This paper examines two prominent psychological treatment approaches — behavioral therapy and Freudian psychoanalysis — by tracing their origins, theoretical foundations, and practical applications. It outlines Freud's psychoanalytic model, which emphasizes unconscious processes and early developmental conflicts, alongside B.F. Skinner's behavioral approach, which focuses on observable actions shaped by environmental reinforcement and punishment. The paper discusses how cognitive-behavioral therapy combines elements of both traditions, compares the goals and techniques of each method, and briefly considers how treatment frequency and duration differ between the two. Ultimately, it highlights how each approach understands human behavior and addresses psychological disorders.
Amazing advances have been made in the treatment of mental illness throughout the years (Merck, 2004). An understanding of what causes some mental health disorders has resulted in greater sophistication in customizing treatment to the underlying basis of specific disorders. As a result, many mental health disorders can now be treated almost as successfully as physical disorders.
Most treatment methods for mental health disorders are either categorized as somatic or psychotherapeutic (Merck, 2004). Somatic treatments include drug therapy and electroconvulsive therapy. Psychotherapeutic treatments include individual, group, or family and marital psychotherapy; behavior therapy techniques; and hypnotherapy, among many others. Research reveals that for major mental health disorders, a treatment plan involving both drugs and psychotherapy is more effective than either treatment method on its own. This paper discusses two treatment methods — behavioral therapy and psychoanalysis — in an effort to shed light on how they are similar and different.
Freud coined the term "psychoanalysis" in 1856 (Beystehner, 1997). In modern times, psychoanalysis has withstood the test of time and remains a valid option for patients suffering from mental illness. Its acceptance and popularity are reflected in the number of institutes, organizations, and conferences established around the world with psychoanalysis as their focus. The theory was innovative and revolutionary, and it has endured for well over a century.
Psychoanalysis is the oldest form of psychotherapy (Merck, 2004). Sigmund Freud developed this method in the early twentieth century. During psychoanalysis, a patient typically lies on a couch in the therapist's office four or five times a week and says whatever comes to mind — a method called free association. A great deal of the focus is on understanding how past patterns of relationships repeat themselves in the present. The relationship between the patient and the therapist is a key part of this focus. Understanding how the past influences the present helps the person develop new and improved ways of functioning in relationships and at work.
Behavior therapy is related to cognitive therapy (Merck, 2004) and was developed by B.F. Skinner, who used positive or negative reinforcers to encourage desirable behavior and punishments to discourage undesirable behavior. In many cases, a combination of the two — known as cognitive-behavioral therapy — is used. The theoretical basis of behavior therapy is learning theory, which holds that abnormal behaviors are the result of faulty learning. Behavior therapy involves numerous interventions designed to help the patient unlearn maladaptive behaviors while learning adaptive ones. Exposure therapy is one example.
There are many theoretical schools of psychotherapy. The most commonly used theoretical approaches are cognitive therapy, behavior therapy, and psychodynamic therapy. In many cases, psychologists combine cognitive and behavioral approaches depending on the problem and the treatment goals.
Cognitive psychotherapy concentrates on present problems and conflicts, although past issues may be part of treatment if they influence current life adjustment. This approach assumes that psychological problems are the result of maladaptive expectations, assumptions, beliefs, and perceptions about oneself and others, resulting in ineffective coping behavior. Most cognitive psychotherapy sessions are scheduled once per week, although additional appointments may be arranged as needed. Treatment length depends on the nature of the problem and may last anywhere from ten to twelve sessions to several years, though it is frequently completed within twenty to thirty sessions.
As a therapy, psychoanalysis is based on the concept that individuals are unaware of the factors causing their behavior and emotions (Beystehner, 1997). These unconscious factors can potentially result in unhappiness, expressed through a range of distinguishable symptoms — including disturbing personality traits, difficulty relating to others, or disturbances in self-esteem or general disposition (American Psychoanalytic Association, 1998).
Psychoanalytic treatment is an individualized form of therapy that seeks to reveal how unconscious factors affect behavior patterns, relationships, and mental health (Beystehner, 1997). Treatment traces these unconscious factors to their origins, determines how they have evolved over time, and ultimately helps patients overcome the challenges they face in life (National Psychological Association for Psychoanalysis, 1998).
According to Beystehner (1997): "The value and validity of psychoanalysis as a theory and treatment have been questioned since its inception in the early 1900s. Critics dispute many aspects of psychoanalysis including whether or not it is indeed a science; the value of the data upon which Freud, the founder of psychoanalysis, based his theories; and the method and effectiveness of psychoanalytic treatment. There has been much criticism as well as praise regarding psychoanalysis over the years, but a hard look at both the positive and negative feedback of critics of psychoanalysis shows, in my opinion, that psychoanalysis is indeed a 'great idea' in personality that should not be overlooked."
To determine the strengths of Freud's theory of psychoanalysis, it is important to consider the qualities that make a theory of personality or behavior "great" (Beystehner, 1997). Among the qualities considered important are that "the theory addresses its problem, can be applied in practical ways, fits with other theories, and withstands the test of time." Additionally, a good theory is falsifiable, able to be generalized, leads to new theories and ideas, and is recognized by others in the field. It is generally believed that psychoanalysis meets many of these criteria.
Psychoanalysis was designed by Freud to help people get in touch with the origins of their problems and ultimately eliminate those problems (HealthinMind.com, 2004). Freud did not believe that psychoanalysis should be used for patients with psychoses. Psychoanalysis has always been a controversial method and has been replaced by or supplemented with many other types of individual psychotherapy. Some, like psychoanalysis, aim to provide patients with insights into their problems, but many have more pragmatic goals — such as helping patients adapt to their problems or eliminate symptoms.
Skinner made an enduring contribution as an experimenter and psychological theorist. Today, there are many forms of behavior therapy. One of the more successful individual therapies is cognitive-behavioral therapy, which aims to change the way a patient thinks about his or her problems (HealthinMind.com, 2004). Behavior is changed either directly or through changes in patterns of thought. This type of therapy has been shown to improve the functioning of depressed individuals and is often used in combination with antidepressant medication.
According to HealthinMind.com (2004): "Behavior therapies are designed to change behavior directly, rather than as an indirect result of gaining insight into the origins of problems or changing thought patterns. Behavior therapy is usually combined with other therapies, most notably with cognitive therapy, to maximize benefits to clients."
Behavior therapy uses learning to develop behavioral change (HealthinMind.com, 2004). Operant conditioning — the process by which the environment shapes people's behavior — is the focus of its treatments. The theory behind operant conditioning holds that behaviors improve when they are reinforced and diminish when they are punished. Positive reinforcement occurs when a person participates in a behavior and is rewarded, resulting in an increase in that behavior. Negative reinforcement occurs when a person avoids a negative outcome by performing a behavior. Both positive and negative reinforcement aim to increase the probability of a behavior, while punishment aims to decrease it.
According to HealthinMind.com (2004): "Behavior therapy can be used to treat a wide range of problems including anxiety, depression, sexual disorders, relational problems, and especially childhood disorders, for which behavior therapy is ideal and is usually taught to parents so that they can implement the techniques at home. Basically, any disorders that involve maladaptive behaviors in people who are physically capable of behavior change can be improved with behavior therapy."
"Freud versus Skinner on behavior's internal and external causes"
In comparison to psychoanalysis, behavior therapy focuses more on specific problems — such as anxiety symptoms — so treatment is often more compressed. The goal of behavior therapy is to eliminate maladaptive behaviors or to develop adaptive coping behaviors, which in turn addresses the underlying problem.
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