History of psychotherapy and clinical psychology

What we currently understand by psychotherapy has existed since the beginning of time, although it has not always had the same form. However, the fundamental role of the word and the change of habits as methods to achieve mental health have been recognized by most human societies.

In this article we will briefly describe the history of psychotherapy and clinical psychology. For this we will take a tour that will go from the Ancient Age to the appearance of the cognitive behavioral therapy, the predominant model today.

• Related article: "Types of psychological therapies"

Psychotherapy throughout the ages

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 as a complement to medical treatments, and the Greeks believed that physical and mental illnesses depended on the bodily imbalance of four fluids or humors. Similarly, in China health was understood as the balance between vital forces.

It is believed that the first psychotherapies emerged in the Islamic world. Between the 10th and 12th centuries d. C., thinkers and doctors like Abu Zayd al-Balkhi, Zakariya al-Razi and Avicenna introduced the concepts of "mental health" and "psychotherapy" and described a large number of disorders neuropsychological.

The appearance of psychotherapy in Europe was delayed until the Renaissance, since in the Middle Ages the yoke of Christianity blocked advances in this field. For many centuries, mental health problems were linked to demonic influences. Actually, mesmerism and hypnotherapy, practiced by Mesmer, Puységur or Pussin, were some of the first properly European psychological treatments, in the 18th century.

Later the influence of the rationalist and empiricist philosophers promoted the consolidation of psychology as a social science. The alienists Pinel and Esquirol were decisive in the development of moral treatment, which defended the rights of psychiatric patients against the abuses of religious “therapies”.

Psychoanalysis and scientific psychology

Charcot's studies of 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 fundamentally determined by unconscious factors and by experiences lived in childhood.

Around the same time, at the end of the 19th century, Granville Stanley Hall founded the American Psychological Association (or APA), which to this day continues to be the main organization of the profession. Clinical psychology also emerged in this period thanks to Witmer's work with children with learning disabilities at the University of Pennsylvania.

While Freud's disciples, such as Adler, Jung or Horney, expanded and revised the hypotheses of psychoanalysis, scientific psychology continued to develop through the founding of institutions, departments, clinics and publications on psychology. The United States established itself as the nucleus of these developments.

The rise of behaviorism

Although psychoanalysis continued to be strong during the first half of the 20th century, behaviorism became the predominant orientation in this period. The contributions of Thorndike, Watson, Pavlov and Skinner made observable behavior the focus of psychological analysis and promoted the development of brief behavioral therapies.

Skinner himself devised a number of techniques based on operant conditioning, mainly reinforcement. Wolpe created systematic desensitization, the antecedent of modern exposure therapy, while that Eysenck compiled the available evidence on the ineffectiveness of psychoanalysis as treatment.

Behaviorism was key in the evolution of psychotherapy, but in the 1940s and 1950s 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 R. D. Laing emerged from psychoanalysis. The same happened with Rogers' client-centered therapy, which managed to focus interest psychotherapeutic in the existence of factors common to the different orientations that explain the efficacy of the therapy.

Carl Rogers and Abraham Maslow were the two pioneers of humanistic psychology. These authors believed that human beings have a natural tendency toward self-realization and personal growth, and defended psychotherapy as a method to help clients develop as persons, based on their values. In this humanist current there is also the Gestalt therapy, created by Fritz Perls and Laura Perls in the middle of the century, although it appeared somewhat before Rogers and Maslow developed their ideas.

Later, in the 1960s and 1970s, authors such as Wilhelm Reich and Alexander Lowen popularized the body psychotherapies, who claimed the body as the center of human experience. However, his theories were dismissed by the scientific community for their lack of empirical solidity.

Systemic and family therapies appeared from the 70s with the popularization of the General Theory of Systems and the contributions from the School of Milan, the Structural School and the Mental Research Institute of Palo High. As existentialism and humanism faded, systemic therapy consolidated during the following years.

Cognitivism: return to mind

Cognitive orientation had as its predecessor George Kelly, who argued that people understand the world through idiosyncratic psychological constructs. However, the turning point was assumed the Ellis and Beck therapies, which emerged in the 1950s and 1960s.

The Rational Emotional Behavioral Therapy (RETT) Albert Ellis's focused on the technique that later became known as "cognitive restructuring." For its part, Aaron Beck developed Cognitive Therapy for depression, a highly structured and systematized procedure that served as a model for many other similar therapies.

Although cognitivist therapies emerged independently, in many cases from the hand of authors trained in the psychoanalytic traditionThe truth is that behaviorism and scientific psychology also had a great influence on them. These complementary models eventually converged in cognitive-behavioral therapies.

Recent therapeutic developments

At least since the 1980s and 1990s the focus of psychotherapy has been the demonstration of the efficacy of treatments for specific disorders and problems. The American Psychological Association, predominantly cognitive-behavioral in orientation, has had a great influence on this.

The turn of the century has also brought a rise of therapeutic eclecticism. Although cognitive-behavioral therapy has established itself as a framework for global action, a large number of professionals and interventions have popularized the use of techniques from varied orientations to compensate for the limitations of therapy cognitive-behavioral.

In particular, the importance of emotions and language has been claimed. The combination of the cognitive-behavioral model with the theory of relational frames and with meditation through mindfulness, among other techniques, has promoted the emergence of third generation therapies, which are currently solidifying as the future of psychotherapy.

• Related article: "What are third generation therapies?"