Psychotherapy

On this page you will learn more about psychotherapy.

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Difficult emotions are often the most arduous part of life but coping with them in a healthy way can make us stronger and can lead to an improved sense of self. Some people may need support to be able to do this as they experience emotions more intensely, or their past might be emotionally prickly and may cause psychological distress. Psychotherapy can aid you in learning how to cope with your emotions. 

This article will explain psychotherapy through the following topics:

  • What is psychotherapy?
  • What is psychoanalysis?
  • What does a psychotherapist do?
  • Who can practice psychotherapy?
  • Results after psychotherapy.

What is psychotherapy?

Psychotherapy, also known as talk therapy, is a general term for the treatment of mental health issues and emotional difficulties by talking about them with a psychologist, psychiatrist, or other trained mental health professional. It enables you to take control of your life and cope with challenging situations in an adaptive way as you learn about your thoughts, feelings, and actions and develop an understanding of how they’re linked. Psychotherapy helps improve well-being and aids you when uncovering and healing from previous issues or trauma. 

Problems that can be targeted through psychotherapy include most mental health disorders, such as:

  • Mood disorders, like depression and bipolar disorder. 
  • Anxiety disorders, such as panic disorder, post-traumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD)
  • Personality disorders such as borderline personality disorder
  • Addictions such as drug addiction, alcohol dependency, and compulsive sexual behaviour
  • Eating disorders like anorexia nervosa and bulimia
  • Schizophrenia and other psychotic disorders

However, you don’t need to have a diagnosed mental illness in order to benefit from psychotherapy; it can also help with problems encountered by most people at some stage in life such as difficulties in coping with day to day activities, dealing with the loss of a loved one, coping with major life changes, coming to terms with a serious illness, and resolving conflicts with someone significant in your life. Psychotherapy can also help people deal with trauma such as physical or sexual abuse, as well as manage sleep disorders. 

The approaches to psychotherapy fall into five broad categories:

  • Psychoanalysis and psychodynamic therapies
  • Behaviour therapy
  • Cognitive therapy
  • Humanistic therapy
  • Integrative or holistic therapy

Incredibly, when adhered to appropriately, psychotherapy can even be as effective as medication when treating certain conditions. Although it is important to be mindful that in some cases a combination approach of therapy and medication may be more suitable. If this is something that you are concerned about then you should contact your GP for advice. 

What is psychoanalysis?

Psychoanalytic psychotherapy is a talking therapy based on whatever is going through your mind at a specific time; it helps you to become more aware of the unconscious meanings and patterns in your thoughts and actions that may be contributing to psychological distress. Psychoanalysis is a theory as well as a therapy, and it is based on a set of psychological concepts and methods that had their genesis in the work of Sigmund Freud. 

Freud believed that the human mind consisted of three factors; the id, the ego, and the superego. According to psychoanalytic theory, the id is the part of the mind that contains sexual and aggressive urges, as well as hidden memories, because it is instinctual and primitive. In contrast, the superego acts as a kind of moral conscience, and the ego mediates between how the id and the superego operate. The basic assumption behind psychoanalytic theory is that everyone has unconscious thoughts, feelings, wants, and memories, and through accessing them and bringing them to the forefront, people can experience cathartic relief from psychological distress. 

The Freudian perspective of the psychoanalytic process gradually fell out of popularity and more empathetic approaches to psychoanalytic therapy developed. These have been shown to have significant benefits for the improvement of mental health. Modern approaches to psychoanalysis promote the beliefs that:

  • Psychological problems (such as depression) are caused by a conflict between the conscious and unconscious mind.
  • Our personality is influenced predominantly by our childhood, especially the first five years.
  • Our behaviours are driven by our subconscious mind.
  • We use defence mechanisms to protect ourselves from the uncomfortable information in our unconscious mind.

Modern psychoanalysis takes the therapeutic stance that reduction of symptoms alone is not enough to resolve a problem. Instead, it focuses on resolving the underlying internal conflict or problem which is causing the symptoms. Otherwise, newer symptoms or maladaptive coping methods will substitute the old ones. 

During therapy sessions, a psychoanalytic therapist typically tries to remain very aloof. Thus, they disclose very little personal information during the therapeutic process as they don’t wish to influence their client’s responses. This helps the client to use therapy sessions as a means to reflect, explore, and work on their unconscious processes without outside disturbance. As a result, they may find that they discover a lot about themselves from how they react to the therapeutic alliance. A skilled psychoanalytic therapist can also help to bring their clients problematic unconscious thoughts to their awareness through strategies such as free association, interpretation such as dream analysis, Rorschach inkblots, and transference.

We all have defence mechanisms that try to fight against unveiling the uncomfortable thoughts that we hold in our unconscious and this can make psychoanalysis a lengthier form of therapy in comparison to other methods. It can even involve between two to five sessions per week for a number of years in order to see results. Therefore, it’s good to be mindful that psychoanalysis is not a quick fix. However, it has been shown to be effective in achieving long-term change as it teaches people the skills of self-examination and even facilitates them in becoming their own therapist over time. 

What does a psychotherapist do?

A psychotherapist is trained to assist people who are struggling to cope with psychological distress, stress, mood disorders, and a range of other mental health issues and emotional problems. They are there to listen to you in a non-judgemental and empathetic way, as they are skilled in listening to not only the words that you say, but also understanding the things that you’re not saying such as your body language, emotional responses, patterns of behaviour, and nuances. Because of their calm, non-judgemental demeanour, the client typically feels safe enough to disclose personal information and uncomfortable topics in a way that allows them to come to their own solutions. As a result, the client increases their sense of ownership over their treatment and also their levels of self-agency. 

The duties of a psychotherapist include:

  • Holding a series of sessions with a client which are designed to build trust, assess their areas of need, and explore their issues. These sessions are typically approximately fifty minutes long.
  • Promoting the discussion and exploration of thoughts, emotions, and actions.
  • Encouraging their client to be involved in their own treatment by helping them to develop strategies for coping with their problems and implementing positive changes to their attitudes and behaviours.
  • Evaluating the success of each session and writing outcome reports based on any developments or lack of.
  • Conducting group sessions for people in a clinical setting who require therapy.
  • Regularly attending supervision/therapy sessions with a qualified supervisor in order to reflect on their sessions with clients and raise any personal concerns which may arise through their work.
  • Supervising the work of other professionals in the same field. 
  • Continuing their professional development by attending courses and keeping abreast of new research and theory.
  • Working towards time-specific targets (especially if the therapy is funded by the NHS).

Who can practice psychotherapy?

Psychotherapy can be provided by trained professionals from a number of different backgrounds including psychologists, psychiatrists, social workers, licensed counsellors, and other licensed therapists. However, in the UK, someone can only practice as a psychotherapist if they have completed a postgraduate training course that has been accredited by the UKCP or British Psychoanalytic Council for psychotherapy. 

In order to get a place on a training course, someone may need to have experience working in a “helping” profession such as psychology, medicine, social work, nursing, and teaching. Training is a demanding process that requires four years of taught-training, as well as evidence of 450 hours of practice, theory, and skills. What’s more, during training psychotherapists have to undergo psychotherapy themselves in order to understand their client’s experience.

Therefore, choosing a psychotherapist that is accredited is a guarantee that they are well-trained and under the supervision of the UKCP or BACP. This means that you can be confident that your welfare is in good hands and that any personal information that you disclose will be kept in the closest confidence. 

Results after psychotherapy

Although psychotherapy sometimes uses a number of different methods, its main goal is to help people to alleviate psychological distress and mental difficulties by helping them to talk about their issues. However, there are a number of factors that influence the success of psychotherapy and the results achieved through the therapeutic process. 

One factor which influences the success achieved through therapy is how ready the client is for change as this affects how motivated and committed they will be to the process. Adherence to the treatment plan and recommended exercises not only increases the benefits of therapy but also decreases the amount of time it takes to see a reduction in symptoms – putting in the work between therapy sessions is often as important as the sessions themselves when trying to achieve lasting change. 

Another element that plays a role in how effective psychotherapy can be is how actively involved a client is in the therapeutic process. Instead of passively going along with what a psychotherapist recommends, it’s important for the client to have a voice and be actively engaged in the process by asking questions about their treatment plan and making suggestions on how to tailor it to suit their personal circumstances.

How comfortable someone is with being active in their treatment often comes down to how well they get along with their therapist. In fact, many studies have shown that the best results from psychotherapy typically happen when the psychotherapist and client establish a strong collaborative relationship or therapeutic alliance. Through this alliance, the psychotherapist and client can work together to establish suitable goals and figure out the best steps towards achieving them. 

Psychotherapy achieves results through changing how we think in order to change how we feel, but lasting change takes time. Whereas some people may see results in as little as a couple of months, research suggests that for most people it takes between 3-6 months to see significant benefits. However, for some people the process may take considerably longer. After all, considering how long mental health difficulties tend to persist before people seek help, it’s not surprising that they may have deep-rooted beliefs about themselves and their environment which are resistant to change. Therefore, altering these beliefs often takes time and intensive work if they hope to see a positive effect on their day to day functioning.

Although the results achieved in psychotherapy often depend on individual differences, adherence to the treatment plan both during and between sessions, and the quality of the therapeutic alliance, psychotherapy can be as effective as medication for the treatment of a wide range of mental health issues and emotional difficulties such as anxiety, depression, and other mood disorders. If you’re wondering whether psychotherapy is the right choice for you, then it might help to discuss your concerns with a medical professional for guidance and advice.

Last updated on: 2022.02.22

Author: Jemma Strain

Reviewed by: Antigone Lanitis