The history of psychiatry is influenced by cultural factors and leading figures, from Socrates to Freud, who created broad psychological theories. The discipline began as a scientific pursuit in the 19th century, with theories like behaviorism and psychoanalysis. Advances in medicine and technology led to the rise of cognitive approaches, psychopharmacology, and the formal recognition of psychiatry as a scientific discipline. Psychiatry has flourished and spawned countless subdisciplines and therapeutic specialties.
The history of any discipline is informed by many factors and psychiatry is no exception. Cultural influences and leading figures ranging from Socrates to Sigmund Freud helped create broad psychological theories such as cognitive theory and psychoanalysis. These theories have laid the groundwork for a better understanding of mental disorders and the development of therapies that could help treat these disorders. By the 21st century, psychiatry had become a recognized medical discipline utilizing improved pharmaceuticals, technology, and diagnostic and therapeutic models.
Deep in the past the supernatural paradigm and mysticism reigned. As such, many mental illnesses were attributed to possession by evil forces, and those afflicted with them were often tortured or locked away in underground chambers. Witch hunts also occurred, with the accused persecuted and sometimes executed. Psychiatry didn’t really begin as a scientific pursuit until around the 19th century, when theories like behaviorism and psychoanalysis vied for recognition.
Investigations into the human mind gained an intellectual foothold with ancient Greek philosophers, namely Socrates. This philosopher first emphasized the importance of a human being’s ability to reason and reflect on himself, and he believed that all truth and knowledge come through reasoning. Socrates, along with individuals such as the 17th-century French scholar René Descartes, introduced rationalism into studies of the human mind. These early approaches in the history of psychiatry were the forerunners of cognitive therapy, which emphasizes the restructuring of erroneous and harmful beliefs and thought processes.
Conversely, individuals such as Aristotle and the 17th-century English philosopher John Locke promoted an empirical view of a passive mind that acquires all knowledge through experience. In other words, the mind is a blank slate on which external stimuli write the story. These beliefs laid the foundation for another significant shift in the history of psychiatry in the late 19th century: behaviorism. Defenders such as John Watson and BF Skinner have emphasized the control of abnormal human behavior through external means such as reward and punishment.
Furthermore, the 19th-century Austrian physician Sigmund Freud developed the preliminary vestiges of psychotherapy with his psychoanalytic theory. This theory centers on the conflict between an individual’s conscious and unconscious awareness. Unconscious instinctual impulses are represented by a force called the id. When individuals repress these feelings from conscious awareness, they can develop into mental neurosis. According to this theory, much of an individual’s personality and behavior is dictated by the battle between the id and the compliant, law-abiding superego; Freud believed that recognizing and dealing with these conflicts could alleviate the negative consequences.
In contrast to Freud, the humanisms of both Alfred Adler and Abraham Maslow – developed after Freud’s psychoanalytic theory – firmly hold that every individual is born good. Adler emphasizes that every person’s ultimate goal in life is to strive towards an ideal, perfect self, free from any blemishes. Furthermore, all individuals work for the common good of society, and therefore possess a high degree of social interest. Similarly, Maslow focused on improving the individual through self-actualization or developing characteristics such as creativity, motivation, empathy, and a lack of negative influences. Both Adler and Maslow promoted a new therapeutic approach in the history of psychiatry: optimistic, future-oriented therapy that sought to build on strengths rather than highlight weaknesses.
Many other individuals in the 19th and 20th centuries also made significant contributions to the history of psychiatry. Jean-Martin Charcot of France gave scientific attention to the use of hypnosis in psychiatry and was also among the first to investigate the role of the nervous system in facilitating mental abnormalities. Other researchers such as Karl Wernicke and Cesare Lombroso have further investigated the biological roots of mental problems, thus introducing an objective medical aspect into previously subjective psychology. Individuals such as James McKeen Cattell and Emile Kraepilin have given psychiatry even more scientific credibility by devising verifiable psychological measures and emphasizing hard data. The impact of culture and other social influences on individual personality and behavior has also been considered by Carl Jung, Alfred Bandura and others.
Significant advances in the history of 20th-century psychiatry include the true rise of cognitive approaches, the continued emphasis on biological and nervous system contributions to mental disorders, and the formal worldwide recognition of psychiatry as a scientific discipline and professional research. Advances in medicine and the inception of neurology as a separate discipline led to psychopharmacology, where drugs are prescribed by psychiatrists to help correct neural imbalances. The first formal textbooks were also introduced at this time that provided descriptions and guidelines for diagnosing various mental disorders. New medical technologies such as digital scanning machines have also offered methods for diagnosis. With the opening of official psychiatric organizations around the world and the creation of educational programs specifically geared towards psychiatry, the discipline flourished and spawned countless branches of psychiatric subdisciplines and therapeutic specialties.
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