A short history, including its failures

Before psychotherapy

Distress has always been treated. What changed in the nineteenth century was who had authority over it. The moral treatment movement — Pinel in Paris, Tuke at the York Retreat — proposed that people in asylums be treated with kindness, occupation and routine rather than restraint, and reported recovery rates that later institutions never matched. It collapsed under scale, and the asylums became warehouses.

The founding period, 1880–1940

• Charcot’s demonstrations of hysteria at the Salpêtrière make the mind a legitimate object of medical attention
• Breuer and Freud’s Studies on Hysteria (1895) and the invention of the talking cure
• Adler and Jung break away; the first schisms establish the pattern the field has followed since
• Watson founds behaviourism (1913); Mary Cover Jones treats a child’s phobia by graded exposure (1924)
• Moral treatment is forgotten; psychoanalysis becomes the dominant framework in American psychiatry

Expansion and reaction, 1940–1980

• The Second World War creates mass demand and the clinical psychology profession to meet it
• Rogers publishes the necessary and sufficient conditions (1957) and begins recording sessions
• Eysenck (1952) claims psychotherapy is no better than spontaneous remission, and the field is forced to produce evidence
• Wolpe, Skinner and the behaviour therapists build treatments from learning theory
• Beck and Ellis found the cognitive therapies; the cognitive revolution absorbs behaviour therapy
• Family therapy emerges from cybernetics; the humanistic movement peaks
• Smith and Glass (1977) publish the first meta-analysis of psychotherapy outcome, and the answer to Eysenck is yes, it works

Evidence, manuals and markets, 1980–present

• Manualisation makes trials possible and changes what gets studied
• The empirically supported treatments movement, and the backlash from practitioners
• Managed care and public systems demand brief, measurable treatment
• Common factors research accumulates; the dodo bird returns
• Third-wave therapies emerge from within the behavioural tradition
• Digital delivery, stepped care, and psychotherapy at population scale

The failures

• Drapetomania (1851): a diagnosis for enslaved people who fled captivity
• Homosexuality as a mental disorder until 1973, treated with aversion therapy including electric shock
• The schizophrenogenic mother, which burdened a generation of families with blame for an illness they did not cause
• Institutional aversive procedures, including with children and with disabled people
• The recovered-memory episode of the 1980s and 1990s: therapeutically induced false memories, wrongful accusations, destroyed families, and a slow professional reckoning
• Facilitated communication, which produced abuse allegations from communications the facilitators were unknowingly authoring
• The routine disbelief of women reporting sexual abuse, and the diagnostic labels applied instead

The question a student should carry out of a history lecture is not how those clinicians were so wrong, but which of our present certainties will read the same way.