The A-Z of Therapy Jargon: Part one (A-H).

So, here goes with another blog post, and a continuation of my theme of trying to demystify the world of therapy with all its complex and inaccessible language and concepts. I hope this may prove helpful to some, although I am always a little nervous to write these posts (perhaps why they are so infrequent) as I have never considered myself a very good writer. I’m hoping with time I will improve with practice (as is the case with most things) and until then you, dear readers, can be forgiving of any clunkiness in the post that follows!

So here goes with the first third of my A-Z of therapy jargon (A-H). I’ll post parts two and three in the coming weeks (or perhaps months….) and perhaps a special post for the letter P, as there are so many P words in the world of therapy! Obviously, this is by no means an exhaustive list and definitions are my own unless otherwise credited.

• A for ACT (Acceptance and Commitment Therapy).

This is a type of therapy that is similar to CBT - focusing very much on the here-and-now, rather than exploring the past. ACT seeks to help us understand and change the way we relate to our thoughts and feelings; as well as identify what is personally valuable to each of us; finding ways to work towards living in line with these values. ACT is often a short course of treatment that feels very practical rather than exploratory and is often offered by IAPT services here in the UK, it is also one of the forms of therapy that I am trained in as a practitioner. For some the short and practical nature of ACT is extremely helpful in the management of low mood and anxiety, although when taken as a focused and short course, can perhaps feel impersonal and leave issues from the past unattended. ACT incorporates elements of mindfulness into the work (see entry for M below).

• B for BACP.

B is for the BACP - or the British Association of Counselling and Psychotherapy. I thought it important to include the BACP in this list as it is a common misconception that terms like ‘counsellor’ ‘therapist’ or ‘psychotherapist’ carry some sort of legal protection here in the UK. In fact, this is not the case, and anyone is legally allowed to set up a business tomorrow claiming to be a psychotherapist whether they are qualified or not - and potential clients of charlatans such as this may risk incredibly damaging experiences.

For this reason, it is important to consider when looking for a practitioner whether they are a member of a professional body, that verifies their qualifications, provides best practice guidance as well as provides advice and complaints/disciplinary procedure should things go wrong or you suspect unethical behaviour has occurred. I am a member of the BACP, however, to complicate things further, the BACP is not the only professional body on the scene….. other major ones include the UK Council for Psychotherapy (UKCP), the National Counselling Society (NCS) and the British Psychological Society (BPS).

• C for Cognitive Behavioural Therapy.

C0gnitive behavioural therapy (or CBT) is probably one of the most well-known modern therapeutic schools of thought, not least because it is usually what is first offered by a GP or NHS service. As with ACT above, CBT is often offered as a short term intervention and feels very practical and focused on the present rather than the past. CBT focuses on the link between thoughts, feelings and behaviours and helps us understand our anxiety response in these terms, learning to challenge unhelpful but ingrained styles of thinking that lead us to feel low or anxious. Your therapist will assist you in understanding these links and thinking styles and work with you to challenge or broaden the way we interpret the world and events around us. CBT therapy sessions often will feature tasks to complete between sessions like thought diaries or other written exercises designed to further the understanding of the concepts introduced in the sessions.

Some people may find themselves able to incorporate some of these ideas and techniques alone without the assistance of a therapist via various online resources (or, increasingly, automated therapy chatbots). Personally, I would recommend (at the risk of offending) the self-help book CBT For Dummies (Ad) as a clear and easy to understanding resource for those without psychological training. Others will benefit from exploring these concepts carefully with a skilled professional.

• D for Dialectical Behavioural Therapy.

Dialectical behavioural therapy is another therapy sometimes available on the NHS, more specifically (although not exclusively) as one of the few interventions for some personality disorders (most commonly borderline personality disorder). Both DBT and CBT will focus on the way we think and how this affects us emotionally, although DBT has a stronger focus both on accepting ourselves and the way in which we relate to others. For this reason, DBT is usually delivered partly or wholly in a group setting, and often over an extended timescale. Often, potential participants are wary of working in groups, however, this has often (in my experience) proved to be some of the most helpful elements of this type of treatment. I do not offer this intervention as part of my private practice and would encourage anyone interested in this to research providers in their area, which will often be organisations rather than individual practitioners.

• E for Eye Movement Desensitisation and Reprocessing.

Eye Movement Desensitisation and Reprocessing is a widely recognised (e.g. by the WHO) therapy with primary applications such as treatment of PTSD or unprocessed trauma. Whilst it is known to be an effective treatment for these issues (which we may often seem to get ‘stuck’ on), the mechanism by which it works is less well known and is an area of ongoing research. The process involves careful preparation with a specialist therapist, moving on to a process of revisiting the trauma or unprocessed events while making regular eye movements or listening to regular sounds in alternate ears through headphones. This is not a form of therapy that I personally practise, and care must be taken to ensure you find a suitably qualified practitioner. If EMDR sounds like a familiar term and you don’t know why it may be because Prince Harry has recently spoken about undergoing the process. 

• F for Freud.

Sigmund Freud - the grandad of the psychological professions, was the founder of psychoanalysis and psychotherapy more broadly. He lived between 1856 and 1939 and was the first to introduce several concepts that we all take for granted today. These include the idea that we have a subconscious that motivates us and that we may not understand, that our past relationships and experiences can affect our current and future ones, and that physical symptoms may have a psychological cause. His method of psychoanalysis was the first time that distress was treated by a process that we are now familiar with as therapy, instead of archaic methods that seem shocking to us now, lobotomies, exorcisms and the like. Dream analysis, hypnosis and free association (word association) were all techniques featured in his work as ways of accessing elements of our subconscious. The Freudian slip, where one accidentally says something that reveals our subconscious desires is one of the ways in which his ideas have entered our common language; so thank you Freud for giving us the language to help us describe what is often an awkward phenomenon.

Some of Freud’s writings and ideas (such as the concept of the Oedipus complex) may seem strange to us today, however, it is important to remember when reading his work (which is often quite a hard read) that there is a symbolic element to some of his writings; also that these ideas have been developed and better understood by subsequent generations. At his time, however, these ideas were revolutionary, as those experiencing mental distress were dismissed as mad, bad or possessed. If you’re interested in learning more about Freud, his writings can sometimes feel inaccessible and challenging to understand (one must also consistently remind oneself that they were written around a century ago in Vienna). I would instead recommend starting with the excellent ‘Knowledge in a Nutshell’ series of books (which I think are fab) - Sigmund Freud: The Complete Guide to the Great Psychologist, Including Dreams, Hypnosis and Psychoanalysis (Ad).

• G for Gestalt Therapy.

Gestalt therapy, developed by Fritz Pearls is a type of therapy that focuses on the present moment and the connection between psychological and physical sensations and the way in which we relate to others. Gestalt therapy encourages us to put distance between ourselves and the past and anxieties about the future, and focus our attention and awareness on ourselves and our current circumstances and relationships. The therapist may use the client-therapist relationship as a tool to help the client explore how they relate to others or use techniques such as the ‘empty chair technique’ where elements of roleplay are used to help the client express their true feelings and thoughts about key figures in their lives. Gestalt therapy can be quite creative and also challenging, but a good gestalt therapist should always foster a profound sense of respect for the client and their experiences.

• H for Humanistic Therapy.

While technically the term humanistic refers to a group of therapies (including Gestalt mentioned above), the term is most commonly used to refer to humanistic person-centred therapy, based on the work of Carl Rogers starting in the 1940s. Rogers believed that all humans possess a tendency toward growth and development (which he called self-actualising) and can achieve this if the right conditions are present (which for many of us, they historically haven’t been). Humanistic therapy seeks to create these conditions in the therapeutic setting in order to provide the client with the optimal environment to tap into our intrinsic ability and desire to improve. According to Rogers, this can be achieved if certain conditions are present in the therapeutic setting, namely the unconditional acceptance of the client (termed unconditional positive regard or UPR), empathy and congruence (genuineness). Person-centred therapy is much more exploratory than the cognitive types mentioned here (DBT, CBT and ACT); the therapist will not have prepared a plan and will take the client’s lead, facilitating the careful explorations of whatever they want to bring to the session. As ever, some will find this approach a safe and helpful approach, while others will prefer a more structured approach.

Post image attributed to vecteezy.com and licenced under creative commons.