Cognitive Behavioral Therapy vs. Psychoanalysis

Nov 26, 2020

The therapy stereotype conjures up images of a patient, recumbent on a sofa, talking to a therapist with an unchanging, enigmatic expression. The patient talks about their problems, occasionally looking at the therapist, and comes to conclusions about their mental/emotional state in response to the therapist's silence. This notion of therapy touches several key aspects of Freudian psychology and the psychotherapy that was derived from it, but is not representative of cognitive behavioral therapy (CBT).

Origins of Therapy

In the late 1800s and early 1900s Sigmund Freud, building on the model of "talk therapy," became known as the father of psychotherapy. The basic idea at that time was that by letting the patient talk at length with little interference they would drop unconscious hints about the nature of their problems. The therapist would then interpret the monologue and its hidden meaning to root out the source of the patient's problems. This formed the basis of psychotherapy up until the 1970s when new ideas about psychological problems were coalescing.

A New Kind of Therapy

By the mid 20th century many psychologists were taking a more scientific look at psychotherapy. The philosophical exploration of the unconscious championed by psychoanalysts was giving ground to provable methods that could be examined empirically. Much focus was placed on mental processes and "cognitive psychology" became a field of study. Rather than delving into the patient's unconscious and piecing together unprovable theories about the nature of their problems, psychiatrists began focusing on the patient's problems and helping them develop coping strategies.

The Essence of Cognitive Behavioral Therapy

Originally used to treat depression, CBT has been adapted to treat a wide range of problems. The premise of CBT is that it is used to treat specific problems related to a diagnosed disorder. For example, if a patient has anxiety the therapist will focus on specific causes of that anxiety, and ways to help the patient cope with those causes. In the common vernacular this could be thought of as a "common sense" approach to dealing with mental health. Instead of delving into the underlying causes of why someone is the way they are, as is done with psychoanalysis, CBT looks to challenge behavioral patterns and beliefs and correct errors in thinking. If one engages in the same series of problematic behaviors, looking for ways to change those behaviors is a viable solution.

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