About Therapy

There are many ways of classifying various psychotherapeutic approaches, so please bear in mind that this is just one way of attempting such a classification.

Broadly speaking, there are two types of therapy. Firstly, we have those which posit that human suffering and uncertainty are symptoms of cognitive distortions (irrationality) or disorder (impaired cognitive function).  These I will call medical approaches, because they consider suffering to be a deterministic symptom of an underlying fault. With medical approaches, the great assumption exists in deciding what constitutes ‘normal’ or ‘healthy’ functioning. This involves demarcating a threshold, beyond which we call something a disorder. Although this threshold-requirement for diagnosis exists in most physical medicine too, where medical signs become clinically significant at particular points (eg, a diagnosis of diabetes will be made with particular blood sugar readings, and these will vary slightly from country to country), it is more philosophically complex to decide upon a threshold-requirement for the normal functioning of our emotions and sense of self. Medical approaches might suit those who want to engage in systematic and peer-reviewed approaches, where more of a directive approach is taken by the therapist, and in which they are in the position of the ‘patient’. Those for whom the idea that the mind and emotions are an organ no different to the body, might also find some resonance in medical approaches. Psychiatry, behavioural therapy (e.g. exposure therapy), and cognitive behavioural therapy (CBT) are all examples of medical approaches. 

Secondly, there are approaches which relate to the human person without medicalisation or focusing on distortion and disorder. These approaches can offer frameworks and ideas, but tend to do so tentatively to see if they are useful to the client, rather than as absolute truths. ‘Humanistic’ is the title often given to the collection of approaches best represented by this starting point. Humanistic approaches usually aim towards what the client chooses, rather than at lessening particular symptoms. Indeed, in humanistic therapy, the focus could be on flourishing, the good life, or happiness, and not focussed only on life challenges. Person centred therapy, Gestalt therapy and Existential therapy are three humanistic approaches. Humanistic approaches might be suited to those who want more of an active role in their own therapy. It may also suit those who are predisposed to a belief that their suffering happens for reasons, rather than being a symptom of irrationality or ill health. 

We might also make room for a third camp, which sits somewhere between the medical and humanistic approaches. This camp is the home of psychoanalytic and psychodynamic approaches. These approaches do have a somewhat mechanistic and deterministic foundation. For example there is a tendency to believe that all unexplained disorder comes from a lack of understanding our unconscious), and their direct grandfather is Sigmund Freud, who thought of psychoanalysis as analogous to physical process of archaeology (where layers of unconscious past experience are uncovered). And yet these approaches tend to be client-led. They therefore sit somewhere between medical and humanistic on my overview. 

Though I hope this brief overview is helpful, I would also caution that it is used tentatively. There will be exceptions to the categories here. Some psychiatrists who work as psychotherapists will be non-directive and client led, while some person centered therapists might give you homework! All approaches endeavour to help a person access new perspectives on their experience. The title of this website is Retreat Forwards, and all therapies should offer their own particular kind of stepping back from our lives in order to move forwards with more clarity.