Lesson 04

Historical Overview ofHistorical Overview of
Clinical PsychologyClinical Psychology
Lecture 4Lecture 4

INTRODUCTIONINTRODUCTION
 The history of clinical psychology, like that of many fields, isThe history of clinical psychology, like that of many fields, is
typically presented as a collection of names and dates.typically presented as a collection of names and dates.
 It is important to understand the individuals who haveIt is important to understand the individuals who have
shaped the field of clinical psychology and to know whenshaped the field of clinical psychology and to know when
landmark events in the field occurred.landmark events in the field occurred.
 Tracing the progression of the development of the field andTracing the progression of the development of the field and
the individuals who have influenced it provides an importantthe individuals who have influenced it provides an important
perspective on the roots of clinical psychology as it existsperspective on the roots of clinical psychology as it exists
today.today.

INTRODUCTION (cont.)INTRODUCTION (cont.)
 However, the primary significance of clinicalHowever, the primary significance of clinical
psychology's relatively short history does not lie inpsychology's relatively short history does not lie in
names and dates. Rather, its historical importancenames and dates. Rather, its historical importance
comes from an understanding of the factors that havecomes from an understanding of the factors that have
shaped the field into its current form and the forces thatshaped the field into its current form and the forces that
are likely to influence its development in the future.are likely to influence its development in the future.
 Three things are striking about the history of clinicalThree things are striking about the history of clinical
psychology.psychology.
 First, many of the significant events and forces that haveFirst, many of the significant events and forces that have
influenced its development have come from outsideinfluenced its development have come from outside
rather than from within psychology.rather than from within psychology.

INTRODUCTION (cont.)INTRODUCTION (cont.)
 Second, there have been significant advances in theSecond, there have been significant advances in the
science of clinical psychology, in some instancesscience of clinical psychology, in some instances
represented by breakthrough pieces of research, butrepresented by breakthrough pieces of research, but
most often through the slow and gradual accumulation ofmost often through the slow and gradual accumulation of
knowledge across many studies.knowledge across many studies.
 And third, clinical psychology has emerged as aAnd third, clinical psychology has emerged as a
profession only recently and is still working to define itsprofession only recently and is still working to define its
identity. More fundamental than the questions of howidentity. More fundamental than the questions of how
and when clinical psychology developed is the questionand when clinical psychology developed is the question
of why the science and profession of clinical psychologyof why the science and profession of clinical psychology
developed so rapidly during the second half of thedeveloped so rapidly during the second half of the
twentieth century.twentieth century.

 The field of clinical psychology came into being for two reasons.The field of clinical psychology came into being for two reasons.
 First, throughout history there has been a need to provide careFirst, throughout history there has been a need to provide care
and services for individuals who are experiencing psychologicaland services for individuals who are experiencing psychological
problems, and clinical psychology emerged in part to help meetproblems, and clinical psychology emerged in part to help meet
this need. The needs of individuals with psychological problemsthis need. The needs of individuals with psychological problems
had been addressed in very different ways over the course ofhad been addressed in very different ways over the course of
history before clinical psychology stepped in to help fill this role.history before clinical psychology stepped in to help fill this role.
 Second, some of the founders of scientific psychology in the lateSecond, some of the founders of scientific psychology in the late
1800s and early 1900s felt that one objective of their new science1800s and early 1900s felt that one objective of their new science
should be to contribute to the welfare of others.should be to contribute to the welfare of others.
 Thus, a societal need existed, and some members of theThus, a societal need existed, and some members of the
psychological community felt a responsibility to fill this need.psychological community felt a responsibility to fill this need.

Early Approaches toEarly Approaches to
Mental Health CareMental Health Care

 The commitment to helping individuals in psychologicalThe commitment to helping individuals in psychological
distress certainly did not begin with the field of clinicaldistress certainly did not begin with the field of clinical
psychology.psychology.
 The major functions that are served by clinicalThe major functions that are served by clinical
psychologists today (understanding and aidingpsychologists today (understanding and aiding
individuals who are suffering from psychologicalindividuals who are suffering from psychological
disorders or are experiencing significant psychologicaldisorders or are experiencing significant psychological
distress) were met by other individuals and institutions indistress) were met by other individuals and institutions in
societies for centuries before the emergence ofsocieties for centuries before the emergence of
psychology as a profession.psychology as a profession.
 In various societies and at different points in history,In various societies and at different points in history,
“who” has been responsible for meeting the“who” has been responsible for meeting the
psychological needs of individuals has depended onpsychological needs of individuals has depended on
“how” mental health and mental disorder have been“how” mental health and mental disorder have been
viewed.viewed.

 Professions that had taken responsibility for the welfareProfessions that had taken responsibility for the welfare
of individuals who suffer from psychological orof individuals who suffer from psychological or
psychiatric disorders included the clergy or otherpsychiatric disorders included the clergy or other
religious groups, physicians, and individuals committedreligious groups, physicians, and individuals committed
to social /welfare.to social /welfare.
 It is important to recognize that psychologists have onlyIt is important to recognize that psychologists have only
recently joined these other groups in the field of mentalrecently joined these other groups in the field of mental
health.health.
 For much of recorded history, treatment of psychologicalFor much of recorded history, treatment of psychological
problems was carried out by religious institutions, thatproblems was carried out by religious institutions, that
was based in demonology, the view that these problemswas based in demonology, the view that these problems
are the caused by forces of evil.are the caused by forces of evil.

The Greek PeriodThe Greek Period

Primitive Greeks viewed mental aberrations in magical andPrimitive Greeks viewed mental aberrations in magical and
religious frame of reference.religious frame of reference.

Several Greek thinkers were pivotal in the early developmentSeveral Greek thinkers were pivotal in the early development
of integrative approaches to illness, and, thus, wereof integrative approaches to illness, and, thus, were
precursors to a bio-psycho-social perspective.precursors to a bio-psycho-social perspective.

Although he ancient Greeks felt that the gods ultimatelyAlthough he ancient Greeks felt that the gods ultimately
controlled both health and illness, these thinkers lookedcontrolled both health and illness, these thinkers looked
beyond supernatural influences and explored biological,beyond supernatural influences and explored biological,
psychological and social influences on illness.psychological and social influences on illness.

Important Greek philosophers :Important Greek philosophers :
 The earliest medical or biological explanation of emotionalThe earliest medical or biological explanation of emotional
and behavioral disorders can be found in the writings ofand behavioral disorders can be found in the writings of
Hippocrates in the fourth century b.c.Hippocrates in the fourth century b.c.
 HippocratesHippocrates felt that disease was primarily the result of anfelt that disease was primarily the result of an
imbalance in four bodily fluids or humors, rather than toimbalance in four bodily fluids or humors, rather than to
spiritual factors.spiritual factors.
 These fluids were black bile, yellow bile, phlegm, and blood.These fluids were black bile, yellow bile, phlegm, and blood.
 Furthermore, Hippocrates felt that the relationship betweenFurthermore, Hippocrates felt that the relationship between
these bodily fluids also determined temperament andthese bodily fluids also determined temperament and
personality.personality.

 PlatoPlato felt that mental illness resulted from sickness in thefelt that mental illness resulted from sickness in the
part of the soul that operates the head, controlling reason.part of the soul that operates the head, controlling reason.
 AristotleAristotle maintained a scientific emphasis and felt thatmaintained a scientific emphasis and felt that
certain distinct emotional states including joy, fear, angercertain distinct emotional states including joy, fear, anger
and courage impacted the functioning of human body.and courage impacted the functioning of human body.
 GalenGalen also used the humoral theory of balance between thealso used the humoral theory of balance between the
four bodily fluids discussed previously as a foundation forfour bodily fluids discussed previously as a foundation for
treatments.treatments.
 He thought that humans experienced one of two irrationalHe thought that humans experienced one of two irrational
sub souls, one for males and one for females.sub souls, one for males and one for females.
 Galen felt that the soul was the slave and not the master ofGalen felt that the soul was the slave and not the master of
the body, and that wishes of the souls in the body resultedthe body, and that wishes of the souls in the body resulted
in health and illness.in health and illness.

THE MIDDLE AGESTHE MIDDLE AGES
 During theDuring the Middle Ages (500-1450A.D),Middle Ages (500-1450A.D), earlier notionsearlier notions
regarding the relationship among health, illness, mind,regarding the relationship among health, illness, mind,
and body reemerged.and body reemerged.
 The focus on supernatural influences to explain eventsThe focus on supernatural influences to explain events
became commonplace.became commonplace.
 Spiritual matters such as the influence of demons,Spiritual matters such as the influence of demons,
witches and sins caused diseases and “insanity”, manywitches and sins caused diseases and “insanity”, many
believed.believed.
 So healing and treatment became, once more, aSo healing and treatment became, once more, a
spiritual rather than a medical issue.spiritual rather than a medical issue.

THE MIDDLE AGES (cont.)THE MIDDLE AGES (cont.)
 The church was responsible for explaining theThe church was responsible for explaining the
causes of psychological disturbance andcauses of psychological disturbance and
providing treatment for it (most often in the formproviding treatment for it (most often in the form
of punishment).of punishment).
 For example, disturbed and disordered behaviorFor example, disturbed and disordered behavior
that today is considered evidence of psychosisthat today is considered evidence of psychosis
(e.g.. hallucinations, delusions) used to be(e.g.. hallucinations, delusions) used to be
interpreted as evidence of possession by theinterpreted as evidence of possession by the
devil and was treated through exorcisms, torture,devil and was treated through exorcisms, torture,
or death by burning at the stake.or death by burning at the stake.

 Not every one during the middle Ages believed that good orNot every one during the middle Ages believed that good or
evil spirits and demons, sorcery and witchcraft contributedevil spirits and demons, sorcery and witchcraft contributed
to mental illness. Some thinkers, such asto mental illness. Some thinkers, such as Saint ThomasSaint Thomas
AquinasAquinas felt that there were both theological and scientificfelt that there were both theological and scientific
reasons of abnormal behavior.reasons of abnormal behavior.
 The late 14th centuryThe late 14th century FrenchFrench bishopbishop Nicholas Ores meNicholas Ores me
felt that abnormal behavior and mental illness were due tofelt that abnormal behavior and mental illness were due to
diseases such as “melancholy” (today’s depression).diseases such as “melancholy” (today’s depression).
 A Swiss physician,A Swiss physician, ParacelsusParacelsus,, popularized the notion thatpopularized the notion that
various movements of the stars, moon, and planetsvarious movements of the stars, moon, and planets
influenced mood and behavior.influenced mood and behavior.
 He also focused on the biological foundations of mentalHe also focused on the biological foundations of mental
illness and developed humane treatments.illness and developed humane treatments.

THE RENIASSANCETHE RENIASSANCE
 During the renaissance, renewed interest in the physicalDuring the renaissance, renewed interest in the physical
and medical worlds emerged, overshadowing previouslyand medical worlds emerged, overshadowing previously
supernatural and religious viewpoints. Interest in the mindsupernatural and religious viewpoints. Interest in the mind
and soul were considered unscientific.and soul were considered unscientific.
 MorgagniMorgagni discovered through autopsy that a diseaseddiscovered through autopsy that a diseased
organ in the body could cause illness and death.organ in the body could cause illness and death.
 Andreas VesaliusAndreas Vesalius emphasized scientific observation andemphasized scientific observation and
experimentation rather than reason, mythology, religiousexperimentation rather than reason, mythology, religious
beliefs, and dogma.beliefs, and dogma.
 Rene' DescartesRene' Descartes argued that the mind and body wereargued that the mind and body were
separate. This dualism of mind and body then became theseparate. This dualism of mind and body then became the
basis for Western medicine until recently.basis for Western medicine until recently.

THE RENIASSANCE (cont.)THE RENIASSANCE (cont.)
 Treatment of medical illness, from the 1500s throughTreatment of medical illness, from the 1500s through
1800s,however, lagged medical developments.1800s,however, lagged medical developments.
 During this period, physicians treated people who wereDuring this period, physicians treated people who were
considered deviant or abnormal by confining them toconsidered deviant or abnormal by confining them to
hospitals and asylums.hospitals and asylums.
 Little treatment, other than custodial care, was providedLittle treatment, other than custodial care, was provided
to these patients and thus these asylums were renownedto these patients and thus these asylums were renowned
for their prison like environments.for their prison like environments.

THE NINETEENTH CENTURYTHE NINETEENTH CENTURY
 The nineteenth century experienced numerous advances inThe nineteenth century experienced numerous advances in
understanding mental and physical illness, and allowed for aunderstanding mental and physical illness, and allowed for a
more sophisticated understanding of the relationship betweenmore sophisticated understanding of the relationship between
body and mind in both health and illness.body and mind in both health and illness.
 Important figures include:Important figures include:
 Louis Pasteur:Louis Pasteur: He believed that disease and illness could beHe believed that disease and illness could be
attributed to dysfunction at the cellular level.attributed to dysfunction at the cellular level.
 Benjamin Rush:Benjamin Rush: He authored the first American text inHe authored the first American text in
psychiatry, positing that the mind could cause a variety ofpsychiatry, positing that the mind could cause a variety of
diseases.diseases.

 Franz Mesmer:Franz Mesmer: He noticed that many people experiencingHe noticed that many people experiencing
paralysis, deafness, and blindness had no biomedical pathology,paralysis, deafness, and blindness had no biomedical pathology,
leaving psychological causes suspect.leaving psychological causes suspect.
 Phillipe Pinel:Phillipe Pinel: He did much to improve the living conditions andHe did much to improve the living conditions and
treatment approaches used by mental hospitals during thetreatment approaches used by mental hospitals during the
nineteenth century. He introduced thenineteenth century. He introduced the “Moral Therapy”.“Moral Therapy”.
 Clause Bernard :Clause Bernard : HeHe was a prominent physician who argued forwas a prominent physician who argued for
recognition of the role of psychological factors in physical illness.recognition of the role of psychological factors in physical illness.
 William Tuke and Dorothea DixWilliam Tuke and Dorothea Dix worked forworked for more humanemore humane
treatment approaches in mental hospitals in United States.treatment approaches in mental hospitals in United States.
 Franz Alexander:Franz Alexander: He also studied the association betweenHe also studied the association between
psychological factors and both physical and mental illnesses.psychological factors and both physical and mental illnesses.

 One of the most dramatic changes in the conceptualizationOne of the most dramatic changes in the conceptualization
and treatment of psychological problems occurred late in theand treatment of psychological problems occurred late in the
nineteenth century with the emergence of truly psychologicalnineteenth century with the emergence of truly psychological
explanations of these problems.explanations of these problems.
 French physicians Jean Charcot, Hippolyte Bemheim, andFrench physicians Jean Charcot, Hippolyte Bemheim, and
Pierre Janet began to experiment with the use of hypnosis inPierre Janet began to experiment with the use of hypnosis in
the treatment of some psychological problems andthe treatment of some psychological problems and
introduced the notion that psychological methods ofintroduced the notion that psychological methods of
treatment could be an alternative to medical and religioustreatment could be an alternative to medical and religious
approaches.approaches.
 Their theories led to the pioneering work of Sigmund Freud,Their theories led to the pioneering work of Sigmund Freud,
an Austrian neurologist, who is perhaps the best-knownan Austrian neurologist, who is perhaps the best-known
proponent of psychological explanations for disorders ofproponent of psychological explanations for disorders of
behavior and emotion.behavior and emotion.

The Birth of PsychologyThe Birth of Psychology
 ININ 1860, Theodor Fechner1860, Theodor Fechner publishedpublished The Elements ofThe Elements of
PsychophysicsPsychophysics whilewhile Wilhelm WundtWilhelm Wundt publishedpublished TheThe
Principles of Physiological PsychologyPrinciples of Physiological Psychology inin 18741874..
 These publications were the first to indicate clearly thatThese publications were the first to indicate clearly that
technique of physiology and physics could be used totechnique of physiology and physics could be used to
answer psychological questions.answer psychological questions.
 The first laboratory of psychologyThe first laboratory of psychology was subsequentlywas subsequently
developed bydeveloped by WundtWundt at theat the University of Leipzig;University of Leipzig;
GermanyGermany inin 18791879 and with it,and with it, psychology was bornpsychology was born..

Foundation of APAFoundation of APA
 InIn 18921892, the, the American Psychological AssociationAmerican Psychological Association
(APA)(APA) was founded, andwas founded, and G. Stanley HallG. Stanley Hall elected aselected as
its first president.its first president.
 During the beginning months and years of its rootsDuring the beginning months and years of its roots
APA was more interested in experimentalAPA was more interested in experimental
psychology as compared to Applied Psychology.psychology as compared to Applied Psychology.

THE EMERGENCE OF CLINICALTHE EMERGENCE OF CLINICAL
PSYCHOLOGY WITHIN THEPSYCHOLOGY WITHIN THE
FIELD OF PSYCHOLOGYFIELD OF PSYCHOLOGY

 Most historians mark the origins of psychology with theMost historians mark the origins of psychology with the
development of Wilhelm Wundt's laboratory for the studydevelopment of Wilhelm Wundt's laboratory for the study
of perception and behavior in Germany in the mid 1800s.of perception and behavior in Germany in the mid 1800s.
 Wundt was trained as a philosopher, and researchWundt was trained as a philosopher, and research
conducted in his laboratory was novel in its attempt toconducted in his laboratory was novel in its attempt to
study observable processes of human sensation andstudy observable processes of human sensation and
perception under relatively controlled and experimentalperception under relatively controlled and experimental
conditions.conditions.
 Wundt had a major effect on American psychologyWundt had a major effect on American psychology
through the relatively large number of Americans whothrough the relatively large number of Americans who
received their doctoral training in his laboratory at thereceived their doctoral training in his laboratory at the
University of Leipzig.University of Leipzig.

 The field of psychology that began to emerge in the United StatesThe field of psychology that began to emerge in the United States
in the latter part of the nineteenth century was an academicin the latter part of the nineteenth century was an academic
discipline committed to the scientific study of human behavior.discipline committed to the scientific study of human behavior.
 The focus of much of the early research in psychology (e.g.,The focus of much of the early research in psychology (e.g.,
examination of the characteristics of color vision) had little to doexamination of the characteristics of color vision) had little to do
with the types of psychological problems that are the focus ofwith the types of psychological problems that are the focus of
clinical psychology today.clinical psychology today.
 Nevertheless, many pioneers of American psychology recognizedNevertheless, many pioneers of American psychology recognized
that one of the important values of psychology would include itsthat one of the important values of psychology would include its
application to the effort to solve human problems.application to the effort to solve human problems.
 One of the doctoral students who worked with Wundt was aOne of the doctoral students who worked with Wundt was a
young American named Lightner Witmer.young American named Lightner Witmer.

 After receiving his doctoral degree with Wundt, Witmer returned to theAfter receiving his doctoral degree with Wundt, Witmer returned to the
United States to accept a position in the psychology department at theUnited States to accept a position in the psychology department at the
University of Pennsylvania, where he could continue to conduct hisUniversity of Pennsylvania, where he could continue to conduct his
research on processes of perception.research on processes of perception.
 In1896, a school teacher asked for Witmer's assistance in working withIn1896, a school teacher asked for Witmer's assistance in working with
an otherwise bright 14-year-old boy who was having severe difficulty withan otherwise bright 14-year-old boy who was having severe difficulty with
spelling and recognizing written words (McRcynolds, 1987, 1997).spelling and recognizing written words (McRcynolds, 1987, 1997).
 Witmer conducted a careful evaluation of the boy's problems andWitmer conducted a careful evaluation of the boy's problems and
developed an intensive treatment program to try to improve his readingdeveloped an intensive treatment program to try to improve his reading
and spelling skills.and spelling skills.
 This case spurred Witmer to open the first Psychological Clinic in 1896 atThis case spurred Witmer to open the first Psychological Clinic in 1896 at
the University of Pennsylvania, designed specifically to treat children withthe University of Pennsylvania, designed specifically to treat children with
learning difficulties.learning difficulties.
 He called for the founding of a new branch of psychology dedicated to theHe called for the founding of a new branch of psychology dedicated to the
goal of helping people and coined the termgoal of helping people and coined the term clinical psychologyclinical psychology toto
describe this new field.describe this new field.

 That same year, 1896, Witmer presented his ideas about theThat same year, 1896, Witmer presented his ideas about the
applications of psychology to the treatment of human problems toapplications of psychology to the treatment of human problems to
the members of the newly formed American Psychologicalthe members of the newly formed American Psychological
Association, and he received a cool rejection at bestAssociation, and he received a cool rejection at best
(McReynolds. 1997; Riesman, 1976).(McReynolds. 1997; Riesman, 1976).
 The APA members' negative response was due to severalThe APA members' negative response was due to several
factors. Although there was some support for the application offactors. Although there was some support for the application of
psychological knowledge to solving human problems, the majoritypsychological knowledge to solving human problems, the majority
of psychologists considered themselves to be scientists and didof psychologists considered themselves to be scientists and did
not regard the role described by Witmer as appropriate for them.not regard the role described by Witmer as appropriate for them.
 They did not wish to endanger their identification as scientists,They did not wish to endanger their identification as scientists,
which was tenuous enough in those early years, by moving theirwhich was tenuous enough in those early years, by moving their
profession into what they felt were premature applications.profession into what they felt were premature applications.
 Even if they had considered his suggestions to be worthy, few ifEven if they had considered his suggestions to be worthy, few if
any psychologists were trained or experienced to perform theany psychologists were trained or experienced to perform the
functions Witmer proposed.functions Witmer proposed.

 Witmer used the term clinical psychology to refer to a method ofWitmer used the term clinical psychology to refer to a method of
teaching and research and not merely as an extension of the wordteaching and research and not merely as an extension of the word
clinic, a place where persons are examined (Reisman).clinic, a place where persons are examined (Reisman).
 Witmer persuaded the University of Pennsylvania administration toWitmer persuaded the University of Pennsylvania administration to
offer formal training in clinical psychology, and its 1904-05 catalogoffer formal training in clinical psychology, and its 1904-05 catalog
announced that students in clinical psychology could take coursesannounced that students in clinical psychology could take courses
for credit in psychology and in the medical school (Riesman, 1976).for credit in psychology and in the medical school (Riesman, 1976).
 By 1907, Witmer had been able to raise sufficient funds to establishBy 1907, Witmer had been able to raise sufficient funds to establish
a hospital school for the training of mentally retarded children as ana hospital school for the training of mentally retarded children as an
adjunct to his clinic, and to found and serve as the first editor of aadjunct to his clinic, and to found and serve as the first editor of a
professional journal “The Psychological Clinic”.professional journal “The Psychological Clinic”.
 For his efforts, Witmer is now widely considered to be the founderFor his efforts, Witmer is now widely considered to be the founder
of clinical psychology.of clinical psychology.

Today’s ConclusionToday’s Conclusion

 Clinical psychology has changed, and it willClinical psychology has changed, and it will
certainly change even more.certainly change even more.
 Witmer would scarcely recognize it,Witmer would scarcely recognize it,
G. Stanley Hall, APA’s first president wouldG. Stanley Hall, APA’s first president would
doubtless be amazed at the things APA anddoubtless be amazed at the things APA and
APS are doing.APS are doing.
 Clinical psychologists are still involved inClinical psychologists are still involved in
assessment and treatment.assessment and treatment.

 They still have research contributions to make,They still have research contributions to make,
and they are still concerned with theirand they are still concerned with their
professional development.professional development.
 The goal that binds clinical psychologistsThe goal that binds clinical psychologists
together remains the same :together remains the same : to apply theirto apply their
knowledge and skill to the mental healthknowledge and skill to the mental health
needs of people everywhere.needs of people everywhere.

Lesson 04

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