HISTORY OF COUNSELLING & PSYCHOTHERAPY

By Dr Greg Mulhauser
Although psychological therapies trace their history back to the contributions of Freud, many modern approaches to
counselling and psychotherapy are now much more firmly grounded in other bodies of thought.
Freud and His Successors
Modern psychological therapies trace their history back to the work of Sigmund Freud in ienna in the !""#s.
$rained as a neurologist, Freud entered pri%ate practice in !""& and by !"'& had de%eloped a method of working
with hysterical patients which he called (psychoanalysis(. )thers such as Alfred Adler, Snador Ferenc*i, +arl
Abraham and )tto ,ank were also analysed by Freud and had brief apprentice-type training from him before
becoming psychoanalysts in their own right.
.n the early !'##s, /rnest 0ones and A.A. Brill, from the 1+ and 1S respecti%ely, %isited Freud in ienna and
returned to their own countries to promote Freud(s methods2 Freud himself began a lecture tour of 3orth America in
!'#'. Gradually many such as Ferenc*i, Adler, ,ank, Stekel and ,eich began to de%elop their own theories and
approaches, which sometimes differed markedly from Freud(s. 0ung in particular, a close collaborator of Freud(s
from !'#4-!'!5 who was in some sense (groomed( as Freud(s intellectual successor, e%entually split from Freud and
pursued the de%elopment of his own school of analytical psychology, drawing hea%ily on both Freud(s and Adler(s
ideas. All these immediate descendants of Freud(s approach are characteri*ed by a focus on the dynamics of the
relationships between different parts of the psyche and the e6ternal world2 thus the term (psychodynamics(.
A separate strand of psychological therapies de%eloped later under the influence of psychology and learning theory
and leading thinkers such as B.F. Skinner. ,e7ecting the notion of (hidden( aspects of the psyche which cannot be
e6amined empirically 8such as Freud(s rendition of the (unconscious(9, practitioners in the beha%ioural tradition
began to focus on what could actually be obser%ed in the outside world.
Finally, under the influence of Adler and ,ank, a (third way( was pioneered by the 1S psychologist :arl ,ogers.
)riginally called (client-centred( and later (person-centred(, ,ogers(s approach focuses on the e6perience of the
person, neither adopting elaborate and empirically untestable theoretical constructs of the type common in
psychodynamic traditions, nor neglecting the internal world of the client in the way of early beha%iourists. )ther
approaches also de%eloped under what came to be called the (humanistic( branch of psychotherapy, including
Gestalt therapy and the psychodrama of 0.;. Moreno. $he figure below illustrates some of the historical links
between these three main strands which de%eloped from Freud(s original contributions.
The Medical vs. Non-Medical Split
Freud strongly supported the idea of lay analysts without medical training, and he analysed se%eral lay people who
later went on to become leading psychoanalysts, including )skar <fister, )tto ,ank and his own daughter Anna
Freud. =e published two staunch defences of lay analysis in !'>& and !'>4, arguing that medicine and the practice
of analysis were two different things. ?hen /rnest 0ones brought psychoanalysis to the 1+ in !'!5, he followed
Freud(s preferences in this area, and the tradition of lay in%ol%ement continues to this day in the 1+, where most
psychoanalysts, psychotherapists and counsellors ha%e a lay background.
.n the 1S, howe%er, Freud(s analysand A.A. Brill insisted that analysts should be medically @ualified -- e%en though
there were already many lay analysts practising in the 1S who, like Brill, had trained with Freud in ienna. Brill
pre%ailed, howe%erA in !'>& the state of 3ew Bork made lay analysis illegal, and shortly thereafter the American
Medical Association warned its members not to cooperate with lay analysts. $o this day, almost all 1S
psychoanalysts are medically @ualified, and counsellors typically study psychology as undergraduates before
becoming counsellors.
The Counselling vs. Psychotherapy Divide
.t was largely in response to the 1S pre7udice against lay therapists that :arl ,ogers adopted the word (counselling(,
originally used by social acti%ist Frank <arsons in !'#". As a psychologist, ,ogers was not originally permitted by
the psychiatry profession to call himself a (psychotherapist(. .ronically, ,ogers himself became renowned as one of
the most influential empirical scientists in the fields of psychology and psychiatry, introducing rigorous scientific
methods to psychology and psychotherapy that psychoanalysts themsel%es had long resisted 8and, in the %iew of
many, still largely resist today9. =e became a 7oint <rofessor in the Departments of <sychology and <sychiatry at
the 1ni%ersity of ?isconsin as well as =ead of the <sychotherapy ,esearch Section of the ?isconsin <sychiatric
.nstitute.
.n the field as it now stands, the argument as to whether counselling differs significantly from psychotherapy is
largely academic. $hose from psychodynamic traditions sometimes e@uate (psychoanalysis( and (psychotherapy( --
suggesting that only psychoanalysts are really psychotherapists -- but this %iew is not common anywhere else.
)thers use (psychotherapy( to refer to longer-term work 8e%en though some psychotherapists offer brief therapy9 and
(counselling( to refer to shorter term work 8e%en though some counsellors may work with clients for years9. $he two
terms are commonly used interchangeably in the 1S, with the ob%ious e6ception of (guidance counselling(, which is
often pro%ided in educational settings and focuses on career and social issues.
Counselling and Psychotherapy Today
Modern counselling and psychotherapy ha%e benefited tremendously from the empirical tradition which was gi%en
such impetus by :arl ,ogers, e%en though the research agendas of psychology and counselling ha%e di%erged
greatly o%er the last half century. Additional work in cogniti%e psychology, learning theory and beha%iour has
informed many therapeutic approaches. $he richness of the bodies of both empirical and theoretical work which are
now a%ailable, coupled with the raw comple6ity of human beings, has led to a profusion of different approaches to
the field. By some accounts, the different strands of counselling and psychotherapy now number in the hundreds.
Mainstream approaches, howe%er, are much fewer in number, and o%er time it is likely that many of the less well-
grounded schools of thought will fade away, while more new ones will emerge to take their place. ?hile the main
approaches continue to de%elop, and others appear and then fade away, clients are left to choose for themsel%es
what might be best for them. =opefully the information pro%ided by this site 8incomplete though it %ery definitely
isC9 will be of some help in this process.