywords: depression, cognitive-behavioral approach, psychodynamic approach.
Psychodynamic and Cognitive-Behavioral Approaches
From its invention, the psychodynamic approach has undergone many changes and today embodies the works of the most prominent people in the history of psychiatry. Dr. Sigmund Freud, Jung, Erikson, and Adler are among those whose theories comprise the foundation of the psychodynamic approach that helps to fight not only depression but also other heavy mental problems such as anxiety and various traumas. Meanwhile, Albert Ellis and Aaron T. Beck were the key figures involved in the development of a cognitive-behavioral theory, setting the basic tenets for the approach. This method has its origins from both psychodynamic and behavioral theory and comprises some different therapies that have some similar elements in common.
The central postulate of the psychodynamic approach is deriving from the belief that every mental dysfunction that takes place is due to the conflict between unconscious and subconscious processes (Freud, S., 1957). Thereby, such processes affect one’s behavior, emotions and eventually makes an unaware individual see the world from a negative viewpoint. Since this approach was mainly based on Freud’s earlier psychoanalysis theory, it comprises some ideas concerning interrelations of the mind’s forces. It is assumed, that an unconscious mind has its divisions, which create one’s whole identity. However, at a certain age, these unconscious parts may come into conflict with one another and make a so-called fixation where a child develops a strong bond with a psychosexual stage. Thereby, the focus of the therapy is to detect which stage is in charge of the depressive symptoms and make an individual aware of the background occurred in the childhood. Eventually, the person should have an insight into the problem to change his behavior and perspective on things. The approach has various techniques including free associations, dream analysis, projective tests, hypnosis, etc. However, the natural defense mechanism of the unconscious tends to make it more complicated for the therapy to reduce the depressive symptoms. Thus, the process of treatment stretches out and includes several sessions per week for a couple of years. Some note that the actual approach lacks general studies and profound data. Freud himself had described the useful experience with his patients; however, other researchers claim that some of these methods are limited and have downsides concerning the performance. For instance, Shapiro and Emde (1991) determined that the use of the psychodynamic approach for reducing the depressive symptoms might have only occasional success. One of the reasons for such conclusion is based on the presumption that people with severe depression are rarely to participate during the session due to the motivational issues.
Albert Ellis questioned whether the personal insight that psychoanalytic theory assumed led to therapeutic change resulted in permanent changes in behavior: The other one is that the whole treatment process can take several years to obtain a result and as it is a quite long-lasting process people may quit the therapy early. There is also a presumption that when applying certain types of techniques, for example, the free association method, it can be hard to achieve any visible results if the person shows resistance to the therapy. Salzman (1980) has proved that the psychodynamic approach can be successful in treating general anxiety unlike any of the depressive symptoms. In general, one of the most severe points the approach has developed during the existence is an importance of a childhood experience involved in our psyche. It has also made several of the methods like projective tests and free associations global and used to treat some of the mental disorders. It also highlights the importance of the defense mechanisms and the key role they play during the therapy. Rachman and Wilson (1980) described that there is no acceptable evidence to support the view that psychoanalysis as an effective treatment. Historically, psychodynamic theories were extensively criticized for their lack of empiricism.
On the other hand, the cognitive-behavioral approach emerged in the early 1960s (Ellis, 1962) and it focuses on three major processes, thoughts, feelings, and behavior. In particular, the thoughts are the ones that trigger the other two aspects to work differently. However, it was not until the 1970s when the comprehensive set of data was published (Kendall & Hollon, 1979; Mahoney, 1974; Meichenbaum, 1977). There were three basic principles in the foundation of the approach:
1. Cognitive activity mostly affects the behavior.
2. Cognitive activity can be controlled and changed.
3. The change in behavior is made through cognitive adjustment.
The key to the cognitive-behavior therapy is to help an individual to develop different thinking patterns and as a result, minimize the adverse outcome. The short-term symptom relief was found during the early cognitive-behavior approach therapies based on the psychodynamic background (Ellis, 2005; Beck, A. T, & Steer, R. A., 1993). However, more and more methods were discovered over the years, which resulted in a variety of procedures today. Rational-emotive behavior therapy (REBT) is regarded to be a premiere example of the cognitive-behavioral approach. At the core of REBT is the assumption that human thinking and emotion are significantly interrelated. According to Ellis’s model, symptoms are the consequences of a person’s irrational belief systems regarding particular activating experiences or events. The goal of therapy is to identify and challenge the irrational beliefs at the root of emotional disturbance. REBT assumed that individuals possess innate and acquired tendencies to think and to behave irrationally. Thus, to maintain a state of emotional health, people must continually monitor and challenge their core belief systems. REBT employs a multidimensional approach that incorporates cognitive, emotive, and behavioral techniques.
What distinguishes the psychodynamic approach from the cognitive-behavioral one is the nature of their focus. Cognitive-behavioral therapy focuses attention on how a person thinks. It means that thoughts are responsible for how a person feels and reacts. Thus, the aim of the approach is to identify and change the dysfunctional patterns of thought. On the other hand, the idea of the psychodynamic approach roots back to the Freud’s psychoanalysis, which describes that a behavior of an individua...