Addressing mental health can be confusing. There are numerous organisations and different methods that deal with what comes up for an individual. Some organisations are crisis based and provide immediate, short-term, practical help for you. Others are varied and have longer-term goals. Whilst there are overlaps, we outline a route map for you to find a pathway to what you need. It helps to understand the difference between the talking therapies and other types of mental health interventions.
Crisis organisations are based on immediate help and relief for those in extreme danger to themselves or from others. These can involve centres that deal with rape, domestic violence and abuse, or drug and alcohol rehab centres. Hospitals can have specialist units and psychiatrists to deal with self-harming, suicidal ideation or psychotic episodes.
Crisis organisations provide legal and practical help to physically remove you from the danger and threat to your mental (and/or physical) health. They often provide group and individual therapy to help restore your sense self so that you can function with better decision-making abilities, and protect yourself from future danger.
Counselling is based on the fundamental principles of all the talking therapies. In counselling, you are not given answers and told what to do as in a treatment plan. The training for counselling is specific to helping individuals understand themselves. By reflection on your life situations, you identify your problems more accurately, then find your own solutions. The focus here is on current and present problem-solving. It is often referred to as the humanist therapies.
Typical approaches to this come from Person Centred Counselling (based on Carl Rogers), Transactional Analysis (based on Eric Berne) and Gestalt Therapy (based on Fritz Perls). Humanist counselling always assumes that you know the answers that lie within you better than any counsellor or therapist ever can. Specific techniques help you to get there through an inner journey with yourself.
Psychotherapy is based on three things.
Firstly, it is a talking therapy rather than a medicalised treatment (see Psychiatry below) based on the pioneering work of Sigmund Freud and his colleague Josef Breuer in 1895. Secondly, it assumes that the negative ways in which you behave, think and feel is caused by dominating or traumatic factors in your past. This refers to your parents, your brothers and sisters or relatives, your early schooling, and the authority figures you meet in the social world outside the home. Thirdly, it assumes that your past is always hidden from you because we have to get on with life. But that hiding creates powerful urges, compulsions, addictive behaviours, destructive patterns and drives that overrule our rational thinking. We do things we do not want to do because of what we suppress or repress in the subconscious, making them unconscious.
Shining a light on our repressed past and hidden subconscious-unconscious gives us choices over the deepest and most powerful influences on our minds. This long-term approach dedicated to the subconscious or unconscious drives is often called “depth psychology”. It is based on the work of several people who developed the work of Freud and Jung, referred to as post-Freudian and post-Jungian therapists. The focus of this work is on your past.
Transpersonal psychology is a therapy that allows for a spiritual dimension in therapy. It’s goal is to help you find your own spirituality rather than any religious, organisational or dogmatic faith being forced upon you. Whilst there are many elements of transpersonal psychology in Jungian therapists, the more formal training for this can be found in Psychosynthesis schools. The focus of this work is on realising your potentials rather than just unblocking your past dysfunctions.
Cognitive Therapies are also a talking therapy. They are based on the assumption that you can change negative beliefs, or mindsets and behaviours, by learning to think differently about yourself and your problems. Thought and thinking is developed to overcome affect (feelings and emotions), but in a gradually learned process with the therapist.
CBT (Cognitive Behavioural Therapy) focuses on the negative beliefs inside yourself. DBT (Dialectical Behavioural Therapy), based on the work of Marsha Linehan, focuses on negative feelings about other people and in relationships. CAT (Cognitive Analytical Therapy), based on the work of Anthony Ryle, looks at some past family events that contribute to negative thoughts, often referred to as psychodynamic elements. Linked to this is some important work from Anthony Bateman and Peter Fonagy on what they call Mentalisation Based Therapy. This seeks to restore a thinking capacity within you before you proceed to look at yourself in depth. The IAPT (Improved Access to Psychological Therapies) was launched in 2008 after the campaigning work of Lord Layard for the NHS. It provides talking therapy for people struggling with severe symptoms, episodes or personality disorders, but usually requires a psychological assessment before services are provided.
In all of these approaches, thinking your way out of your problems is the goal.
Psychiatry is not a talking therapy. It is a mental health solution based on medication for very extreme psychological conditions. It is practiced and run by trained and qualified doctors. Psychiatrists are often referred to by GPs and doctors for the correct drugs and dosage that you may require. Together, psychiatrists, psychologists and doctors make an assessment based on behaviours and symptoms, aiming to contain, reduce or alleviate them. Psychiatrists use the DSM 5 (Diagnostic Statistical Manual Version 5) to classify symptoms and behaviours, from which they measure the severity of your symptoms. Psychiatry provides a pharmaceutical treatment.
Psychology is a science based on external behaviours and symptoms. In mental health, it provides a number of inventories, scales of measurement or an index to assess the severity of your condition. Psychologists work closely with Psychiatrists and GPs to provide further psychological evaluations for the NHS or for social workers. Psychology evaluations are particularly important for referrals to IAPT (Increased Access to Psychological Therapies) offered by the NHS.
The word therapy is popular because it implies an authority and knowledge about the human mind. As you can see here, it is used in different ways. There is no monopoly of knowledge or single approach about how you resolve the dysfunctions of your mind or personality disorders.
When looking for help in mental health, try to keep these different options in mind.
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