History of psychotherapy

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Many 18th-century treatments for psychological distress were based on pseudo-scientific ideas, such as phrenology. Phrenology1.jpg
Many 18th-century treatments for psychological distress were based on pseudo-scientific ideas, such as phrenology.

Although modern, scientific psychology is often dated from the 1879 opening of the first psychological clinic by Wilhelm Wundt, attempts to create methods for assessing and treating mental distress existed long before. The earliest recorded approaches were a combination of religious, magical and/or medical perspectives. [1] Early examples of such psychological thinkers included Patañjali, Padmasambhava, [2] Rhazes, Avicenna [3] and Rumi [4] (see Islamic psychology and Eastern philosophy and clinical psychology).

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In an informal sense, psychotherapy can be said to have been practiced through the ages, as individuals received psychological counsel and reassurance from others. Purposeful, theoretically-based psychotherapy was probably first developed in the Middle East during the 9th century by the Persian physician and psychological thinker, Rhazes, who was at one time the chief physician of the Baghdad bimaristan. In the West, however, serious mental disorders were generally treated as demonic or medical conditions requiring punishment and confinement until the advent of moral treatment approaches in the 18th century. This brought about a focus on the possibility of psychosocial intervention—including reasoning, moral encouragement and group activities—to rehabilitate the "insane".

In the 19th century, one could have ones head examined, literally, using phrenology, the study of the shape of the skull developed by respected anatomist Franz Joseph Gall. Other popular treatments included physiognomy—the study of the shape of the face—and mesmerism, developed by Franz Anton Mesmer—designed to relieve psychological distress by the use of magnets. Spiritualism and Phineas Quimby's "mental healing" technique that was very like modern concept of "positive visualization" were also popular. By 1832 psychotherapy made its first appearance in fiction with a short story by John Neal titled "The Haunted Man." [5]

While the scientific community eventually came to reject all of these methods, academic psychologists also were not concerned with serious forms of mental illness. That area was already being addressed by the developing fields of psychiatry and neurology within the asylum movement and the use of moral therapy. [1] It wasn't until the end of the 19th century, around the time when Sigmund Freud was first developing his "talking cure" in Vienna, that the first scientifically clinical application of psychology began—at the University of Pennsylvania, to help children with learning disabilities.

Although clinical psychologists originally focused on psychological assessment, the practice of psychotherapy, once the sole domain of psychiatrists, became integrated into the profession after the Second World War. [6] Psychotherapy began with the practice of psychoanalysis, the "talking cure" developed by Sigmund Freud. Soon afterwards, theorists such as Alfred Adler and Carl Jung began to introduce new conceptions about psychological functioning and change. These and many other theorists helped to develop the general orientation now called psychodynamic therapy, which includes the various therapies based on Freud's essential principle of making the unconscious conscious.

In the 1920s, behaviorism became the dominant paradigm, and remained so until the 1950s. Behaviorism used techniques based on theories of operant conditioning, classical conditioning and social learning theory. Major contributors included Joseph Wolpe, Hans Eysenck, and B.F. Skinner. Because behaviorism denied or ignored internal mental activity, this period represents a general slowing of advancement within the field of psychotherapy. [7]

Wilhelm Reich began to develop body psychotherapy in the 1930s.

Starting in the 1950s, two main orientations evolved independently in response to behaviorism—cognitivism and existential-humanistic therapy. [8] The humanistic movement largely developed from both the Existential theories of writers like Rollo May and Viktor Frankl (a less well known figure Eugene Heimler [9] ) and the Person-centered psychotherapy of Carl Rogers. These orientations all focused less on the unconscious and more on promoting positive, holistic change through the development of a supportive, genuine, and empathic therapeutic relationship. Rollo May, Carl Rogers, and Irvin Yalom acknowledge the influence of Otto Rank (1884-1939), Freud's acolyte, then critic.

During the 1950s, Albert Ellis developed the first form of cognitive behavioral therapy, Rational Emotive Behavior Therapy (REBT) and few years later Aaron T. Beck developed cognitive therapy. Both of these included therapy aimed at changing a person's beliefs, by contrast with the insight-based approach of psychodynamic therapies or the newer relational approach of humanistic therapies. Cognitive and behavioral approaches were combined during the 1970s, resulting in Cognitive behavioral therapy (CBT). [8] Being oriented towards symptom-relief, collaborative empiricism and modifying core beliefs, this approach has gained widespread acceptance as a primary treatment for numerous disorders.

Since the 1970s, other major perspectives have been developed and adopted within the field. Perhaps the two biggest have been Systems Therapy—which focuses on family and group dynamics—and Transpersonal psychology, which focuses on the spiritual facet of human experience. Other important orientations developed in the last three decades include Feminist therapy, Somatic Psychology, Expressive therapy, and applied Positive psychology. Clinical psychology in Japan developed towards a more integrative socially-orientated counseling methodology. Practice in India developed from both traditional metaphysical and ayurvedic systems and Western methodologies. [10]

Since 1993, the American Psychological Association Division 12 Task Force has created and revised a list of empirically supported psychological treatments for specific disorders. [11] [12] [13] The Division 12 standards are based on 7 "essential" criteria for research quality, such as randomization and the use of validated psychological assessments. [14] In general, cognitive behavioral treatments for psychological disorders have received greater support than other psychotherapeutic approaches. Passionate debate among clinical scientists and practitioners about the superiority of evidence-based practices is ongoing, [15] and some have presented correlational data that indicate that most of the major therapies are about of equal effectiveness and that the therapist, client, and therapeutic alliance account for a larger portion of client improvement from psychotherapy. [16] [17] While many Ph.D. training programs in clinical psychology have taken a strong empirical approach to psychotherapy that has led to a greater emphasis on cognitive behavioral interventions, other training programs and psychologists are now adopting an eclectic orientation. This integrative movement attempts to combine the most effective aspects of all the schools of practice.

See also

Related Research Articles

Cognitive behavioral therapy Therapy to improve mental health

Cognitive behavioral therapy (CBT) is a psycho-social intervention that aims to improve mental health. CBT focuses on challenging and changing cognitive distortions and behaviors, improving emotional regulation, and the development of personal coping strategies that target solving current problems. Originally, it was designed to treat depression, but its uses have been expanded to include treatment of a number of mental health conditions, including anxiety, alcohol and drug use problems, marital problems, and eating disorders. CBT includes a number of cognitive or behavior psychotherapies that treat defined psychopathologies using evidence-based techniques and strategies.

Psychology is the science of mind and behavior. Psychology includes the study of conscious and unconscious phenomena, as well as feeling and thought. It is an academic discipline of immense scope. Psychologists seek an understanding of the emergent properties of brains, and all the variety of phenomena linked to those emergent properties, joining this way the broader neuro-scientific group of researchers. As a social science, it aims to understand individuals and groups by establishing general principles and researching specific cases.

Psychoanalysis Psychological theory and therapy established by Sigmund Freud

Psychoanalysis is a set of theories and therapeutic techniques used to study the unconscious mind, which together form a method of treatment for mental disorders. The discipline was established in the early 1890s by Austrian neurologist Sigmund Freud, who retained the term psychoanalysis for his own school of thought. Freud's work stems partly from the clinical work of Josef Breuer and others. Psychoanalysis was later developed in different directions, mostly by students of Freud, such as Alfred Adler and his collaborator, Carl Gustav Jung, as well as by neo-Freudian thinkers, such as Erich Fromm, Karen Horney, and Harry Stack Sullivan.

Psychotherapy is the use of psychological methods, particularly when based on regular personal interaction with adults, to help a person change behavior and overcome problems in desired ways. Psychotherapy aims to improve an individual's well-being and mental health, to resolve or mitigate troublesome behaviors, beliefs, compulsions, thoughts, or emotions, and to improve relationships and social skills. There are also numerous types of psychotherapy designed for children and adolescents, such as play therapy. Certain psychotherapies are considered evidence-based for treating some diagnosed mental disorders. Others have been criticized as pseudoscience.

Psychology is an academic and applied discipline involving the scientific study of human mental functions and behavior. Occasionally, in addition or opposition to employing the scientific method, it also relies on symbolic interpretation and critical analysis, although these traditions have tended to be less pronounced than in other social sciences, such as sociology. Psychologists study phenomena such as perception, cognition, emotion, personality, behavior, and interpersonal relationships. Some, especially depth psychologists, also study the unconscious mind.

Abnormal psychology is the branch of psychology that studies unusual patterns of behavior, emotion and thought, which could possibly be understood as a mental disorder. Although many behaviors could be considered as abnormal, this branch of psychology typically deals with behavior in a clinical context. There is a long history of attempts to understand and control behavior deemed to be aberrant or deviant, and there is often cultural variation in the approach taken. The field of abnormal psychology identifies multiple causes for different conditions, employing diverse theories from the general field of psychology and elsewhere, and much still hinges on what exactly is meant by "abnormal". There has traditionally been a divide between psychological and biological explanations, reflecting a philosophical dualism in regard to the mind-body problem. There have also been different approaches in trying to classify mental disorders. Abnormal includes three different categories; they are subnormal, supernormal and paranormal.

Clinical psychology is an integration of science, theory, and clinical knowledge for the purpose of understanding, preventing, and relieving psychologically-based distress or dysfunction and to promote subjective well-being and personal development. Central to its practice are psychological assessment, clinical formulation, and psychotherapy, although clinical psychologists also engage in research, teaching, consultation, forensic testimony, and program development and administration. In many countries, clinical psychology is a regulated mental health profession.

Psychodynamic psychotherapy or psychoanalytic psychotherapy is a form of depth psychology, the primary focus of which is to reveal the unconscious content of a client's psyche in an effort to alleviate psychic tension.

The Dodo bird verdict is a controversial topic in psychotherapy, referring to the claim that all empirically validated psychotherapies, regardless of their specific components, produce equivalent outcomes. It is named after the Dodo character in Alice in Wonderland. The conjecture was introduced by Saul Rosenzweig in 1936, drawing on imagery from Lewis Carroll's novel Alice's Adventures in Wonderland, but only came into prominence with the emergence of new research evidence in the 1970s.

This article is a compiled timeline of psychotherapy. A more general description of the development of the subject of psychology can be found in the History of psychology article. For related overviews see the Timeline of psychology and Timeline of psychiatry articles.

The following outline is provided as an overview of and topical guide to psychology:

Psychodynamics

Psychodynamics, also known as psychodynamic psychology, in its broadest sense, is an approach to psychology that emphasizes systematic study of the psychological forces that underlie human behavior, feelings, and emotions and how they might relate to early experience. It is especially interested in the dynamic relations between conscious motivation and unconscious motivation.

The following outline is provided as an overview of and topical guide to abnormal psychology:

Peter Fonagy

Peter Fonagy, is a Hungarian-born British psychoanalyst and clinical psychologist. He studied clinical psychology at University College London. He is Professor of Contemporary Psychoanalysis and Developmental Science and Head of the Division of Psychology and Language Sciences at University College London, Chief Executive of the Anna Freud Centre, a training and supervising analyst in the British Psycho-Analytical Society in child and adult analysis, a Fellow of the British Academy, the Faculty of Medical Sciences, the Academy of Social Sciences and a registrant of the BPC. His clinical interests centre on issues of borderline psychopathology, violence and early attachment relationships. His work attempts to integrate empirical research with psychoanalytic theory. He has published over 500 papers, 270 chapters and has authored 19 and edited 17 books.

A clinical formulation, also known as case formulation and problem formulation, is a theoretically-based explanation or conceptualisation of the information obtained from a clinical assessment. It offers a hypothesis about the cause and nature of the presenting problems and is considered an adjunct or alternative approach to the more categorical approach of psychiatric diagnosis. In clinical practice, formulations are used to communicate a hypothesis and provide framework for developing the most suitable treatment approach. It is most commonly used by clinical psychologists and psychiatrists and is deemed to be a core component of these professions. Mental health nurses and social workers may also use formulations.

Common factors theory, a theory guiding some research in clinical psychology and counseling psychology, proposes that different approaches and evidence-based practices in psychotherapy and counseling share common factors that account for much of the effectiveness of a psychological treatment. This is in contrast to the view that the effectiveness of psychotherapy and counseling is best explained by specific or unique factors that are suited to treatment of particular problems. According to one review, "it is widely recognized that the debate between common and unique factors in psychotherapy represents a false dichotomy, and these factors must be integrated to maximize effectiveness". In other words, "therapists must engage in specific forms of therapy for common factors to have a medium through which to operate". Common factors is one route by which psychotherapy researchers have attempted to integrate psychotherapies.

Psychology encompasses a vast domain, and includes many different approaches to the study of mental processes and behavior. Below are the major areas of inquiry that taken together constitute psychology. A comprehensive list of the sub-fields and areas within psychology can be found at the list of psychology topics and list of psychology disciplines.

A Bachelor in Clinical Psychology is a type of postgraduate academic bachelor's degree awarded by universities in many countries. This degree is typically studied for in Clinical Psychology.

Victor Campbell Meyer, or Vic Meyer, was a British psychologist at the Middlesex Hospital Medical School of the University of London and has been called the father of behavioral case formulation, an approach toward understanding complex psychiatric problems using learning principles derived from scientific psychological research and uniquely adapted to the individual case by means of the experimental method as a way to develop an effective intervention regimen. Meyer is credited by the British Psychological Society for his influential work in creating case formulation along with three other innovators: Hans Eysenck, Monte B. Shapiro, and Ira Turkat. Turkat credited Meyer as the pioneer of the framework of what is generally known today as case formulation, a required core skill for all British practicing psychologists since 2011.

Dianne Lynn Chambless is an American clinical psychologist.

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