What Is the History of Psychiatry?

The history of any discipline is informed by many factors, and psychiatry is no exception. Cultural influences and prominent figures ranging from Socrates to Sigmund Freud helped create broad psychological theories such as cognitive theory and psychoanalysis. These theories laid the foundation for better understanding mental disorders and developing therapies that could help treat these disorders. By the 21st century, psychiatry had become a recognized medical discipline utilizing pharmaceuticals, technology, and improved 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 were often tortured or locked up in dungeon-like rooms. Witch hunts also occurred, with the accused persecuted and sometimes executed. Psychiatry would not truly begin as a scientific pursuit until roughly the 19th century, when theories like behaviorism and psychoanalysis competed 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 self-reflect, and he believed that all truth and knowledge came through reasoning. Socrates, along with individuals like 17th century French scholar Rene Descartes, introduced rationalism into studies of the human mind. These early approaches in the history of psychiatry were the precedents of cognitive therapy, which emphasizes restructuring faulty and damaging beliefs and thought processes.

Conversely, individuals such as Aristotle and 17th century English philosopher John Locke furthered 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 writes the tale. These beliefs laid the foundation for another significant shift in the history of psychiatry in the late 19th century: behaviorism. Advocates like John Watson and B.F. Skinner emphasized controlling abnormal human behavior via external means like reward and punishment.

In addition, 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. The unconscious, instinctual impulses are represented by a force called the id. When individuals repress these feelings from conscious awareness, they can transform into mental neurosis. According to this theory, most of an individual's personality and behavior is dictated by the battle between the id and the law-abiding, conforming superego; Freud believed that recognizing and confronting these conflicts could alleviate negative consequences.

Contrasting Freud, the humanism of both Alfred Adler and Abraham Maslow — developed after Freud's psychoanalytic theory — strongly holds that every individual is born good. Adler points out how each person’s ultimate goal in life is striving toward an ideal, perfect self free of any blemishes. Also, individuals all work for the common good of society, and thus possess a high degree of social interest. Similarly, Maslow focused on the betterment of 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: an optimistic, future-oriented therapy that sought to build on strengths rather than highlight weaknesses.

Many more individuals in the 19th and 20th century also made significant contributions in the history of psychiatry. Frenchman Jean-Martin Charcot gave scientific attention to the use of hypnosis in psychiatry, and he was also among the first to investigate the nervous system's role in facilitating mental abnormalities. Other researchers such as Karl Wernicke and Cesare Lombroso further investigated the biological roots of mental problems, thus introducing an objective medical aspect into the previously subjective psychology. Individuals like James McKeen Cattell and Emile Kraepilin gave psychiatry even more scientific credibility by devising testable psychological measures and emphasizing hard data. The impact of culture and other social influences on individual personality and behavior were also given consideration by Carl Jung, Alfred Bandura, and others.

Significant advances in the 20th century history of psychiatry include the true rise of cognitive approaches, the continued emphasis on biological and nervous system contributions to mental disorders, and worldwide, formal recognition of psychiatry as a scientific discipline and occupational pursuit. Medical advances and the onset of neurology as a separate discipline led to psychopharmacology, in which drugs are prescribed by psychiatrists to help correct neural imbalances. The first formal manuals that provided descriptions and guidelines for diagnosing various mental disorders were introduced during this time as well. New medical technologies such as digital scanning machines also offered methods for diagnosis. With the openings of official psychiatric organizations around the world and the creation of educational programs specifically geared toward psychiatry, the discipline thrived and generated countless branches of psychiatry sub-disciplines and therapeutic specialties.