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What is the History of Psychotherapy?

Historically, counselling and psychotherapy have mainly focused on the inner lives of clients without consideration of social and cultural influences. Elliott (2010, p. 70), suggested that Sigmund Freud (1856-1939) was largely responsible for “…suppressing the external social conditions that generate personal distress and individual oppression”, with regard to the practice of psychotherapy.Freud’s theories, in particular his abandoned Theory of Seduction and the Oedipus Complex, continue to have a great influence upon the current practice of psychotherapy, especially in the area of childhood sexuality. Some of Freud’s ideas are now regarded as problematic because his viewpoint of the world was restricted by the environment in which he lived. In many respects, however, early psychotherapists, along with other health professionals, thought that beyond the disease, the patient was merely a “passive receptacle”.

The definition of psychotherapy was later challenged by many other theorists, such as McLeod (1999, P.2) who says that psychotherapy is more than just an interaction between the client and the therapist, but “…a social institution which is embedded in the culture of modern industrialized societies”.

Carl Jung (1875-1961) was Freud’s chosen successor for a short time, but irreconcilable differences led to their relationship breakdown and Jung’s subsequent development of his own theories. One of his concepts is what Jung named “the collective unconsciousness” which consists of shared universal images (archetypes) and instinctive behaviours, often expressed in dreams. Jung suggested that these archetypes would influence every person’s actions, both in their external world and in their internal world, or unconscious. Thus, every individual would not only be linked to the past, but would also be an inevitable part of the present; linked by their “collective unconsciousness” to form part of society as a whole.

Alfred Adler (1870-1937), abandoned many of Freud’s theories, declaring that people are not solely determined by their heredity or environment but have the ability to change and interpret their lives. One of his most important concepts was social interest, or Gemeinschaftsgefuhl. Corey (1996, p.137) defines this as “…an individual’s awareness of being part of the human community and to the individual’s attitudes in dealing with the social world…” I suggest that Adler was one of the first major contributors to modern practice of psychotherapy, by recognition that all people are part of, and influenced by, the social environment and not merely the aforementioned “passive receptacle”.

Erving Goffman (1922-1982), regarded the self as a performer, who interacts with social situations according to the role required. Goffman used the metaphor of the theatre to express his theories, suggesting that our identity is something that we do, not whom we are. To Goffman, life was habitually a performance and the self always socially defined, not merely an outcome of inner conflicts or family history.

The theory of Neurobiology of Attachment indicates that psychotherapy cannot be practised solely as an intellectual exercise but needs to incorporate the emotional and physical parts of an individual. Cozolino (2006, p. 307) says that “Humans serve as external neural circuits that we can use to help each other bridge dissociated neural networks” and we can…”help and heal each other”.

He also suggests that therapists need to be included in those relationships, in order to maximize their therapeutic influence on the social brain. Cozolino suggests that “The brain is an organ of adaptation; it can adapt to any environment, including those that are not conducive to happiness and health”. (2006, p.307) Neurobiology suggests that early attachment styles are one of the greatest influences on how we behave as social creatures, and that there is less choice as a “creative and reflective agent”.Recognition of the need to include social context, became apparent as family therapy perspectives developed during the 1960s and 1970s. Despite different approaches Corey (1996, p.367) suggests that all family therapists agreed that clients were “…connected to living systems and that change in one part of the unit reverberates throughout the other parts”. An acceptance that people are social beings, embedded in a social structure and culture meant that psychotherapists also had to be regarded as part of that social structure.

Michel Foucault (1926-1984), the French philosopher and historian, whose theories were hugely influential during the 1960s and 1970s, should also be mentioned. His project “The History of Sexuality”, according to Elliott (2009, p.92) suggests that “…knowledge about sexuality in the late modern age compels individuals to situate themselves in relation to regimes of sexuality, particularly to what is regulated, forbidden, prohibited”. A critical appraisal of Freudianism, it states that many of the problems in society are reflected in this repressed sexuality. However, Foucault did not discuss social practices which related to the specific gender of the individual.

Modern or second-wave feminism also dates to the 1960s, when the importance of the sex/gender distinction became apparent and women used consciousness-raising to create an awareness of how they were socialized into an oppressive, second-class existence. Feminism also highlighted the realization that so called “universal” knowledge, was not objective, but reflected the historical views of subjective males.

Problems with gender and multicultural counselling continue to be presented in contemporary practices of psychotherapy, where it is still often seen as the province of the privileged white, middle-class Christian. There also appears to be a general perception in society that psychotherapy is, and maybe should be, available only to people who can afford to pay the traditionally high fee. If individuals are encouraged to believe that their problems are caused by “personal pathologies” then therapy could also be seen to promote the empty pursuit of individual happiness as an end in itself.

It is my opinion, that psychotherapy has an obligation to offer an alternative to the therapy often offered by psychologists and psychiatrists, which can run the risk of presenting a “personal pathology” solution to the problems presented. To be in a position to offer this alternative service, then psychotherapists will have to be seen as providing a social practice, which truthfully reflects all positive aspects of society and allows affordable access to everyone who may need to seek their services, not just the favoured few.

References:

  • Corey, G. (1996) Theory and Practice of Counselling and Psychotherapy. (5th ed.) Brooks/Cole: CA.
  • Cozolino, L. (2006) The Neuroscience of Human relationships. W.W. Norton & Co: New York.
  • Elliott, A. (2010) Concepts of the Self (2nd ed.). Polity Press: London.
  • McLeod, J. (1999) An Introduction to Counselling. Open University Press: Buckingham.

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