Which Style of Therapy Should I Choose?

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This week, I want to talk about psychotherapy. If you are on my list, you probably have considered or received therapy. It's possible that you may have had great therapy, but it is not too uncommon to feel uninspired and apathetic about your sessions.

Sometimes, therapy is just dull. But more often than not, you may be with the wrong therapists or the wrong therapy style. If you are or have been in this boat, I hope this email might help.

There are various kinds of psychotherapy out there--CBT, Gestalt, Psychodynamic, ACT--and the list goes on. Naturally, one question I get asked often is which style of therapy I would recommend.

I don’t think there is one answer to this question. Different therapeutic styles are going to appeal to different people, or even the same person at different times. But what I can do is outline my thoughts on the ones I know, so that you can choose from a more informed space.

Here are some of the styles I am personally familiar with –

Psychodynamic/Freudian/Jungian - This is the broad family of therapies rooted in the original Freudian psychoanalysis methods. Typically, these styles would seek to extract the meaning of your experiences from your past. Topics of sexuality, shadow, anima, etc. are discussed.

My opinion: My recommendation is that if you are just starting out, this may not be the right choice. It is also important to choose a very good therapist if you are going this route because it is easy to waste time and go in circles without achieving healing in this style.

Acceptance and Commitment Therapy (ACT) - This style is based on Buddhist literature around acceptance as a core part of emotional wellbeing. As the name suggests, therapists practicing this style will place a lot of emphasis on accepting the present emotions without trying to resolve them.

My opinion: This is a great first start. However, ACT may not be the right style for the “nice person” or the “people pleaser”. Why? The core skill that the nice person needs to learn is setting strong boundaries, and being “selfish enough” to uphold them. ACT can feed into the trap of “be the sponge” to absorb others’ feelings and never encourage proactivity in setting boundaries.

Cognitive Behavioural Therapy (CBT) - One of the most widely practiced therapy styles of our generation, CBT is based on the assumption that our thoughts and feelings are deeply interlinked. Our thoughts may sometimes represent a distorted sense of reality, which may lead to unpleasant feelings. Correcting such distorted beliefs may lead to psychological relief.

My opinion: The core strength of CBT is its short-term problem-solving approach. While psychodynamic and ACT can be open-ended, CBT tries to get right to the point sooner. It is great if you are facing challenges that you can clearly define.

The downside is that it often can feel rushed or quick, and therefore not lead to long-lasting changes. Besides, if someone has had a good education in disciplines like mathematics or philosophy, CBT might even come across as elementary grade logic.

Like ACT, I think CBT is a great first place to start. The availability of CBT practitioners is high, and even mental health apps like Wysa or Woebot do a good job of administering basic CBT.

Humanistic - Rooted in existentialism, this style tries to put the human experience at the center. Often questions about death, grief, and suffering are addressed. Finding the meaning of life is given a lot of emphasis.

My opinion: I recommend this style for dealing with emotions like grief, sadness, and melancholy. If life has been “unfair” in big ways–abuse, trauma, even torture–this style of therapy can offer deep solace and reconciliation.

The downside is that this style can be quite heavy. If not handled skillfully, people might end up more upset than when they started. I do not recommend getting this style of therapy unless you are confident that this is what you want.

Internal Family Systems (IFS) - This is currently my preferred style of therapy. It is based on the assumption that we are a collection of parts. Different parts can have different desires, and such conflicting desires can lead to suffering. Parts can often be hurt from the past. No part is bad - a stark difference from styles of therapy and systems of morality that may talk about us having “evil desires”, “malicious intent”, or “ulterior motives”.

My opinion: I highly recommend this style of therapy. It is quite powerful and in my opinion the best the psychotherapy world has produced. It learns all the good things from its predecessors but also takes a firm stance in some areas where needed (like the claim that there are no bad part in any of us).

If you are on my list, chances are you already a little ahead on the self-discovery journey than the average person. If that is the case, then you will be frustrated if you take ACT or CBT. I would recommend that you take IFS.

I have made a number of episodes on IFS. Give them a listen. Here is the epsidoe I recommend starting with.