The term psychotherapy (Greek : heal the soul) represents a generic term for the combination of a large number of theories and methods, with different theoretical foundations, to remedy a disorder of both emotional state and behavior. The methodology for overcoming the disorder is based on verbal interaction between therapist and patient. According to psychotherapist Strotzka’s theory, which is still valid today, psychotherapy is an “interactional process for influencing behavioral disorders and states of suffering by means of teachable communicative techniques based on a theory of normal and pathological behavior” (1978). Thus, the basis of successful treatment is a viable therapeutic relationship between the patient and the treating therapist. From a historical and methodological point of view, psychotherapy can be divided into modern therapy, traditional therapy and “treatment of the insane”. Already the ancient Romans and other advanced civilizations of the antiquity spoke about psychic changes of people. As a consequence of unachievable and also undesirable integration of the mentally ill, the first special institutions for the mentally ill were founded in the 12th century, for example in Cairo and Frankfurt. The treatment of people in these homes is described as either benevolent or torture for the “lunatic,” depending on the place and era. In the Middle Ages, the opinion about mentally ill people changed to the extent that these persons were considered to be possessed by the devil and were persecuted. Also in the 17th and to some extent still in the 18th century, the view of the ill resembled prisoners in penitentiaries rather than patients in hospitals. Only the later traditional psychotherapy of the 18th century, which is interpreted as a consensus of medicine and psychiatry, is decisively based on the research results of the physician Franz Anton Mesmer (1734-1815), whose theory of magnetic animalism can be seen as a counter-opinion to exorcism, which was applied as therapy at that time. According to him, a balance of “bodily humors and bodily energies” is needed to treat an existing emotionally induced disease. Although this rationale for treatment can by no means be justified scientifically, his therapeutic measures nevertheless represent the beginning of traditional psychotherapy, as his interpretations of animal magnetism led him to treat patients with modern hypnosis. At the end of the 19th century, psychotherapy developed rapidly as a result of the influence of Sigmund Freud and other important psychotherapists or psychoanalysts. Various subgroups emerged from the generic term of psychotherapy.
Indications (areas of application)
- Psychological distress due to the presence of a “mental illness“.
- Processing of grief as a counseling of the patient
- Depression
- Anxiety disorders
The procedure
As already mentioned, the concept of psychotherapy is by no means a therapy based on a theory, but various psychotherapy procedures:
- Psychoanalytic therapy – this form of therapy refers to a procedure based on the uncovering of unconscious conflicts, using psychoanalytic treatment methods. An example of this would be the standard psychoanalytic model according to Freud. The principle of this treatment is the long-term and intensive care of a patient and the setting (the patient relaxes on a couch while the therapist sits behind him out of sight of the patient). The patient is asked to communicate his thoughts to the analyst as uncontrolled as possible. In response to the information released by the patient, the therapist should allow self-interpretation of what is said, and in no case make his own interpretation of what is heard.
- Behavioral therapy – this therapy method consists of various sub-forms (e.g., cognitive behavioral therapy (KVT)), all of which have in common that this should stimulate help to self-help. After clarifying the origin of the behavioral patterns, it is the therapist’s task to present the patient with methods to reduce his suffering and expand his ability to act. The focal points for influencing behavior are social interactions as well as a change in the social environment.From the above points, the main principle of behavioral therapy can be derived – the training and promotion of self-acquired abilities for improved self-regulation (strengthening of self-control). The ability of human beings to renew themselves independently after deep crises is described by the term resilience.In order to identify the patient’s suffering and problems, a behavioral analysis according to Kanfer’s SORKC model is carried out at the beginning of the treatment in order to find out the origin, maintenance and possible consequences of the behavior. In order to achieve the therapy goals in several sessions following the analysis, a treatment form is chosen. On the one hand, there is the possibility of achieving the treatment goal by means of confrontation with the problem in need of therapy, on the other hand, an implementation of an operant procedure (procedure whose principle is based on the use of reward and punishment) or a cognitive procedure (interpretation and transformation of experiences made) should also be considered.
- Client-centered conversational psychotherapy – a model developed by Rogers (1902-1987) to motivate the patient to self-exploration (discovery of oneself) by means of verbalization of feelings. The therapist’s task is to offer support and acceptance of the patient’s problems. According to Rogers, the person is able to work out solutions for himself through this assistance. The function of the treating therapist is to be seen in the exercise of compassionate behavior.
- Humanistic psychotherapy method – a method such as Gestalt therapy counted among this form of therapy is based on the principle that the patient communicates fears and confrontation points instead of verbalizing them by means of physical expression.
- Body therapy – similar to Gestalt therapy, here a confrontation should be defused primarily by exploiting physical experiences. An example of this would be the bioenergetics method according to Lowen.
- Relaxation techniques – as the best known and most important representatives here are autogenic training (training of the subconscious), progressive muscle relaxation and hypnosis. All have in common the goal of enabling a state improvement with the help of relaxation.
- Systemic psychotherapy – it is a collection of procedures that consider a mental stress as a disorder of the system (as examples family or profession). Based on this, the interaction in the system is improved and thus an improvement in the patient’s condition is achieved.The Joint Federal Committee (G-BA) has confirmed the benefits and medical necessity of systemic therapy for adults for five areas of application. Among them are the most common disorders anxiety and obsessive-compulsive disorders and affective disorders (depression).
