The history of individual psychotherapy stretches back thousands of years, from ancient Greek ideas about the mind and healing, through centuries of misunderstanding and harsh treatment, to the talking therapies used today. Individual psychotherapy in its modern form is a one-to-one conversation between a person and a trained therapist, yet the road to that simple idea was long. Understanding where psychotherapy came from helps explain why it works the way it does today.
What Is Individual Psychotherapy?
Individual psychotherapy is a form of treatment in which one person works one-to-one with a trained mental health professional to understand their thoughts, feelings and behaviour, and to develop ways of coping with difficulties. Sessions usually take place regularly, often weekly, and the conversation is guided by the therapist’s training in a particular approach. Individual therapy differs from group therapy, family therapy and couples therapy, where more than one person takes part, and it differs from medication, which works through the body rather than through conversation. Today it is used for a wide range of concerns, from anxiety and low mood to grief, trauma and relationship problems.
The Ancient World: Early Ideas About the Mind
The word psychotherapy comes from the Greek words psyche, meaning soul or mind, and therapeia, meaning healing or care. The ancient Greeks were among the first to describe mental distress in terms of the body and the mind rather than the gods. The physician Hippocrates, writing around 400 BCE, argued that mental illness had natural causes, and he described an imbalance of four bodily fluids, or humours, as the source of illness. That theory is no longer accepted, but the idea that mental distress could be understood and treated rather than feared was an important step.
In Greece, temples dedicated to Asclepius, the god of healing, offered rest, bathing, dreams and quiet reflection to people seeking relief from illness, including distress of the mind. In other cultures of the ancient world, mental illness was often explained as the work of spirits or demons, and people were treated with rituals intended to drive the spirits away. Across these different views, one idea was shared: distress of the mind was real, and people sought help for it.
The Middle Ages: Custody, Care and Misunderstanding
In medieval Europe, explanations of mental illness were often religious, and people with severe mental health conditions were sometimes treated harshly or locked away. At the same time, more humane care existed. In the Islamic world, hospitals known as bimaristans in cities such as Baghdad and Cairo provided care for people with mental illness, with rest, music and conversation among the treatments offered. In Europe, some monasteries and religious houses gave shelter to people who had nowhere else to go.
By the later Middle Ages, institutions for people with mental illness began to appear in Europe. Bethlem Hospital in London, founded in 1247, is one of the best known. But these early institutions were mostly places of custody. They kept people contained rather than treating them, and conditions inside them were often poor.
The 18th and 19th Centuries: Reformers and the Birth of Psychology
Moral Treatment: Pinel and Tuke
Change began in the late 18th century with reformers who argued that people with mental illness deserved kindness rather than chains. In France, the physician Philippe Pinel removed the chains from patients at the Bicetre hospital in Paris and argued for humane, respectful care. In England, the Quaker William Tuke opened the York Retreat in 1796, a small, calm place where patients were treated as guests, given work, rest and conversation, and encouraged to take part in daily life. This approach became known as moral treatment, and it influenced how asylums were run in many countries.
Asylums in North America
The first asylum in North America was established in Williamsburg, Virginia, in 1773. By the end of the 19th century, most American towns had an asylum, but admission often meant staying for a long time, and care still included restraints and harsh treatment in many places. Reformers such as Dorothea Dix campaigned for better conditions and for public asylums run with more care, and their work slowly improved standards.
Wundt and the First Psychology Laboratory
In 1879, Wilhelm Wundt established the first laboratory for psychological research at the University of Leipzig in Germany. Wundt treated psychology as a science in its own right, separate from philosophy, and his students went on to found psychology departments around the world. His work gave the new science of the mind a research base, and it prepared the ground for therapeutic methods based on observation and experiment.
Freud and the Talking Cure
The most famous early figure in psychotherapy is Sigmund Freud. Working in Vienna in the late 19th century, Freud and his colleague Josef Breuer published Studies on Hysteria in 1895, describing patients who improved after talking through painful memories. The phrase “talking cure” came from one of Breuer’s patients. Freud developed psychoanalysis, a method based on free association, dream analysis and the idea that unconscious thoughts and early experiences shape behaviour. Psychoanalysis was the first fully developed system of individual psychotherapy, and its ideas influenced every approach that followed.
The 20th Century: New Schools of Thought
During the 20th century, many new approaches to individual therapy grew out of, or in reaction to, psychoanalysis. Each school offered a different view of how people change.
Psychoanalysis and Its Offshoots
Freud’s students developed their own directions. Carl Jung founded analytical psychology, with its focus on archetypes and the collective unconscious. Alfred Adler founded individual psychology, which looked at a person’s goals, social interest and feelings of inferiority. These approaches kept the idea of the unconscious but changed the emphasis.
Behaviorism
Behaviorism, led by figures such as Ivan Pavlov, John Watson and B. F. Skinner, focused on observable behaviour and learning rather than on inner thoughts. From this school came techniques that are still used today, such as exposure therapy, in which a person gradually faces feared situations, and behavioural activation, which helps people re-engage with rewarding activities.
Humanistic Therapy
The humanistic school, led by Carl Rogers and Abraham Maslow, took a different view. Rogers developed person-centred therapy, based on empathy, genuineness and unconditional positive regard, with the belief that people have a natural tendency towards growth. The therapist’s role was to provide the right conditions for that growth rather than to direct it.
Cognitive Behavioral Therapy
In the 1960s, Aaron Beck and Albert Ellis developed approaches that focused on the links between thoughts, feelings and behaviour. Cognitive behavioral therapy, or CBT, helps people notice unhelpful thought patterns, test them against evidence, and practise new ways of thinking and acting. Because it is structured and practical, and because its effects have been widely studied, CBT has become one of the most commonly used forms of individual therapy today.
Individual Psychotherapy in the 21st Century
Today, individual psychotherapy draws on all of these traditions. Many therapists work integratively, combining methods to suit the person in front of them. Mindfulness-based approaches, trauma-informed care and therapies informed by neuroscience have become part of mainstream practice, and therapy is increasingly available online as well as in person. Psychotherapy is now understood as one option among several, often used alongside medication, group work or self-help, and the quality of the relationship between therapist and client is recognised as one of the most important factors in whether therapy helps. Stigma around seeking therapy has lessened in many places, although it has not disappeared, and talking to a therapist is now a normal part of looking after mental health for many people.
Key Takeaways
- The history of individual psychotherapy begins with ancient Greek ideas about the mind and healing, including the work of Hippocrates.
- For centuries, mental illness was poorly understood, and care was often harsh or custodial, though humane approaches existed in places such as the bimaristans and the York Retreat.
- Reformers like Pinel and Tuke, the first psychology laboratory of Wilhelm Wundt, and Freud’s talking cure laid the foundations of modern therapy.
- The 20th century added behaviorism, humanistic therapy and cognitive behavioral therapy, each with a different view of how people change.
- Modern individual psychotherapy is integrative, evidence-based and increasingly accessible, including online.
Frequently Asked Questions
Who founded psychotherapy?
No single person founded psychotherapy. Wilhelm Wundt founded scientific psychology in 1879, Sigmund Freud founded psychoanalysis in the 1890s, and many others, including Jung, Adler, Rogers, Beck and Ellis, shaped the approaches used today.
What is the oldest type of psychotherapy?
Psychoanalysis is the oldest formal school of psychotherapy. But healing conversations, rituals and rest cures for distress of the mind existed long before Freud, in ancient Greece and in many other cultures.
How is psychotherapy different from counselling?
The two overlap a great deal. In general, counselling tends to be shorter-term and focused on a specific problem, while psychotherapy is often longer-term and explores deeper patterns. The distinction varies by country, and the terms are sometimes used interchangeably.
Is modern psychotherapy still based on Freud’s ideas?
Modern practice draws on many schools, not only Freud’s. Psychoanalysis is one approach among many, alongside CBT, humanistic therapy, behavioural approaches and integrative therapy.
How long has individual therapy existed in its modern form?
Modern individual psychotherapy began in the late 19th century with Freud and Breuer, so it has existed for well over a century. Informal talking help for distress is as old as human society.
What should I look for in a therapist today?
Look for a qualified, registered or licensed therapist whose approach fits your needs, and pay attention to whether you feel understood and comfortable with them. A good therapeutic relationship is one of the strongest predictors of a helpful outcome.
Reviewed by Aamir Ranjha.
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