Alleviating Distress

The goals and techniques of psychotherapy were first discussed by the
psychodynamic theorists who originated the modern practice of psychotherapy.
Sigmund Freud and Josef Breuer are generally credited with describing
the first modern case treated with psychotherapy, and Freud went
on to develop the basis for psychodynamic psychotherapy in his writings between
1895 and his death in 1939. Freud sat behind his patients while they
lay upon a couch, so that they could concentrate on saying anything that
came to mind in order to reveal themselves to the psychotherapist. This also
prevented the patients from seeing the psychotherapist’s reaction, in case
they expected the psychotherapist to react to them as their parents had reacted.
This transference relationship provided Freud with information
about the patient’s relationship with parents, which Freud considered to be
the root of the problems that his patients had. Later psychodynamic psychotherapists
sat facing their patients and conversing with them in a more conventional
fashion, but they still attended to the transference.
Carl Rogers is usually described as the first humanistic psychotherapist,
and he published descriptions of his techniques in 1942 and 1951. Rogers
concentrated on establishing a warm, accepting, honest relationship with
his patients. He established this relationship by attempting to understand
the patient from the patient’s point of view. By communicating this “accurate
empathy,” patients would feel accepted and therefore would accept
themselves and be more confident in living according to their wishes without
fear.
Behavioral psychotherapists began to play a major role in this field after
Joseph Wolpe developed systematic desensitization in the 1950’s. In the
1960’s and 1970’s, Albert Bandura applied his findings on how children
learn to be aggressive through observation to the development of modeling
techniques for reducing fears and teaching new behaviors. Bandura focused
on how people attend to, remember, and decide to perform behavior they
observe in others. These thought processes, or “cognitions,” came to be addressed
in cognitive psychotherapy by Aaron T. Beck and others in the
1970’s and 1980’s. Cognitive behavioral therapy became a popular hybrid
that included emphasis on how thinking and behavior influence each other.
In surveys of practicing psychotherapists beginning in the late 1970’s, Sol
Garfield showed that the majority of therapists practice some hybrid therapy
or eclectic approach. As it became apparent that no one model produced
the desired effects in a variety of patients, psychotherapists used techniques
from various approaches. An example is Arnold Lazarus’s multimodal behavior
therapy, introduced in 1971. It appears that such trends will continue
and that, in addition to combining existing psychotherapeutic techniques,
new eclectic models will produce additional ways of understanding psychotherapy
as well as different techniques for practice.
Sources for Further Study
Garfield, Sol L. Psychotherapy: An Eclectic Approach. New York: John Wiley &
Sons, 1980. Focuses on the patient, the therapist, and their interaction
within an eclectic framework. Written for the beginning student of psychotherapy
and relatively free of jargon.
Goldfried, Marvin R., and Gerald C. Davison. Clinical Behavior Therapy. New
York: Holt, Rinehart andWinston, 1976. An elementary, concise description
of basic behavioral techniques. Includes clear examples of how these
techniques are implemented.
Goldman, George D., and Donald S. Milman, eds. Psychoanalytic Psychotherapy.
Reading, Mass.: Addison-Wesley, 1978. A very clear, concise treatment
of complicated psychodynamic techniques. Explains difficult concepts
in language accessible to the layperson.
Phares, E. Jerry. Clinical Psychology: Concepts, Methods, and Profession. 3d ed.
Pacific Grove, Calif.: Brooks/Cole, 1988. An overview of clinical psychology
that includes excellent chapters summarizing psychodynamic, behavioral,
humanistic, and other models of psychotherapy. Written as a college-
level text.
Rogers, Carl Ransom. Client-Centered Therapy. Boston: Houghton Mifflin,
1965. A classic description of the author’s humanistic psychotherapy that
is still useful as a strong statement of the value of the therapeutic relationship.
Written for a professional audience, though quite readable.
Teyber, Edward. Interpersonal Process in Psychotherapy: A Guide to Clinical
Training. 3d ed. Pacific Grove, Calif.: Brooks/Cole, 1997. An extremely
clear and readable guide to modern eclectic therapy. Full of practical examples
and written as a training manual for beginning psychotherapy
students.
Wolpe, Joseph. The Practice of Behavior Therapy. 4th ed. Elmsford, N.Y.:
Pergamon, 1990. Written by the originator of behavioral psychotherapy.
Introduces basic principles, examples of behavioral interventions, and
many references to research. Initial chapters are elementary, but later
ones tend to be complicated.
Richard G. Tedeschi
See also: Cognitive Therapy; Drug Therapies; Psychoanalysis; Psychoanalytic
Psychology. 704