Psychology
is very often, by many, seen as the study and treatment of mental problems; it
is seen as a field of study that deals with abnormal behavior and psychological
problems. However, initially, psychology had no association with mental illness
and disorders. This aspect of psychology emerged much later.
Modern
psychology began in 1879, with the establishment of Wundt’s laboratory at
Leipzig. Psychology then, and for many years later, was the study of conscious
experiences and its aim was to understand basic human processes. The major
topics of study were sensation, perception, memory, and learning. In 1892, when
the American Psychological Association (APA) was established, psychology was
regarded as an academic discipline with its roots in experimentation and was
considered to be a field of study based only on research.
With
the formation of the APA, psychology was said to be firmly established as a
distinct discipline. Psychology was regarded as a scientific, research based
discipline as in the beginning of modern psychology, and psychologists were
even then mainly concerned with sensation, perception, and dimensions of the
mind.
It
was only in 1896, seventeen years after the beginning of modern psychology and
four years after the formation of the APA that psychology began to be concerned
with mental disorders. The year 1896 is regarded as the birth of clinical
psychology – the area of psychology concerned with the diagnosis and treatment
of psychological disorders.
The
opening of the first psychological clinic, in 1896, by Lightner Witmer, at the
University of Pennsylvania, is regarded as the formal beginning of clinical
psychology. After completing his PhD under Wilhelm Wundt, Witmer returned to
the University of Pennsylvania and became the director of the psychology
laboratory. While doing research, he was always very keen of using the basic
principles of human behavior to help individuals with their difficulties.
In
1896, a teacher consulted Witmer about the problems her student was facing in
school. Witmer organized a make shift clinic and after assessing the student’s
problem, he developed a specific treatment program. He found that the child had
difficulty in spelling, reading, and memory, and recommended tutoring, which
later proved to be a successful intervention.
Lightner Witmer |
Witmer,
thus, became the first psychologist to use his understanding of the principles
of human behavior to help an individual with a particular problem. Within a few
months, Witmer was preparing courses on methods for treating mentally
defective, blind, and disturbed children.
Later,
in the same year, Witmer presented a paper at the annual meeting of APA in
which he described his methods of diagnosis and treatment. It was here that he
used the term clinical psychology for
the first time. He also proposed that a psychological clinic could be devoted
to diagnosis and evaluation, individual treatment, public service, research,
and the training of students.
By
1904, the University of Pennsylvania began offering formal courses in clinical
psychology and Witmer went on to offer the first college course on clinical
psychology. In 1907, Witmer founded the journal Psychological Clinic, which became the first journal in the field. For
many years, this was the only journal for clinical psychology.
In
the first issue of the journal, Witmer proposed a new application of psychology
and a new profession to be called clinical psychology. The following year, he
established a boarding school for retarded and disturbed children, and in 1909
his university clinic expanded and was established as a separate administrative
unit.
Witmer
independently developed his psychological clinic at the University of
Pennsylvania along with programs to assist children with primarily school related
difficulties and challenges. Teachers began sending to Witmer’s new clinic many
other children with a broad range of deficiencies and problems, which included
hyperactivity, learning disabilities, and poor speech and motor development. As
his experience with these problems increased, Witmer developed standard
programs of assessment and treatment.
A
number of psychologists followed Witmer’s example, and within a few years many
psychological clinics opened. All these clinics were patterned on Witmer’s
clinic.
Many
of the principles that Witmer developed in his psychological clinic are still
used today - he favored a diagnostic evaluation prior to offering treatment
procedures and services, he favored a multidisciplinary team approach instead
of individual consultation, he used interventions and diagnostic strategies
based on research evidence, and, he was interested in preventing problems
before they emerged.
Therefore,
clinical psychology, the area of psychology devoted to the diagnosis and
treatment of abnormal behavior and psychological disorders began in 1896. This was
the first time a psychologist used the understanding of basic processes in
order to treat abnormal behavior.
A
year before the birth of clinical psychology, abnormal behavior, which was only
studied in psychiatry, became a part of psychology, due to the beginning of the
classical school of psychology called Psychoanalysis.
In
his career as a neurologist, Sigmund Freud, the founder of psychoanalysis,
realized that many of his patients had neurological problems without any organic
pathology. Freud found that the neurological symptoms of his patients were
caused by hysteria, which was due to an emotional conflict that individuals
might be suffering from.
This
emotional conflict, according to Freud was due to painful childhood memories,
forbidden sexual wishes, or forbidden aggressive wishes that were hidden in the
unconscious mind of the individuals. When not resolved, this emotional conflict
gets manifested as neurological symptoms.
Sigmund Freud |
It
was this realization that led Freud towards the founding of psychoanalysis. In 1895,
Freud collaborated with his colleague and mentor Joseph Breuer in the publication
of the book Studies on Hysteria. The
book was about the description of the cases of hysteria that they had treated. The
publication of this book is said to be the beginning of psychoanalysis – a system
of psychological theory and therapy that aims to understand and treat mental
illness by investigating the unconscious elements of the mind.
After
separating from Breuer, Freud further developed his theory with the publication
of his books The Interpretation of
Dreams, in 1900, and The Psychopathology
of Everyday Life, in 1901. Freud majorly used the techniques of free association
and dream analysis for treating his patients.
In free
association, the patient lies on a couch and is encouraged to talk openly
and spontaneously, giving complete expression to every idea, no matter how
embarrassing, unimportant, or foolish it may seem. Such thoughts were often
jumbled and fragmentary, with no apparent patterns. However, Freud would
gradually see a pattern emerge, which resulted in a highly emotional recall of
forgotten events.
These events, according to Freud were repressed in
the unconscious mind of the patient and were only revealed in the conscious awareness
due to free association. This recall of repressed memories and events would
help the patients to be treated of their emotional trauma.
Freud also analysed the dreams (dream analysis) of his patients. He
believed that dreams represent a disguised satisfaction of repressed desires
and that the essence of a dream is wish
fulfilment. Freud believed that when patients described their dreams, their
forbidden desires (the latent dream content) are expressed only in symbolic
form. This revealing of forbidden desires of his patients helped him in their
treatment.
Freud used clinical observations as his
primary data. He was a gifted observer and heavily relied on clinical data. He
derived his theory from the experiences he had with his patients in his clinic.
Freud also believed that normal and abnormal behavior can be seen in continuity.
According to him normality and abnormality differed only in terms of degree and
not in type; and thus, had a humane approach towards mental illness.
Among all the classic schools of
psychology, Psychoanalysis is the only one that made its aim to improve the
mental health of an individual. Freud’s psychoanalytic theory,
according to which behavior is guided by the unconscious forces of the mind,
was the first comprehensive theory of personality.
The ideas of Freud became very crucial to the
development of clinical psychology. It moved the field far beyond its origins
in Witmer’s clinic. Psychologists were fascinated with Freud’s work and his
ideas provided clinical psychologists with their first psychological techniques
of therapy.
Therefore,
in 1895, sixteen years after the beginning of modern psychology, with the
formation and rise of psychoanalysis, the study abnormal behavior which was
only a part of psychiatry had also become a part of psychology.
Psychology,
even though popularly seen as synonymous with the study and treatment of
abnormal behavior, initially had no association with it. Modern psychology
began as a scientific, research-based field to understand general, normal basic
human processes. It was a good sixteen to seventeen years after the beginning
of modern psychology that abnormal behavior was included as a part of
psychology. Before this, abnormal behavior was only a part of psychiatry.
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