Humanistic Psychotherapy emphasizes our intrinsic capacity for growth and healing. As opposed to seeing the client as in need of tools or techniques, the client is seen as needing a space to be heard, understood, and related to. There is an underlying faith that the client possesses the internal resources to cope with their life; they are not inherently deficient or broken. Instead, they are struggling to find, trust, and establish relationships that can support their health and recovery. In Humanistic Psychotherapy, the therapist does not assume a superior role to the client, like that of a coach or a teacher. The therapist is more of a facilitator and collaborator, helping to draw out the client’s own insights and solutions. This is why Humanistic Psychotherapy is often seen as synonymous with Person-centered Psychotherapy; the individual person is the focus of therapy, not the concepts, tools, or techniques of a particular model.

Research Support for Humanistic Psychotherapy: https://psycnet.apa.org/doiLanding?doi=10.1037%2F10439-002 (Elliott, 2002)

Psychodynamic Psychotherapy is sometimes used interchangeably with Psychoanalysis. When people hear Psychoanalysis they often think of Freud and may have heard that much of his theory has been debunked by contemporary science. It is true that Psychoanalysis was developed by Freud and originally drew upon biological concepts that have since become outdated, but the field of Psychoanalysis has evolved significantly since Freud’s time and has found increasing support in the research field of interpersonal neurobiology (Schore, 2011). Essentially, the focus of Psychoanalysis has shifted away from conflicting instinctual drives to the significant role early relationships play in structuring and informing our emotional lives (Mitchell, 1988).

Psychodynamic Psychotherapy differs from contemporary Psychoanalysis in that there is typically only one or two sessions per week as opposed to four or five and the practitioner does not have to have completed intensive psychoanalytic training. The underlying assumption of Psychodynamic Psychotherapy is that we exist within the context of our most significant relationships, seeking to feel close and bonded to others, but also to feel separate and distinct, to be our own person (Mitchell, 1988). During our early developmental years, we are constantly learning how to navigate this complex and demanding balance between our self-definition and our relationships with others. Much of this learning is implicit or unconscious; we are rarely able to consciously elaborate upon what we learned in childhood, but nonetheless it heavily informs how we relate and how we establish our sense of self as adults. For many, this early emotional learning makes relating difficult, creating strong, internal conflicts that can manifest as depression, anxiety, addictive behaviors, or bewildering self-sabotage.

In Psychodynamic Psychotherapy, therapist and client work to make sense of present difficulties within the greater context of the client’s developmental history (Shedler, 2010). The client is given significant room to speak openly about themselves, allowing their mind to freely associate during session. Core emotional themes or patterns begin to emerge as clients engage in this exploration. These patterns are seen in the recollections of their childhood, their daydreams or fantasies, their present relationships with others, and even, in their relationship with the therapist. Emotional and behavioral disturbances, such as depression or addiction, which the client once felt victimized by, come to make sense given the client’s life. They are seen as crude, yet understandable strategies to uphold and fulfill the emotional demands of childhood. This level of awareness allows for a greater flexibility in navigating our emotional lives and building bonds with others that are truly satisfying.

Research support for Psychodynamic Psychotherapy: https://www.apa.org/pubs/journals/releases/amp-65-2-98.pdf (Shedler, 2010)

Internal Family Systems Therapy (IFS) sees the mind as a collection of distinct parts (Schwartz, 1995). As the name implies, these different parts of us have separate roles and attempt to work in harmony much like a family. There are parts that are more parental and managerial, making sure we eat healthy and get enough sleep, as well as parts that are more sensitive and playful. In IFS, it is understood that while we have these different parts of us, we also have a core Self, a leader that harmonizes the system in the pursuit of deeper values. Ideally, the Self acts as a symphony conductor, allowing different parts to shine at the right moment (p. 40). However, when we experience trauma or significant stress in our lives, our internal family can become unbalanced or polarized. Different parts can come to take on more extreme roles and begin to act antagonistically towards the rest of the system.

For example, someone who experienced frequent abandonment and neglect as a child may come to have a part that holds the pain of this abandonment, an emotionally overwhelmed child part, as well as another part that works to keep this pain from being felt and flooding the nervous system. This often takes the form of perfectionism, the belief that if they can be perfect, they will never be abandoned. This creates a polarity between the hurt inner child who wants to cry out and seek reassurance and the perfectionistic inner critic who sees this child’s feelings as weak or pathetic, hampering their pursuit of perfection. Each part escalates the other and the core Self becomes overtaken by the parts’ increasingly extreme positions.

In IFS Therapy, therapist and client work to reestablish a connection to the Self by gaining greater perspective on the different parts (Schwartz, 1995). This involves fleshing out each part and giving them a forum to be heard and understood. As the client begins to understand the underlying motivations of each part, they become better able to negotiate with the polarized parts and establish greater cooperation within the internal system. Like Humanistic Psychotherapy, the Self is never thought of as deficient or broken. Instead, it has been temporarily usurped by more extreme parts, parts that are desperate to find healing and avoid further suffering. When the Self is given some room to breathe and operate, the client begins to understand their own healing process and a sense of harmony doesn’t feel so out of reach.

Research support for IFS: https://pubmed.ncbi.nlm.nih.gov/27500908/ (Haddock et al., 2016) + https://pubmed.ncbi.nlm.nih.gov/23950186/ (Shadick et al., 2013)

EMDR is an increasingly popular approach to treating trauma induced stress, though it can be used for many other psychological ailments as well (Shapiro, 2001). In EMDR, the client is asked to focus on a distressing memory. The feelings and thoughts associated with the memory are fleshed out and then begins what is referred to as bilateral stimulation. The therapist lifts their fingers in front of the client’s eyes, about 12 to 14 inches away, and asks the client to follow their fingers while they move from left to right, generating a full range of eye movement. Neurologically, the two hemispheres of the brain are being stimulated by the back-and-forth eye movement, thus the term bilateral stimulation. The client is asked to keep dual attention on both their internal experience as well as the therapist’s moving fingers. Though the session begins with a distressing memory, the client is instructed to allow their mind to wander or free associate, without holding on to any particular mental content. After about 24 sets of bilateral stimulation, there is a pause, and the client briefly reports on what they are noticing in their mind and body. The therapist then continues with more eye movements, leaving at least 10 minutes at the end of session for relaxation exercises. What occurs during the bilateral stimulation is both a desensitization and reprocessing of the distressing memory. Desensitization meaning that the memory becomes less overwhelming and anxiety producing. Reprocessing is a bit more complicated of a concept and lies at the heart of the underlying model behind EMDR: Adaptive Information Processing.

The Adaptive Information Processing Model rests on the premise that we have a natural capacity for integrating new experiences and responding in an adaptive manner (Shapiro, 2001). When we experience something traumatic it challenges our existing understanding of reality, in particular, what is safe and what is not safe. We are forced to process this disturbing experience: think about it, talk to others about, dream about it, etc. Eventually it becomes less disturbing and contributes to a more adaptive worldview. For example, when someone gets into a car accident for the first time, they can suddenly develop a different relationship with driving. Perhaps they used to text a lot while driving, feeling generally safe about it, but now even getting into a car feels unsafe. As they mentally process the car accident, the emotional intensity of the accident becomes less severe; its desensitized, and they come to terms with the real dangers of driving. They feel unsafe when driving distracted and no longer text, but they can also relax when they are focused on the road. The disturbing memory is not being reactivated and re-experienced by the act of driving itself. It has moved into long-term memory. This is an example of adaptive processing.

However, some traumatic experiences can severely compromise this natural capacity for adaptive processing (Shapiro, 2001). This can be due to the sheer horror of the event, as well as a lack of resources, both external and internal, that support us in our need for processing. External resources are safe people to talk to about the experience, as well as more basic needs such as a safe home to sleep in. Internal resources refer to our emotional development, what we learned growing up about painful experiences and our capacity to recover from them. If these resources are lacking, then the experience is not integrated and becomes stuck in a raw, unprocessed form. Anything in the environment that reminds us of the experience triggers a powerful physiological response as if the traumatic event were happening again. The brain loses the capacity to discriminate between safe and not safe and prepares us for life threatening danger.

The rationale for EMDR is that the bilateral stimulation helps activate the adaptive processing system (Shapiro 2001). Though it is unclear why exactly bilateral stimulation helps, one explanation is that it mimics the Rapid Eye Movement (REM) stage of sleep, which is most associated with dreaming. REM sleep has been shown to be involved in memory consolidation and the acquisition of new skills (Fishbein & Gutwein, 1977; Karni et al., 1992 as cited in Shapiro, 2011). Regardless of the explanation, bilateral stimulation is demonstrated to facilitate traumatic processing (Lee & Cuijpers, 2013). Painful and disturbing memories can become desensitized, triggering less emotional intensity, as well as reprocessed. The brain can use the memory to inform behavior, such as the driver who stopped texting, but maintains its capacity for discriminating between safe and not safe during experiences that are similar to the original trauma.

Research support for EMDR:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3951033/ (Shapiro, 2014) + https://www.sciencedirect.com/science/article/abs/pii/S0005791612001000?via%3Dihub (Lee & Cuijpers, 2013).