We tend to think of psychotherapy — the treatment of emotional or psychological problems — as a modern, 20th century invention. Yet people wanting to help others’ emotional trauma and difficulties can be traced back far further in history.
Helping Others in Ancient Times
The ancient Greeks were the first to identify mental illness as a medical condition, rather than as a sign of malevolent deities or gods. While their understanding of the nature of the mental illness was not always correct (e.g., they believed that hysteria affected only women, due to a wandering uterus!), and their treatments rather unusual (e.g., bathing for depression, blood-letting for psychosis), they did recognize the treatment value of encouraging and consoling words.
With the fall of the Roman Empire, the Middle Ages saw the return of a belief in the supernatural as a cause for mental illness and the use of torture to gain confessions of demonic possession. However, some physicians began to support the use of psychotherapy. Paracelsus (1493-1541) advocated psychotherapy for treatment of the insane.
Psychotherapy in the 19th and 20th Centuries
While there were scattered references to the value of “talking” in the treatment of emotional problems, the English psychiatrist Walter Cooper Dendy first introduced the term “psycho-therapeia” in 1853. Sigmund Freud developed psychoanalysis around the turn of the century, and made profound contributions to the field with his descriptions of the unconscious, infantile sexuality, the use of dreams, and his model of the human mind.
Freud’s work with neurotic patients led him to believe that mental illness was the result of keeping thoughts or memories in the unconscious. Treatment, primarily listening to the patient and providing interpretations, would bring these memories to the forefront and thus decrease symptoms.
For the next fifty years, Freud’s methods of psychoanalysis and various versions of it were the main type of psychotherapy practiced in clinical settings. Around the 1950s, the growth of American psychology led to new, more active therapies that involved the psychotherapeutic process and a better understanding of human behavior.
Modern Psychotherapy Practice
The practice of behavioral psychology borrowed principles from animal psychology to treat emotional and behavioral problems. Over the years, behavior therapy has been enhanced to include emphasis on the thoughts and feelings of the person. This combined cognitive-behavioral therapy (CBT) has become a major type of treatment for many psychiatric conditions.
The interpersonal therapy developed by Carl Rogers during the 1940s and 1950s focused on the transmission of warmth, genuineness, and acceptance from the therapist to the individual. By the late 1960s there were over 60 different types of psychotherapies, ranging from psychodrama (using drama techniques) to guided imagery (using mental pictures and stories).
The next major style of psychotherapy was developed not as the result of new ideas, but due to economic issues. Traditionally, psychotherapy was a long progress, often involving years of treatment. As psychotherapy became more widely available, emphasis was placed on a more brief form of treatment. This trend was further driven by the arrival of managed care insurance plans and limitations to coverage for mental health issues. Today, virtually all therapeutic modalities offer some sort of brief therapy designed to help the person deal with specific problems.
Most therapists today use an approach called “eclectic” therapy, which is combining techniques from various schools of therapy tailored to each individual person’s needs and insight. The foundation of most therapist’s practice are CBT techniques, combined with a warm, supportive therapeutic relationship built on trust and acceptance. Most modern therapy is time-limited, and most problems can be treated in less than a year’s time. Most health insurance in the U.S. covers the cost, minus the co-pay, of psychotherapy treatment.
Learn more: Psychotherapy Overview