Brief History Of Psychotherapy

Psychotherapy is a very recent branch of psychology. In fact, we cannot properly speak of it until the last quarter of the nineteenth century, when mental illness was finally dissociated from supernatural conceptions. However, in the meantime, society has always had an interest in explaining some phenomena that occurred in people in which no clear biological cause could be found.

If we go back to the more distal beginnings, tribal societies already spoke of a soul that was present in all natural objects. They believed in animinism and thought that disease was a phenomenon of possession of a strange soul. The methods available until then were: ceremonies for the restoration of that lost soul, exorcism, confessions and incubation.

A little later, with Greece and the ancient world, we find the origin of contemporary psychotherapy and its rational thinking, as well as philosophy and medicine. In this context, Aristotle distinguishes the different uses of the word incantation. It was a persuasive word according to which the human being changes.

We cannot stop naming Hippocrates and Galen.

• The Corpus Hipocraticum is one of the landmarks of modern medicine. Hippocrates related diseases to states of the organism and postulated the existence of four humors associated with a temperament, namely: blood-blood, phlegm-phlegmatic, yellow-choleric bile, and black-melancholic bile.

• Galen, for his part, developed the Hippocratic postulates and distinguished between preternatural, natural, and unnatural things.

From the Middle Ages to Psychotherapy

In the Middle Ages the Church considered mental illness as a product of the will of the devil. Confession was the vehicle for healing. Later, in the Renaissance, authors such as Pinel began to stand out, who introduced the moral treatment of the mentally ill. It was about starting to humanize these patients, having an optimistic conception of the disease.

As we have commented, psychotherapy appears as such in the nineteenth century. Cobbe uses the term “psychotherapeutic” in an article in which he defends the role of faith in healing. At this stage, key elements are the fact of isolating diseases for which an anatomical lesion could not be found. On the other hand, mesmerism is purged and hypnosis is seen as an acceptable procedure. The therapeutic procedure par excellence is hypnotic suggestion.

From this trend arose followers (the “fluidists”) and detractors (the “animists”). The Marquis of Puysegur would be one of these animists, he used hypnosis as an “artificial sleepwalking” with which he allowed the patient to recover memories that outside of that state he was unable to recover.

Later, Braid, coined the term hypnosis and defined it as a nervous dream. Subsequently, and based on these advances, the Nancy schools emerged, with Liébault and Berheim as representatives, who abandoned hypnosis, creating the same state, but in wakefulness. This state was then called “psychotherapy”.

In 1895 a Viennese neurologist, Sigmund Freud, published together with Breuer Studies on hysteria . With this work they would develop the cathartic method, applied to the patient Ana O. Later, he would develop free association, by means of which the patient lay down on a couch and spoke freely about some topic in his biography.

Development to date

Following psychoanalysis, a variety of alternative approaches emerge, such as Carl Rogers’ more person-centered.  Subsequently, behaviorism is presented as a tool that understands disorders as learning. But it is not until the 60s and 70s that behavior therapy is consolidated with authors such as Skinner and Wolpe.

In addition, models such as Humanistic Psychology led by Maslow and his pyramid of needs and the Systemic Model emerge, applied above all to family therapy. On the other hand, cognitive models appear as an evolution to behavioral theories based on learning. Their representatives are Beck, Ellis, Mahoney and Meichembaum.

Finally, since the 90s, third generation therapies or contextual therapies began to emerge. They suppose a return to radical behaviorism, taking into account the cognitive part, but without trying, like the rationalists, to modify its content, but rather the patient’s relationship with it.

What is clear today is that psychotherapy is more effective than no treatment, but that it would not be possible to establish significant differences between the different approaches and that they should be considered equivalent, as the paradox of the Dodo bird or “all they win ”.