What kind of therapy is right for you?

Hillary McBride is a therapist — but she's not your therapist. 

If you've listened to Other People's Problems, you've heard the podcast's host make this disclaimer. But if you don't have a therapist of your own, or haven't familiarized yourself with the different kinds of therapy, here's a quick overview of the main camps. 

The right fit

According to the Canadian Mental Health Association, one in five people living in Canada will experience mental illness in any given year. Therapy offers one path forward. 

"With an effective therapist, science shows that psychotherapy even works better in the long-term and is more enduring than medication," researchers A. Brownawell and K. Kelley note in their paper Psychotherapy Is Effective and Here's Why.

But finding the right type of treatment can take time. Many factors influence what type of psychotherapy is most suitable for a client. Access to resources, spiritual values, length of treatment and cost all guide what type of treatment a person receives. It often takes multiple attempts for someone to find a therapist and form of therapy that's the right fit.

The field of psychotherapy can be broadly broken down into five approaches that guide therapists to a deeper understanding of their clients.

These approaches can be used in solo, couple and group sessions. Remember, therapy is highly individualistic. Therapists will often draw from one or more approach during their sessions.

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Psychodynamic therapy

Psychodynamic therapy focuses on the person's conscious and unconscious behaviours, thoughts and feelings. Based off of the work of Sigmund Freud, this therapy assumes that because our attachment patterns are unconscious until we make them conscious, they often come out unconsciously in our relationships. So, solutions that centre on conscious thought may not be helpful. With the help of a therapist, clients explore patterns in their unconscious psyche.  

​Psychodynamic therapy is widely used today. Freudian psychoanalysis is still quite popular in Europe and on the east coast of the U.S. — primarily in New York City. In fact, Hillary McBride practices relational psychodynamic or AEDP (accelerated experiential dynamic psychotherapy) — a form of therapy that uses findings from the field of interpersonal neurobiology which indicate how early experiences, like our attachments, shape our brain.

Behaviour therapy

Behaviour therapy works on the premise that normal and abnormal behaviours develop through learned actions and responses. Classic conditioning and associative learning are at the heart of this approach — think Ivan Pavlov's dogs salivating to a bell ringing in anticipation to food.

In a session, a therapist may repeatedly expose a client to whatever is causing them anxiety or fear until the client is desensitized and learns a healthier reaction.

Many variations of behavioural therapy have been developed since the work of Pavlov and Edward Thorndike in the 1950s. One popular method is cognitive-behavioural therapy, which centres on thoughts and behaviours.

Cognitive-behavioural therapy

Cognitive-behavioural therapy (CBT) focuses on changing harmful thinking. Therapists help clients become aware of how negative thoughts, beliefs and attitudes contribute to anxiety, depression and general sadness.  

This approach teaches clients how to identify and alter negative thinking patterns. According to Psychology Today, a client who is feeling negative or depressed may be advised to start a routine of writing down specific parts of their day that were positive. Clients may also be advised to schedule pleasant healthy activities throughout the week.

Ultimately, clients aim to gain control over their moods. The Centre for Addiction and Mental Health says "CBT is considered by many experts to be the number one way to treat depression and anxiety."

• How Other People's Problems invites audiences into (normally) private therapy sessions

According to  McBride, it's important to note that CBT is easy to study, so there's a lot of empirical evidence defending this approach. But there's increasingly more neuroscientific evidence that thoughts are the dumping ground of the limbic system, so just changing thoughts once they come up doesn't always make the problem go away.

Humanistic therapy

Humanistic therapy aims to develop a healthier sense of self within the client. It's a holistic approach that considers all parts of a person, taking into account an individual's free will and creativity. The three widely practiced techniques within humanistic therapy are gestalt therapy, client-centred therapy and existential analysis.

Gestalt therapy examines thoughts and feelings happening in the present as opposed to tracing back root causes. Client-centred therapy lets the client tell their own story at their own pace, with little or no intervention from the therapist. Existential analysis deals with existential concerns, general angst, fear of death, feeling alone in life and wanting to feel more free in life. 

In any given year, 1 in 5 people in Canada will personally experience a mental health problem or illness.- Canadian Mental Health Association

Depression, relationship issues, personality disorders, anxiety are among the mental health issues that have been treated by humanistic therapy.

However, this approach has been criticized by some for lacking empirical evidence.

In the Australian Journal of Psychology, researcher T. McMullen argued that the "two cornerstones of humanistic psychology, its phenomenology and its doctrine of self-determinism, are incoherent when analyzed conceptually."

McMullen went on to compare the therapy to "paranormal, magic, prophecy and astrology." 

Body or experiential therapies

Body-oriented psychotherapies use physical techniques to treat mental health issues. Eye movement desensitization and reprocessing (EMDR), light therapy, hypnotherapy and yoga all fall under the umbrella of body-oriented psychotherapies.  McBride saya approaches like sensorimotor psychotherapy, somatic experiencing as well as trauma sensitive yoga are all gaining traction. 

Much of this work is based on the principles of Wilhelm Reich, who believed that muscular tension was a reflection of unconscious emotion. Several body-oriented psychotherapies stem from Reich's work in the 1930s.  

In the International Journal for Theory, Research and Practice, Frank Röhricht asserts that "the evidence base is not yet sufficiently developed in order to get body-oriented psychotherapies recognised as suitable mainstream treatment by national health services."  

Röhricht argues that "qualitative research is needed to further investigate the specific interactive therapeutic relationship." 

But these are just some ideas.

According to McBride, "it's important to find what works best for you."

Research says that relational connection with therapist is ultimately more important than what kind of therapy they do, so even if the kind of therapy is difficult at first, but you have a good connection with the therapist stick with them.

Ultimately it's about looking for a therapy and therapist who helps you feel safe and seen.