Psychiatrists and psychologists both understand brain function, thought processes, and behavior, and use counseling and psychotherapy to help with mental health issues. Psychiatrists can prescribe medication, while psychologists cannot.

Psychologists are beneficial for anxiety, depression, and mental health assessments. For severe conditions, psychiatrists may be more effective because a medical treatment is necessary. Psychoanalysts provide long-term therapy based on psychoanalytical theory but do not hold university degrees.

In essence, while both therapies aim to explore the unconscious mind and its influence on behavior, psychoanalytic therapy is more intensive and long-term, whereas psychodynamic therapy is shorter, more flexible, and often more collaborative

Psychoanalytic therapy:

• Origin: Developed by Sigmund Freud
• Focus: Explores the unconscious mind, including repressed desires, fears, and unresolved conflicts
• Techniques: Utilizes methods like dream interpretation, free association, and analysis of resistance and transference
• Duration: Typically long-term, often lasting several years, with multiple sessions per week
• Setting: Often involves the patient lying on a couch with the therapist out of view

Psychodynamic therapy:

• Origin: Based on psychoanalytic principles but evolved to be more flexible
• Focus: Concentrates on current emotions and relationship patterns while integrating insights from the past
• Techniques: Includes some psychoanalytic techniques but is more eclectic, incorporating methods from other orientations like cognitive and behavioral therapies
• Duration: Generally shorter-term, with sessions usually once a week
• Setting: Conducted face-to-face, with the therapist actively engaging with the patient

Further reading: Psychoanalysis vs. psychodynamic therapy (apa.org)

Psychodynamic therapy is beneficial for individuals seeking deeper self-understanding, working through impactful past experiences, achieving a more fulfilling life, addressing persistent issues unresponsive to other treatments, and exploring connections between various mental health challenges.

Psychoanalysis therapy is suitable if you seek to:

• explore deep-seated thoughts and feelings
• understand the root causes of your behaviors
• commit to long-term therapy
• address persistent mental health issues
• gain profound self-awareness
• and if you are open to discussing your dreams and feelings in a non-directive setting

• Introduction and rapport building: The psychologist will introduce themselves and explain their background, approach, and what to expect from therapy sessions
• Information gathering: You will be asked about your reasons for seeking therapy, your current concerns, and your goals for therapy. The psychologist may also inquire about your personal history, including family background and past experiences
• Discussion of therapy process: The psychologist will explain the type of therapy they practice and how it might help you. They may also discuss confidentiality, session frequency, and other logistical details
• **Setting goals:_ Together, you and the psychologist will outline your goals for therapy and what you hope to achieve
• Questions and clarifications: You will have the opportunity to ask any questions you may have about the therapy process, the psychologist’s approach or any other concerns
• Initial Impressions: This first session is also a chance for you to get a sense of the psychologist’s style and determine if you feel comfortable working with them

A common question I encounter in my daily clinic is about the importance of the therapeutic relationship. The foundation of long-term consultations is to offer a safe, non-judgmental space for patients to express themselves authentically.

Trust (confidentiality, consistency) and the quality of our exchanges (feeling understood) are crucial for patient progress. Renowned therapists like Carl Rogers (Person-Centered Therapy) and Irving Yalom (Existentialist) emphasize the importance of empathy, congruence, and unconditional positive regard in improving patient well-being.

Choosing a therapist with whom you feel safe and understood is vital. Sometimes, the therapist-patient relationship can mirror early relationships, providing an opportunity to analyze and resolve past issues. For example, if a therapist arrives late and the patient feels resentful, discussing these feelings can uncover deeper, unresolved emotions from past experiences.

On the other end, if a patient misses a session, it can be an opportunity for the therapist to reflect on improving the therapeutic relationship. I often use this time to think about how to better support my patients, rather than switching to another task.

Further reading:

• Irvin Yalom, The Gift of Therapy: An Open Letter to a New Generation of Therapists and Their Patients, 2009
• Carl Rogers, On Becoming a Person, 1977

Transcultural Psychiatry

It is a field that examines how cultural and social factors influence mental health and illness. It aims to understand the impact of cultural differences on the expression, diagnosis, and treatment of psychiatric disorders.

This approach considers both the cultural background of the patient and the cultural influences on the psychiatrist.

Transcultural Group Therapy

It involves a group of therapists working together to address the specific needs of patients from diverse cultural backgrounds. These therapies are designed to be culturally sensitive and effective when standard treatments may not be sufficient.

They focus on understanding and integrating the cultural, social, and historical contexts of the patients to provide more comprehensive care. Commonly, an interpreter, in addition to psychiatrists, psychologists and anthropologists, joins the sessions with patients.

Sometimes, as practitioner we can be asked to realize a psychological evaluation. These assessments are used to help to diagnose mental health conditions, understand personality traits, and assess cognitive abilities to provide valuable insights for treatment and intervention. The standardized tests are only one part of the evaluation as well as informal tests, such as surveys, clinical interviews, observational data, medical exams, previous educational and medical history.

Below few examples of standardized psychological tests:

• Minnesota Multiphasic Personality Inventory (MMPI-2): Used to assess mental health disorders and personality structure

• Wechsler Adult Intelligence Scale (WAIS): Measures cognitive ability and intelligence in adults

• Stanford-Binet Intelligence Scales: Evaluates intelligence and cognitive abilities across various age groups

• Beck Depression Inventory (BDI): Assesses the severity of depression symptoms

• Rorschach Inkblot Test: Analyzes personality characteristics and emotional functioning through interpretation of inkblots

• Thematic Apperception Test (TAT): Explores underlying motives, concerns, and the way individuals see the social world through storytelling

Group therapy is a form of psychotherapy where one or more therapists work with a small group of individuals simultaneously. This therapeutic approach offers several unique benefits:

1. Support and Shared Experiences

Group therapy provides a supportive environment where individuals can share their experiences and realize they are not alone in their struggles. This sense of community can be incredibly validating and comforting1.

2. Diverse Perspectives

Participants benefit from the diverse perspectives and coping strategies of other group members. This diversity can offer new insights and approaches to dealing with personal challenges.

3. Skill Development

Group therapy often focuses on developing specific skills, such as communication, social interaction, and problem-solving. These skills are practiced within the group, providing a safe space for experimentation and feedback.

4. Cost-Effective

Compared to individual therapy, group therapy can be more cost-effective, making it accessible to a broader range of people.

5. Accountability and Motivation

The group setting fosters a sense of accountability and motivation. Members encourage each other to stay committed to their therapeutic goals and provide mutual support.

Who Benefits from Group Therapy?

Group therapy is suitable for individuals facing a variety of issues, including:

• Mental Health Conditions: Depression, anxiety, panic disorders, and substance abuse.
• Life Transitions: Grief, divorce, job loss, and other significant life changes.
• Social Skills Development: Those struggling with social anxiety, shyness, or low self-esteem.

How Group Therapy Works

• Structure: Groups typically consist of 5 to 15 members and meet regularly, often weekly, for sessions lasting one to two hours.
• Facilitation: Sessions are led by one or more trained therapists who guide discussions, introduce therapeutic techniques, and ensure a safe and respectful environment2.
• Focus: Groups may be general or targeted towards specific issues, such as anger management, grief, or social skills.
• Interaction: Members share their experiences, provide feedback, and support each other, fostering a collaborative and empathetic atmosphere.

Group therapy leverages the power of collective experience and mutual support to facilitate personal growth and healing. It is a valuable therapeutic option for many individuals seeking to improve their mental health and well-being.

The following differences highlight the unique contributions and perspectives each theorist brought to the field of psychoanalysis, enriching our understanding of the human mind and behavior.

Sigmund Freud

• Unconscious Mind: Freud is the pioneer of psychoanalysis and introduced the concept of the unconscious mind, which houses repressed desires, memories, and emotions.
• Psychosexual Development: Freud proposed that personality development occurs through a series of psychosexual stages (oral, anal, phallic, latency, and genital), each characterized by the erogenous zone that is the focus of a child’s libido.
• Oedipus Complex: Central to Freud’s theory, this concept describes a child’s feelings of desire for the opposite-sex parent and jealousy and rivalry with the same-sex parent.
• Defense Mechanisms: Freud identified mechanisms like repression, denial, and projection that the ego uses to manage conflict between the id (instinctual desires) and the superego (moral standards).

Carl Jung

• Collective Unconscious: Jung expanded on Freud’s idea of the unconscious by introducing the collective unconscious, a shared reservoir of experiences and archetypes common to all humans.
• Archetypes: Jung identified universal, symbolic images and themes (e.g., the Hero, the Shadow, the Anima/Animus) that arise from the collective unconscious and influence behavior and experiences.
• Individuation: Jung emphasized the process of individuation, where an individual integrates different aspects of the self to achieve wholeness and self-realization.
• Synchronicity: Jung introduced the concept of synchronicity, the meaningful coincidence of events that are not causally related but are connected by meaning.

Jacques Lacan

• Return to Freud: Lacan sought to reinterpret and return to the original ideas of Freud, emphasizing the importance of language and the symbolic order.
• Mirror Stage: Lacan introduced the mirror stage, a developmental phase where an infant first identifies with their reflection, leading to the formation of the ego.
• The Real, the Imaginary, and the Symbolic: Lacan’s theory is structured around these three orders. The Real is the raw, unmediated reality; the Imaginary is the realm of images and illusions; and the Symbolic is the domain of language and social structures.
• Desire and the Other: Lacan focused on the role of desire, which is always mediated by the Other (the symbolic order and language). He argued that our desires are shaped by the desires of others and the structures of language.

Comparative Analysis

• Unconscious Mind: While Freud focused on the personal unconscious filled with repressed material, Jung expanded this to include the collective unconscious with its archetypes. Lacan, on the other hand, emphasized the unconscious as structured like a language, deeply intertwined with the symbolic order.
• Developmental Focus: Freud’s theory is heavily centered on early childhood and psychosexual stages, whereas Jung’s concept of individuation spans the entire lifespan, focusing on achieving self-realization. Lacan’s mirror stage and his emphasis on language development highlight different aspects of psychological growth.
• Therapeutic Goals: Freud aimed to make the unconscious conscious to resolve repressed conflicts. Jung sought to integrate the conscious and unconscious aspects of the self for individuation. Lacan’s therapy focused on understanding the structures of language and desire that shape the individual’s psyche.