Behavior Therapy Vs. Psychoanalysis: What’s The Difference?

Mental and emotional problems vary, as do the approaches used to treat them. In the field of psychology, numerous forms of therapy are used to relieve the distress of people experiencing mental and emotional pain. These forms of therapy fit into a few general categories. Continue reading this article to learn more about the difference between behavior therapy, psychoanalysis, and other modalities.

What makes behavior therapy different than psychoanalysis?

Before we take a deep dive, you might be wondering: how is behavior therapy different from psychoanalysis, in general? While psychoanalysis techniques take a closer look into the unconscious mind, behavior therapy takes an action-oriented approach to the treatment of mental health issues. How does behavioral therapy work? One of the main differences is that behavioral therapy focuses more on your conscious behavior while psychoanalysis involves the analysis of unconscious thoughts to work through unresolved issues that may be affecting your mental health.

This article will explain the background and methods of two major forms of psychotherapy:  psychoanalysis and behavior therapy.

Behavior therapy as a concept

Behavior therapy, also called behavioral modification, uses people’s actions as the focal point for solving a variety of problems—not only behavioral problems but also problems involving thoughts and feelings. Behavioral psychologists presume that problematic behaviors are caused by interactions between people and their environments. That is, problems occur when a person’s environment rewards damaging behaviors. Over time, these behaviors become habits.

Behavior therapy is used to treat such dangerous habits as smoking, substance use, eating disorders, insomnia, and the inability to manage stress effectively, for example. Behavior therapy can also be used to treat more severe psychological disorders, including obsessive-compulsive disorder, schizophrenia, bipolar disorder, psychotic disorders, depression, anxiety, and personality disorders.

For example, to help a client with obsessive-compulsive disorder, a behavioral therapist might teach that individual, little by little, to tolerate a reasonable amount of dirt in their environment or to refrain from constantly washing their hands. This technique is called exposure therapy. Behavior therapy can also be used to enhance positive behaviors such as organization, involvement in sports, and boundary forming, for instance.

Origins of behavior therapy in psychology

Behavior therapy can be traced to the research of Russian psychologist Ivan Pavlov, which was published in the 1920s and 1930s. Pavlov’s work focused on classical conditioning, which means learning through association. In classical conditioning, two stimuli (i.e., objects or events that produce a reaction) are linked together to produce a new response. In a famous experiment, Pavlov classically conditioned dogs to salivate when he rang a bell because the dogs learned to associate the presence of food with the sound of the bell.

Behavior therapy is also associated with the work of US psychologist B.F. Skinner, who studied operant conditioning in the 1930s. Operant conditioning means learning behavior through rewards and punishments. While working with patients in a psychiatric hospital, Skinner found that behaviors could be “shaped” (i.e., gradually changed) when positive behaviors were followed by desirable consequences and negative behaviors were followed by undesired consequences.

Behavior therapy was later established as a treatment method when the work of psychologists such as Aaron Beck and Albert Ellis resulted in cognitive behavioral therapy (CBT). CBT is based on the theory that people’s thoughts determine both their emotions and their behaviors. Therefore, when therapists help people change their thoughts, they can help them change their lives.

Significance of behavior therapy

Components of behavioral therapy techniques

Specific types of behavior therapy include the following:

Cognitive-behavioral therapy

In cognitive behavioral therapy (CBT), the therapist helps the client identify unhealthy thought patterns. The therapist then helps the client understand how these patterns are associated with self-destructive beliefs, or schemas, which lead to both negative moods and destructive behaviors. With these behavioral therapy techniques, the client learns to challenge unhealthy thoughts and replace them with healthier ones.

Flooding therapy

Flooding therapy is a type of exposure therapy, meaning the therapist exposes the client to a feared object or situation in a safe, controlled setting. The principle behind flooding therapy is that when a client learns that their fear won’t harm them, that fear will disappear, or be extinguished.

In flooding therapy, the client is not gradually exposed to the thing they fear; rather, they are “flooded” by that thing, meaning they are exposed to a large “dose.” For example, with a client who is afraid of snakes, the therapist might bring live snakes to a session and have the client stay in the room with the snakes and the therapist for a full hour. The theory behind flooding is that initial fear responses are time-limited, and once the fear dies down and the client sees that they are not harmed, their fear will disappear.

Flooding psychology may be used to treat phobias. Behaviorists believe that phobias are learned through association, meaning that a person learns to interpret an environmental stimulus (e.g., snakes) as dangerous through association (e.g., stepping on a snake and being startled or bitten). After the initial experience, the person becomes anxious that the experience will happen again. In extreme situations, this anxiety can become post-traumatic stress disorder. In exposure therapies such as flooding, clients are taught to relax during exposure in a safe environment.

Aversion therapy

In aversion therapy, an undesired behavior is paired with an unpleasant stimulus to break an unwanted habit. A well-known example of aversion therapy has to do with substance use. When a client takes Antabuse, they become sick when they drink alcohol. This method creates an aversion to drinking as the client learns to associate alcohol with feeling ill. Thus, this form of behavior therapy reinforces the breaking of unhealthy habits.

Systematic desensitization

Like flooding, systematic desensitization is a type of exposure therapy. However, it is both gentler and more gradual than flooding. Systematic desensitization focuses on relaxation, so the client learns to associate feared objects and events with a sense of safety and calm. Anxiety, panic, and phobias can be treated by teaching clients to relax their muscles, breathe deeply, and/or meditate while being exposed, little by little, to feared stimuli.

Gradual exposure means that fears are faced step by step. Suppose you are anxious about leaving your house. Using systematic desensitization, your therapist may advise you to start by getting dressed for an outing while breathing deeply and listening to soothing music. Next, you might be encouraged to relax your muscles while you step outside your door. Finally, you would practice visiting a close friend, all the while making sure to keep your body relaxed. Throughout this process, you would be encouraged to visualize solutions to problems that might come up. This form of behavior therapy takes longer to produce outcomes compared to flooding.

The theory of psychoanalysis

Psychoanalysis or the freudian therapy originated with Sigmund Freud, an Austrian neurologist who began his work in the 1890s. It consists of theories and therapeutic methods grounded in the belief that people have thoughts, feelings, memories, and unconscious desires that are not directly available. The purpose of psychoanalytic therapy is to bring unconscious content, such as repressed memories, to consciousness through a cathartic, or transformational, healing experience.

During traditional psychoanalysis, just like in object relations therapy, a trained psychoanalyst (or psychoanalytic therapist) asks the patient to lie on a couch. The analyst sits outside the patient’s field of vision. The client talks about their dreams, fantasies, and childhood experiences while the analyst takes notes. Analysts use techniques such as free association and dream analysis for past traumas, some of which are believed to go back to childhood memories that have been repressed and are hidden from the patient’s conscious mind.

Psychoanalysis is a longer process than behavior therapy, often lasting years and involving two or more sessions a week. Unlike behavior therapy, which focuses on actions that can be seen, psychoanalysis focuses on the patient’s unconscious mind, such as unseen desires and motivations.

Psychoanalysis has been used to treat psychological issues including phobias, anxiety, depression, sexual dysfunction, personality disorders, panic attacks, workaholism, and hypersensitivity, for example.

History of psychoanalysis

Psychoanalysis is considered to be the first form of psychotherapy. In addition to Sigmund Freud, theorists including Anna Freud (Sigmund Freud’s daughter), Carl Jung, and Erik Erikson made lasting contributions to the field. Erikson expanded upon Freud’s theories by examining human development and stressing the need for growth throughout the life cycle.

The six tenets of psychoanalysis

• The unconscious mind largely determines human behavior.
• Personality is influenced by early childhood events (between the ages of one to five).
• The unconscious is made conscious through catharsis, which leads to the ability to deal with underlying issues.
• Unconscious experiences can be made conscious by exploring dreams.
• Psychoanalysis explores how people use defense mechanisms to defend themselves from the awareness of unconscious memories and desires.
• Mental breakdown occurs when there is a conflict between the conscious and unconscious mind.

Psychoanalytic therapy strategies

Free association

In psychoanalytic therapy, free association is used as a vehicle for memories stored in the unconscious. The analyst reads a list of words, and the patient responds to each with whatever immediately comes to mind. Freud believed that the responses to these words revealed repressed traumatic memories.

Dream interpretation

Freud believed that dreams were a gateway to the unconscious. He developed a method of dream interpretation to understand his patients’ inner experiences. Freud was convinced that many dreams had sexual meanings that were hidden by their literal, or manifest, content.

Inkblot tests

Another way psychoanalysts approach the unconscious mind is by using a Rorschach Test (1921), which is a patient’s interpretation of inkblots. Inkblot tests are known as projective tests because the patient projects, or casts, the contents of their mind onto a neutral image. This projection is thought to reveal hidden parts of the patient’s personality. In the Rorschach Test, patients are shown 10 inkblots and asked about each, “What might this be?” The analyst then interprets their answers using guidelines developed by comparing the results of many tests to the personality traits and psychiatric diagnoses of the test takers. There has been controversy about the value of inkblot testing, with some arguing in favor of its clinical utility and others arguing that it has little validity.

Transference analysis

Transference is defined as the “transfer” of a patient’s feelings toward key figures from their past onto their therapist or analyst. In psychoanalysis, transference analysis means that the analyst interprets the patient’s transference, bringing those earlier feelings to consciousness. Transference analysis is believed to bring insight to relationship patterns by helping patients better understand their earliest connections.

Differences between behavior therapy and psychoanalysis

Like all forms of therapy, behavior therapy and psychoanalysis have the goals of reducing psychological symptoms and improving quality of life. In addition, the success of both may be determined more by the strength of the relationship between client and therapist than by the methods used. However, there are some critical differences between behavior therapy and psychoanalysis.

Time frame

One key difference between behavior therapy and psychoanalysis is the time frame for successful treatment. Patients in psychoanalysis often see their analyst two or more times a week for multiple years. Behavior therapies are much briefer: Some last only five sessions.

Belief system

Behavior therapy professionals believe that what causes a person’s emotional or mental instability is the negative thought patterns and ideas they have. They are not focused on a person’s past experiences.

Psychoanalysts have different opinions. They believe that the repressed emotions in the unconscious mind cause mental health relapse. According to them, if you want a lasting solution to emotional breakdown or mental instability, you have to bring your unconscious mind to light.

Approach

A psychoanalyst takes a different approach to solving clients’ problems than a behaviorist. Psychoanalytic sessions are largely led by the patient’s train of thought. The analyst may speak very little and take notes while the patient-free associates. The goal is for the patient to experience repressed thoughts, feelings, and memories, thereby gaining insight into their past and releasing associated pain. Behaviorists, on the other hand, are concerned with what can be measured or quantified, and they carefully direct therapy sessions to meet specific goals.

The benefits of online therapy

CBT with a licensed therapist is a first-line treatment for conditions from phobias to PTSD. CBT helps people reframe negative thoughts into positive ones; this reframing leads to more positive emotions and healthier behaviors as well. And research shows that online CBT is an effective alternative to in-person treatment. One recent study found no significant differences at a three-month follow-up between the depressive symptoms of those who received in-person CBT and internet CBT. Another study found that those who received CBT had significantly fewer depressive symptoms than a control group during a 10-week trial. 

Behavioral therapy like CBT focuses on using proven techniques with a licensed therapist to work on anxiety, depression, and other mental health conditions. But when you’re experiencing symptoms like fatigue and fear, it can be hard to find the motivation to leave home. This is where online therapy comes in. There’s no need to sit in traffic or take time out of your busy workday to drive to your appointment. Instead, you can speak with your licensed therapist from wherever you have an internet connection. BetterHelp’s therapists have used CBT to help numerous people with a variety of challenges that are affecting their mental health.