A brief history of therapy

Most of us probably have an instinctive sense of what we believe ‘therapy’ to be. The image of the ‘psychiatrist’s couch’ has long been entrenched in popular culture, and the notion of people resorting to various toxic behaviours “instead of going to therapy” has even become the subject of memes

In recent times, terms such as ‘mental health’ and ‘wellness’ have also become buzzwords across social media and other facets of our popular culture. However, this has not always had the consequence of those who use such terms developing much of an understanding of actual psychotherapeutic practices. 

As the popular debate surrounding mental health has raged again amid the strains on many people’s lives imposed by the coronavirus pandemic, so it has become more urgent for those exploring therapy – whether personally or professionally – to better grasp its nature and origins. 

The story of psychotherapy is a messy and multi-layered one 

Referring to current dictionary definitions is instructive on the matter of what ‘therapy’ could be described to be. The Collins English Dictionary, for instance, defines therapy as “the treatment of someone with mental or physical illness without the use of drugs or operations.” 

Meanwhile, the Encyclopaedia Britannica has described psychotherapy as “any form of treatment for psychological, emotional or behaviour disorders in which a trained person establishes a relationship with one or several patients for the purpose of modifying or removing existing symptoms and promoting personality growth.” 

The question of where the story of psychotherapy began, however, can only produce a much more muddled answer. 

After all, some kind of ‘talking therapy’, or verbal communication by which humans attempt to ease other humans’ troubled minds, has existed practically for as long as humans have. Even our pre-language hominid ancestors were as social as we are, and for thousands of years prior to the emergence of written language, people told stories to each other. Some of those stories would have effectively served as forms of therapy. 

So, for the sake of keeping this history short, let’s fast-forward to the Industrial Revolution of the 18th and 19th centuries, when the development of the steam engine and the technology of hydraulics did so much to upend how Western people lived their lives – and thought about the mind. 

This era saw the advent of a tendency to think about the mind using somewhat ‘hydraulic’ metaphors – “letting off steam”, for example, or “releasing pent-up emotion” – that largely persist in popular use today. The legacy of these metaphors isn’t an entirely positive one for psychotherapy, recent research suggesting that it could be as harmful to the heart and immune system to release extreme anger, as it is to “keep the anger in”. 

The 19th to 20th centuries: dramatically evolving psychiatric services 

The early 19th century saw further leaps in how humans perceived and dealt with matters of the mind. In England and Wales, the County Asylums Act of 1808 established public mental asylums for the treatment of mental illness. The Lunacy Act of 1845, however, altered the status of mentally ill people to that of patients. 

Such institutions, evolving from asylums into large psychiatric hospitals, were products of the philanthropic ‘moral’ treatment ideology that characterised the era. They also survived long past the stage they had effectively become outmoded, with the National Health Service (NHS) being founded a century after the Lunacy Act, and inheriting mental health provision that was less than therapeutic. 

The ongoing development of the field of psychotherapy throughout this time helped to make clear just how poorly matched these hospitals’ methods often were to the needs of their patients. With the hospitals still following an overall treatment ethos that emphasised physical and medical treatments over psychological ones, it was left to psychotherapy to begin exerting its influence over wider society. 

The 19th and 20th centuries saw the emergence of many influential thinkers who have helped shape the psychotherapy field we know today – not least the Austrian neurologist Sigmund Freud (1856-1939), in whose work the psychodynamic, or psychoanalytic, model was originated. Freud’s model postulated that unconscious processes strongly influenced all human actions and experiences. However, subsequent figures in the development of psychotherapy challenged the Freudian notion of the unconscious as a seething cesspool of repressed, but scandalous thoughts and wishes. 

Another central player in the evolution of psychotherapy was the American psychologist, Carl Rogers (1902-1987). He is remembered for his development of the psychotherapy method known as client-centred therapy, and as one of the founders of humanistic psychology. Whereas Freud had considered neurosis to be an illness in need of being cured, Rogers avoided pathologizing his students in such a way. This proved to be a landmark in the development of psychotherapy, as ‘patients’ came to be known – and treated – as clients. 

From the early 1960s, it became the policy of the UK Government to close the surviving large psychiatric hospitals, amid a gradual shift from institutional to community-based practices. By the 1990s, however, much talk in the media centred on the failure or breakdown of community mental health services. 

The new Labour Government’s response to this after the 1997 election was to invest resources and action into modernising mental health services for the 21st century, including combating discrimination and promoting social inclusion. 

The National Service Framework for Mental Health, issued by the Department of Health in 1999, emphasised the importance of identifying the needs and strengths of clients, instead of concentrating on their problems and weaknesses. This marked another move away from the ‘pathologizing’ approach that had formerly characterised mental health services. 

Furthering our collective understanding of psychotherapeutic approaches 

Today, there are hundreds of different psychological models, but also an infinite range of emotional problems and challenges that may lead someone to seek out psychotherapy. Unsurprisingly, then, many different types of psychotherapies have gained acceptance, including – but not limited to – individual talking therapy, family therapy, couples therapy, art therapy, and many more. 

It may seem a considerable challenge, then, to keep your knowledge and capabilities up to date for the needs of today’s clients, if you are a current or prospective therapist yourself. 

This is where the hundreds of constantly evolving seminars, workshops, online webinars and conferences made available to all audiences through providers like nscience are likely to come in useful. The world-class content that our courses provide are based on the latest developments and accepted best practice in psychotherapy and counselling, to help ensure you remain as effective as you can be for your clients as a mental health professional. 

Why not contact us today for answers to any of the questions you may have about our many fields of specialism within the broader discipline of therapy, which remains as crucial and relevant as ever?  

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