I am not normally one to stand on a soap-box and shout out my thoughts and feelings on a subject. I am usually content to work within my values in my client, teaching and writing work, sharing my position on subjects through my way of being in the world. Today though, I’m feeling the need for a bit of a shout!
The issue that is animating me is the confusion between the words ‘psychotherapy’ and ‘psychoanalysis’. Now, I can forgive the general public for not knowing the difference between these terms. Why would they? But I find it more difficult to accept when people within the profession use these words interchangeably. They are not the same thing!
‘Psychotherapy’ is the generic term for talking therapy, the process of addressing emotional concerns with a trained professional. If it is to be used interchangeably with another word, the closest would be ‘counselling’, (although there can be some training differences between counsellors and psychotherapists).
‘Psychoanalysis’ is a type of psychotherapy, one of many, many different approaches, (referred to as modalities), to the work of resolving emotional difficulties.
As the British Association for Counselling and Psychotherapy explains.
‘Counselling and psychotherapy are umbrella terms that cover a range of talking therapies. They are delivered by trained practitioners who work with people over a short or long term to help them bring about effective change or enhance their wellbeing.’
‘there are different ways of working with people, usually referred to as ‘approaches’, ‘techniques’ or ‘modalities’.
So, if psychotherapy is ‘fruit’, psychoanalysis is ‘a banana’.
The reason this is bothering me is the contexts in which these words are used to mean the same thing. I sat through an Improving Access to Psychological Therapies, (IAPT), training recently and the presenter confidently announced that ‘psychotherapy does not work with OCD’. I was bemused. If psychotherapy does not work with OCD then OCD is not treatable. CBT works with OCD, which is the point the presenter was trying to make, and CBT is a modality of psychotherapy. What the presenter meant was that, in her opinion, psychoanalysis doesn’t work with OCD. Over 100 IAPT trainees left that course thinking that psychotherapy means psychoanalysis. It doesn’t! More worryingly, they left thinking that psychotherapy doesn’t work. And this is only one of several occasions recently where I’ve heard the terms used to mean the same thing.
‘So what?’ you might ask. My fear is that if this mix up of the terms isn’t addressed the idea will filter out to GP’s, commissioning bodies, employers, students and the general public that psychotherapy does not work and those of us who have trained as psychotherapists and achieve evidenced change in our clients will be overlooked or maligned.
I’m not entering into a debate here as to whether or not psychoanalysis works. I am a believer in ‘horses for courses’ in therapy. Humans are varied and a variety of approaches is needed to help them. I am just calling for clarity.
So, can we please remember that psychotherapy is the job of supporting people through a change and psychoanalysis is just one approach to that job?
Thank you. I have now stepped off my soap box!
If you would like to learn more about the various approaches to therapy or if you are looking for support with an emotional issue please visit www.localcounsellingcentre.co.uk