Historical Background of Psychotherapy

Psychotherapy - basic characteristics

1. verbal interaction between therapist & client

2. development of a supportive relationship in which a client can bring up & discuss traumatic or 
bothersome experiences that may have led to current problems

3. analysis of the client’s experiences &/or suggested ways for the client to deal with or overcome 
his or her problems

Early Treatments
    •  From 1400 to 1700, people who today would be diagnosed as schizophrenics were considered 
insane & called lunatics. In the late 1700s, Dr. Benjamin Rush, (considered the father of American 
Psychiatry), developed the “tranquilizing chair.

Reform Movements

     •  Moral therapy became popular in the early 1800s. It held the belief that mental patients could 
be helped to function better by providing humane treatment in a relaxed & decent environment. 
Moral therapy was abandoned late 1800s. Mental facilities begin to resemble human snake pits.
    •   In the 1930s, Sigmund Freud developed psychoanalysis.

     •   Until the early 1950s, wretched conditions & inhumane treatment of patients persisted; 
however, in the mid 1950s, two dramatic changes happened:
              1. discovery of antipsychotic drugs,

                2. development of community mental health centers.

Phenothiazines, Deinstitutionalization & Community mental health centers.

     •  Phenothiazines werediscovered in the early 1950s, they block or reduce the effects of the 
neurotransmitter dopamine and reduce schizophrenic symptoms, such as delusions and 
hallucinations. Chlorpromazine (Thorazine) was the first important typical neuroleptic.

     •  Deinstitutionalization refers to the release of mental patients from mental hospitals and their 
return to the community to develop more independent and fulfilling lives. A result of the 
introduction of phenptiazines.

     •  Community Mental Health Centers offer low-cost or free mental health care to members of the 
surrounding community, especially the underprivileged. They provide briefer forms of therapy 
that are needed in emergencies & focus on the early detection and prevention of psychological 

Questions About Psychotherapy

Different Kinds of Therapists

    Psychiatrists go to medical school, receive an M.D. degree, and then take a psychiatric 
residency, which involves additional training in pharmacology, neurology, psychopathology, 
and psychotherapeutic technique.

    Clinical psychologists go to graduate school in clinical psychology and earn a doctorate 
degree (Ph.D., Psy.D., or Ed.D.).

    Counseling psychologists go to graduate school in psychology or education and earn a 
doctorate degree (Ph.D., Psy.D., or ed.D).

Different Therapy Approaches

    Insight therapy where the therapist & client talk about the client’s symptoms & problems 
with the goal of reaching or identifying the cause of the problem.
   Cognitive-behavior therapy involves the application of principles of learning. The therapist 
focuses on the client’s problem, identifies specific thoughts & behaviors that need to be changed 
& provides techniques based on learning principles to make desired changes.

    The eclectic approach involves combining & using techniques & ideas from many different 
therapeutic approaches.

    Medical therapy involves the use of various psychoactive drugs to treat mental disorders by 
changing biological factors, such as the levels of neurotransmitters.

Insight Therapies

- Psychoanalysis -

    Psychoanalysis focuses on the idea that each of us has an unconscious part that contains 
ideas, memories, desires, or thoughts, that have been hidden or repressed because they are 
psychologically dangerous or threatening to our self-concept,

    Freud believed that Unconscious conflicts are the chief reason for the development of 
psychological problems (e.g. paranoia) and physical symptoms (e.g. loss of feeling in a hand).
  Neuroses are maladaptive thoughts & actions that arise from some unconscious thought or 
conflict and indicate feelings of anxiety.

    Three techniques of psychoanalysis:

1. Free Association - This is a technique that encourages clients to talk about
    any thoughts or images that enter their heads, the assumption is that this kind of
    free-flowing, uncensored talking will provide clues to unconscious material.

2. Dream Interpretation - is a psychoanalytic technique based on the
    assumption that dreams contain underlying, hidden meanings
    & symbols that provide clues to unconscious thoughts and desires.

3. analysis of slips of the tongue (Freudian slips)

Problems during Psychoanalysis

Transference is a process by which a client expresses strong emotions toward the therapist 
because the therapist substitutes for someone important in the client’s life, such as the 
client’s mother or father.

Resistance is characterized by the client’s reluctance to work through or deal with feelings or 
to recognize unconscious conflicts and repressed thoughts.

Short-term dynamic psychotherapy emphasizes a limited time for treatment (3-20 sessions) and 
focuses on limited goals, such as solving a relatively well-defined problem.

- Client-centered therapy - 

    Client-centered therapy; a.k.a. person-centered therapy, assumes that each person has an 

actualizing tendency, which is a tendency to develop one’s full potential.

      • Traits required of the therapist in client-centered therapy:

Empathy is the ability to understand what the client is saying & feeling.

Positive regard is the ability to communicate caring, respect, & regard for the client.

Genuineness is the ability to be real and non defensive in interactions with the client.

- Cognitive Therapy -

    Cognitive therapy; developed by Aaron Beck, assumes that we have automatic negative 
thoughts that we typically say to ourselves without much notice & repeating these automatic 
negative thoughts causes distortion in how we perceive and interpret our world and influences 
how we behave and feel.

Behavior Therapy

    •  Behavior Therapy, also called behavior modification, uses the principles of classical & 
operant conditioning to change disruptive behaviors & improve human functioning. Behavior 
Therapy focuses on changing particular behaviors rather than the underlying mental events 
or possible unconscious factors.

    •  Systematic Desensitization is a technique of behavior therapy in which the client is 
gradually exposed to the feared object while simultaneously practicing relaxation.

    •  Cognitive-Behavior Therapy combines the cognitive therapy technique of changing negative,
 unhealthy, or distorted thought patterns, with behavior therapy. It is a technique of changing 
maladaptive or disruptive behaviors by learning & practicing new skills, to improve functioning.

                 Topics in Psychology
                      Robert C. Gates