The most common types of Psychotherapies in SG.
Your guide through the maze of psychotherapy.
Finding a Therapist or Psychologist can be like shopping in a Shoe Store sometimes - there's wayyy too many options.
Yet, it's important to find a therapist that suits you.
Thankfully, more and more Singaporeans are open to the idea of counselling and therapy - especially so with the COVID crisis that's been wrecking havoc in our lives.
However, put in a google search for "counselling in Singapore" or "Therapy Singapore" and you'll be faced with a plethora of clinics to choose from. What do you do? Do you just go for the cheapest option?
That's not the best idea - because you might find yourself face-to-face with an old-school Freudian therapist (Heard of Sigmund Freud?) who might be telling you that you are stuck in the anal stage (one of his actual theories).
More importantly, it's about finding a therapy that's a right fit for you and what you're going through.
When it comes to talk-therapies, there are actually almost six hundred varieties in the world. Why not take some time to get to know the eight most common ones - and whether they suit you.
1) Psychoanalytic Therapy
This is the modern day version of Sigmund Freud's form of therapy - minus all the fixation on mothers and genitals of course. Psychoanalytic Therapy focuses on repressed experiences and emotions, and what goes on in your unconscious mind.
It delves deeply into your earlier stages of life, including your childhood. The idea is that by bringing up these repressed early experiences to the surface, it opens up a space for you and the therapist to talk through them together. You'll learn to understand how they've impacted your thinking, emotions and behaviour.
I would say Psychoanalytic Therapy is used about 15% of the time, often in combination with other therapies.
It's good when:
You suspect that early experiences continue to play a role in your life.
You're okay with spending time talking about childhood memories
You're open to the idea of Hypnosis (sometimes).
You're affected by earlier experiences of trauma or grief.
2) Gestalt Therapy
Unlike Psychoanalytic therapy, Gestalt therapy focuses more on the present - i.e. what is happening in your life right now. Instead of talking about your thoughts and feelings in the past tense, you are encouraged to experience them in the present, through techniques like re-enactment or role-playing.
One famous Gestalt Therapy technique is called the "Empty Chair". Using an example of a past conflict with a loved one, you might be asked to pretend that that loved one was sitting in the chair - and talk to him or her as if she was there.
The therapist might ask you questions like "How does this make you feel now?" or "What's going on in your mind?"
Gestalt is the German word for "Whole", This means Gestalt therapists are looking to understand how you function within your environment. Through issues that arise in therapy, you'll learn to gain more self-awareness about the role you play in your own unhappiness.
It's good when:
You feel comfortable re-enacting painful experiences.
You are interested in working on your self-awareness.
You don't really understand why unhappiness is happening in your life.
3) Person-Centered Therapy
In this therapy, the Therapist acts purely as a facilitator. You might be asked to take more of a lead in discussion, where you will be able to discover the solutions to your own problems, all while the therapists helps you facilitate your thoughts.
The Therapist acts as an unconditionally compassionate listener for you, listening without judgement, and will not directly advice you or give you direction. To be honest, this therapy is seldom practiced on its own nowadays, because of its extremely passive nature.
However, most therapists you meet will draw from the counselling skills of this therapy - including being non-judgmental, active listening and empathy.
4) Solution-Focused Brief Therapy (SFBT)
Unlike other forms of Therapy that takes some time to analyse your problems and past experiences, SFBT focuses on finding solutions to your problems in the present.
At the heart of SFBT is problem-solving. One of the first things the Therapist will work with you is to identify and clarify on your goals in life. Instead of overly focusing on your problems, the Therapist will ask you to visualise what life is like when the problem is solved.
One of the key questions the therapist asks is called the miracle question: “If a miracle occurred while you were asleep tonight, what changes would you notice in your life tomorrow?”
It's a different way of approaching a problem - almost by starting with the solution in mind first! You'll then work with the therapist to identify steps to reach that solution together and come up with a plan for change.
It's good when:
You're after solutions, rather than spending time analysing the problem.
You're after a relatively less time-consuming form of Therapy.
You aren't experiencing a deeper disorder - like Depression, Anxiety or Personality Disorders.
5) Cognitive-Behavioural Therapy (CBT)
CBT is considered to be the gold-standard of modern day therapy. It's an umbrella of approaches that help you to identify and change disruptive thought patterns that have a negative influence on your behaviour.
Many of these thoughts are what's known as Automatic Negative Thoughts (ANTs). A CBT therapist will help you to recognise when such thoughts and beliefs arise, and how to dispute and restructure those thoughts in line with what's actually happening in your life.
In parallel, it also focuses on behavioural techniques like exposure therapy - where you'll be encouraged to take minute steps to face whatever is causing you anxiety.
It's good when:
You want to learn how to handle cognitive and mood disorders.
You're aiming to gain self-awareness.
You're overcoming anxiety and phobias.
You feel trapped by your thoughts and beliefs.
6) Acceptance & Commitment Therapy (ACT)
ACT is one of the newer waves of CBT. It's one that I write about actively in this blog. Like CBT, ACT is about learning to stop struggling with difficult thoughts, beliefs and emotions and instead, understand why they emerge and come to accept them.
How is this done? ACT teaches you how to recognise harmful thoughts on the fly, gain some distance from them and let them pass. Just like a storm, difficult thoughts and emotions also come and go.
The key difference from CBT is that it doesn't teach you to rationalise or restructure your thoughts. In ACT, that's still viewed as another way we try to struggle with our thoughts.
Along with the above, you'll learn skills to keep your head in the present, while discovering and acting on what you truly value in life, and keep moving toward them.
It's good when:
You've tried CBT and it hasn't helped.
Rationalising with your thoughts doesn't seem to work.
You feel lost in life and affected by a sense of meaningless.
You want to learn techniques to get out of your head.
7) Dialectical Behaviour Therapy
DBT is yet another kind of CBT. It was originally created to help people who suffer with Borderline Personality Disorder. Nowadays, it's been adapted to treat a wider range of mental health conditions.
DBT is actually an umbrella framework made up of four skills:
Mindfulness: learning to live in the moment.
Emotional Regulation: navigate powerful emotions.
Interpersonal effectiveness: be assertive in a relationship
Distress tolerance: self-soothing techniques.
It's good when:
You have difficulty regulating powerful emotions (crying, anger, rage)
You have self-destructive behaviours (self-harm, eating disorders).
You suffer from a Personality Disorders.
8) Eye Movement Desensitization Re-processing (EMDR)
Lastly, EMDR is a type of therapy that uses optical (eye) stimulation to help people recover from traumatic or distressing experiences.
Through guidance of the therapist, you might be asked to target a traumatic memory or belief that has been affecting you. The therapist will then stimulate your eyes to rapidly move from left to right (bilateral), simply by moving his or her fingers rapidly in front of you.
This bilateral stimulation is thought to unblock emotional process that have been sealed off by trauma. This process brings out the pain and fear associated with the trauma, and over time and exposure, the impact of these emotions on distressing you will lessen.
It's good when:
You have been through trauma, .e.g PTSD.
You experience distressing memories or nightmares.
You don't want a therapy that involves a lot of talking.
A note of encouragement.
I hope this resource has been helpful in getting an idea of how the different psychotherapies work. If you've found a therapy you're leaning toward, do remember to include the term in your search, e.g. "CBT singapore therapy".
Seeking help and going to therapy is a really brave thing to do. Please do be reassured that therapy is an entirely safe environment for you to talk about what you're going through.
And if you ever have more questions and need a friend, I'm here for you too.
Thanks for reading Kaya Toast for the Soul. Remember, you are not alone.