Psychotherapy Health Article

Origins

Psychotherapy had its beginnings in the ministrations of some of the earliest psychologists, priests, magicians, and shamans of the ancient world. They attempted to determine the causes of a person's emotional distress by talking, counseling, and educating, and interpreting both behavior and dreams. Many of these practices became suspect as the work of charlatans, and fell into disrepute over the centuries. There was little change or progress in the treatment of mental illness over the centuries that followed.

Austrian physician Franz Anton Mesmer (1734–1815) began using what he termed magnetism and both the power of suggestion and hypnosis in 1772. Mesmer's treatments, too, fell into disrepute after his theories were rejected by a medical board of inquiry in 1784. Then, nearly a century later, Mesmer's ideas were rediscovered by French neurologist Jean-Martin Charcot (1825–1893). Dr. Charcot used suggestion and hypnosis for treating psychological difficulties at the Salpêtrière Hospital in Paris in the late nineteenth century. Mesmer is now known as the Father of Hypnosis.

In the late nineteenth and early twentieth century, Austrian physician Sigmund Freud studied Charcot's work, and came to believe that hypnosis was less a treatment for mental illness than a means of determining its underlying cause. Freud used hypnosis as one means of uncovering the often traumatic, not consciously recalled memories of his neurotic patients, just as he used their dreams to evaluate their mental conflicts. He later abandoned hypnosis because he did not induce successful trances in his neurology patients. His The Interpretation of Dreams, published in 1899, made the point that a person's dreams were actually a window into the inner, unknown mind—the royal road to the unconscious. He used the information he obtained not only to help his patients, but also to collect data that eventually helped verify some of his psychodynamic assumptions.

Sigmund Freud theorized that the human personality is composed of three basic parts, the id, the ego, and the superego. The id is defined as the most elemental part, the one that unconsciously motivates people toward fulfilling instinctive urges. The ego is more related to intellect and judgment. It arbitrates between the internal, usually unrecognized desires all human beings have and the reality of the external world. The superego, unconscious controls dictated by moral or social standards outside of ourselves, is probably most easily described as another name for the conscience.

Freud believed that mental illness was the result of people's being unable to resolve conflict, or inadequate settlement of disharmony among the ego, superego, and id. To deal with these internal psychic conflicts, people develop defense mechanisms, which is normally a healthy response. The defense mechanisms become harmful to mental health when overused, or used inappropriately. Freud further postulated that childhood psychic development is primarily based upon sexuality; he divided the first eighteen months of life into three sexbased phases, oral, anal, and genital.

Freud's earliest students, including Carl Jung and Alfred Adler, came to believe that Freud had overestimated the influence sexuality has on psychic development, and found other influences that help to shape human personality. In the late 1800s and into the twentieth century, 1904 Nobel Prize winner Ivan Petrovich Pavlov pioneered the research that would later result in behavioral therapies, such as the work of American behaviorist Burrhus Frederic Skinner. And in the 1930s, American psychologist Carl Ransom Rogers began his school of psychology that emphasized the importance of the relationship between the patient (or client, according to Rogers) and the therapist in bringing about positive psychic change.

Primal therapy, developed by Arthur Janov in the 1960s, is based upon the assumption that people must relive early life experiences with all the acuity of feeling that was somehow suppressed at the time in order to free themselves of compulsive or neurotic behavior. Primal therapy was a cathartic approach that many therapists now believe can impede progress because a person can become addicted to the release (even "high") associated with the catharsis and seek to keep repeating it for the momentary satisfaction. Transactional analysis, based on Eric Berne's work, came into favor in the 1970s, and supposes that all people function as either a parent or child at various times. It teaches the person to identify which role he or she is filling at any given time and to evaluate whether this role is appropriate.