What we mean today by psychotherapy has been around since the dawn of time, although it has not always been the same. However, the fundamental role of the word and changing habits as methods of achieving mental health have been recognized by most human societies.
In this article we will concisely describe history of psychotherapy and clinical psychology. To do this, we will take a journey that will go from Antiquity to the emergence of cognitive behavioral therapy, a predominant model today.
Psychotherapy over time
In ancient times, our ancestors attributed inexplicable phenomena to the action of supernatural forces such as gods, demons and spirits. Psychic life and mental disorders were no exception.
The Egyptians viewed suggestion as a form of magic that could be used in addition to medical treatmentsAnd the Greeks believed that physical and mental illness depended on the bodily imbalance of four fluids or humors. Likewise, in China, health was understood as the balance between vital forces.
One thinks that the first psychotherapies appeared in the Islamic world. Between the 10th and 12th centuries AD, thinkers and physicians such as Abu Zayd al-Balkhi, Zakariya al-Razi, and Avicenna introduced the concepts of “mental health” and “psychotherapy” and described many neuropsychological disorders.
The emergence of psychotherapy in Europe was delayed until the Renaissance, because in the Middle Ages the yoke of Christianity blocked advances in this area. For many centuries, mental health problems they were related to demonic influences. In fact, mesmerism and hypnotherapy, practiced by Mesmer, Puységur and Pussin, were among the first appropriate psychological treatments in Europe in the 18th century.
Later, the influence of rationalist and empiricist philosophers promoted the consolidation of psychology as a social science. The alienists Pinel and Esquirol were instrumental in the development of moral treatment, which defended the rights of psychiatric patients against the abuse of religious “therapy”.
Psychoanalysis and Scientific Psychology
Charcot’s studies on hysteria and other neuroses, as well as Janet’s work on dissociation, influenced the emergence of Sigmund Freud’s psychoanalytic theory, Which postulated that human behavior is primarily determined by unconscious factors and by childhood experiences.
At the same time, at the end of the 19th century, Granville Stanley Hall founded the American Psychological Association (or APA), Which remains today the main organization of the profession. Clinical psychology also emerged during this period through Witmer’s work with children with learning disabilities at the University of Pennsylvania.
While the disciples of Freud, like Adler, Jung or Horney, have broadened and revised the hypotheses of psychoanalysis, scientific psychology continued to develop through the creation of institutions, departments, clinics and publications on psychology. The United States has imposed itself at the heart of these advances.
The rise of behaviorism
Although psychoanalysis continued to be strong during the first half of the 20th century, behavioralism has become the predominant orientation in this period. The contributions of Thorndike, Watson, Pavlov and Skinner made observable behavior the center of psychological analysis and fostered the development of brief behavioral therapies.
Skinner himself devised a number of techniques based on operant conditioning, primarily strengthening. Wolpe created systematic desensitization, the antecedent of modern exposure therapy, while Eysenck gathered the available evidence on the ineffectiveness of psychoanalysis as a treatment.
Behavioralism played a key role in the evolution of psychotherapy, but in the 1940s and 1950s it emerged different perspectives that reacted to behavioral reductionism, Which minimized the relevance of thought, emotion and will.
Existentialism, humanism and systemic therapy
The existential psychotherapies of Viktor Frankl, Otto Rank or RD Laing come from psychoanalysis. The same happened with Rogers’ client-centered therapy, which succeeded in focusing psychotherapeutic interest on the existence of factors common to different orientations that explain the effectiveness of therapy.
Carl Rogers and Abraham Maslow were the two pioneers of humanistic psychology. These authors believed that human beings have a natural tendency to self-actualization and personal growth, And advocated psychotherapy as a method to help clients develop as individuals, based on their values. In this humanist current is also Gestalt therapy, created by Fritz Perls and Laura Perls in the middle of the century, although it appeared a little before Rogers and Maslow developed their ideas.
Later, in the 1960s and 1970s, authors such as Wilhelm Reich and Alexander Lowen popularized bodily psychotherapies, which claimed the body as the center of human experience. However, his theories have been rejected by the scientific community for their lack of empirical soundness.
Systemic and family therapies they appeared from the 1970s with the popularization of general systems theory and contributions from the Milan school, the structural school and the Palo Alto Institute for Mental Research. As existentialism and humanism diluted, systemic therapy consolidated over the following years.
Cognitivism: back to mind
Cognitive orientation was preceded by George Kelly, who argued that people understand the world through idiosyncratic psychological constructs. However, the turning point meant it Ellis and Beck’s therapies, which appeared in the 1950s and 1960s.
Albert Ellis’ Rational Emotional Behavioral Therapy (TREC) focused on the technique that would later become known as “cognitive restructuring.” For his part, Aaron Beck developed Cognitive Therapy for Depression, a highly structured and systematized procedure that has served as a model for many other similar therapies.
While cognitivist therapies have emerged independently, in many cases from the hands of authors trained in the psychoanalytic traditionThe truth is that behaviorism and scientific psychology have had a great influence on them as well. These complementary models eventually converged on cognitive-behavioral therapies.
Recent therapeutic developments
At least since the 1980s and 1990s, psychotherapy has focused on demonstrating the effectiveness of treatments for specific disorders and problems. The American Psychological Association, with a mainly cognitive-behavioral orientation, has had a great influence on this point.
The turn of the century also brought a boom in therapeutic eclecticism. As cognitive behavioral therapy has established itself as a global framework for action, a large number of professionals and interventions have popularized the use of techniques from a variety of orientations to compensate for the limitations of therapy. cognitive-behavioral.
In particular, the importance of emotions and language has been confirmed. The combination of the cognitive-behavioral model with the theory of relational frameworks and mindfulness meditation, among other techniques, has promoted the emergence of third generation therapies, Which are currently solidifying as the future of psychotherapy.