History of psychiatry : Timeline

The history of psychiatry is a fascinating story of progress, setbacks and changes in the way we understand and treat mental health. From the earliest ideas about mental illness to modern treatments, psychiatry has come a long way. In this timeline, we discover the key moments that have shaped the development of the field.

Early history of psychiatry

Not much is known about the time of hunter-gatherers and early agrarian cultures. It is assumed that most groups of people believed in nature religions. All good and bad things were seen as manifestations of supernatural forces, beyond human control. Personality disorders were caused by natural forces, evil spirits and devils and being either chosen by or disobeying Gods.

There are some indications that mental disorders were also seen as an illness from which you could be cured. At this time, treatment was given by medicine men and magicians, because they had knowledge of the secrets of nature. They also possessed great knowledge of herbs and poisons, which were also used in treatment; hypnosis and suggestion also played a role. The demon had to be driven out of the body, by beating it, punching it, starving it and giving it herbal mixtures. Prayer rites and talismans were used. In extreme cases, piercing the skull was a possibility.

2000 B.C.
In ancient times, holes were drilled into the skulls of people who were behaving in ways then considered abnormal. This is called skull trepanation. Evidence of trepanation has been found in prehistoric human remains from Neolithic times to early modern times. Cave paintings show that people believed the treatment would cure seizures, migraines and mental disorders. The demon could escape through this hole in the skull. New bone growth proves that at least some of those treated remained alive.

1550 B.C.
Ebers’ papyrus, one of the most important medical papyri of ancient Egypt, reported clinical depression. The papyrus consists of 110 pages, covering over 700 ailments. This makes it the largest papyrus with medical information from ancient Egypt. The book is divided into several chapters, the largest of which deals with the heart. There are pieces about the fact that the heart pumps the blood, but also that that is where tears, semen and urine came from. They also thought the heart caused depression. Dementia is also discussed here. It is written about the heart: “When the doctor puts his finger on a part of the body, he touches the heart, since it penetrates all the limbs through its veins.”

1400 B.C.
The Hindu scripture Atharva-Veda mentions mental illness. The Vedas are god-given texts (similar to the Christian Bible). The Atharva-Veda deals with the place of the human mind in the world, its normal and abnormal states, and also named a series of techniques for developing personality and overcoming mental suffering. Meditation and the spiritual path are mentioned as remedies.

1000 B.C.
An ancient Chinese text documents case studies of dementia, “madness” and epilepsy. The case studies appeared in the Huangdi Neijing (The most recent translation is The Yellow Emperor’s Classic of Medicine), an ancient treatise on health and disease, said to have been written by the famous Chinese emperor Huangdi around 2600 BC. Huangdi, however, is a semi-mythical figure. The texts probably date from 1000-300 B.C. and are a compilation of the writings of several authors.

Greek civilization and Roman empire

Many cities had temples to Asklepios, the god of healing. These temples were placed next to healing springs or high in the mountains. Around the temples, so-called health centers sprang up. Such an Asklepieion was a mix of a medical center and a spa, where sick people were given dream therapy and could relax and enjoy themselves, whether mentally or physically ill. Psychosomatic sick people were also treated there.

Around the 5th century BC, dream therapy disappeared and a more scientific approach to the phenomenon of “madness” emerged. This is mainly due to Hippocrates. He is considered the founder of modern medicine. He separated the phenomenon of illness from magic and superstition and rejected the Greek belief that illness was a punishment from the gods. He also emphatically viewed mental illnesses as treatable diseases.

600 B.C..
The first sleep therapiesin Asklepieion took place. The sick were grouped around the altar. After preparatory ceremonies, they became intoxicated by sweet smells and soft music. In their dream, the healing deity appeared to them. Through this temple sleep, a sick person could be cured. During the day, healing baths were taken, diets were followed, walks were taken and special body exercises were performed. If the treatment did not help, the patient was chased away from the temple grounds and sometimes stoned to death.

400 B.C.
Hippocrates was a Greek physician who lived around 400 B.C. and one of the first in the Western world who did not view illness as sorcery or divine punishment, but diagnosed illness on the basis of physical symptoms and prescribed a particular therapy in the process.

He saw man as a miniature incarnation of the four main elements of the universe: water, earth, air and fire. Each of these elements was represented in the body by a fluid. He believed that health in humans depended on the balance of body fluids; imbalance would cause disease. The human body was said to consist of four types of bodily fluids: mucus (air), blood (fire), yellow bile (earth) and black bile (water). This is called the doctrine of humores.

Hippocrates made no distinction between somatic and mental illnesses. In fact, he emphasized that people with mental illness were truly suffering, and therefore should be treated like other sick persons. Hippocrates saw people with depression or schizophrenia as being in a state of “discomfort,” much like a diabetic or someone with high blood pressure. According to him, the brain was the “seat of the human mind,” the organ of consciousness, intellectual life and emotions. If a person’s thinking and behavior were abnormal, there was a brain disease (brain pathology). In addition to the physiological explanation of disease, he also believed that environmental and emotional stress could harm the body and mind. Hippocrates classified mental disorders into three main forms: mania, melancholia and brain fever/frenzy.

Hippocrates was the first to provide a description of gestational neurosis and anxiety neurosis. He provided remarkably detailed reports of symptoms now known to include epilepsy, delirium tremens, cerebral hemorrhage and paranoia. Hysteria, he said, was caused by the uterus wandering through a woman’s body in search of the fulfillment of her deepest desire: a child. The therapy was simple: get married.

An imbalance of body fluids could be cured with diet. For Hippocrates, hygiene and a healthy way of life were very important in preventing disease. Treatment of patients with mental disorders consisted of cold or hot pours, rest, diet and distraction in the form of singing and music.

390 B.C.
Plato distinguished four stages of human knowledge acquisition, stated that all knowledge is innate and distinguished between perception and reality.

350 V. Chr.
Aristotle wrote a philosophical book on a psychological subject: De anima (On the soul). Aristotle was the first to make an implicit distinction between psychology and philosophy. He examined the relationship between soul and body.

200 BC.
The first anatomical models: the Greek physician and philosopher Herophilus studied the nervous system and distinguished between sensory nerves and motor nerves. The Greek anatomist Erasistratus studied the brain and distinguished between the cerebellum and the cerebellum.

130 BC.
The last great physician of classical times was Claudius Galenus (Galen). He followed the humoral pathology of Hippocrates and was also the first experimental physiologist.

He linked four types of men to the four bodily fluids:

• Blood: dominance of it gives varying temperament, hopeful and bold; sanguine type.
• Yellow bile: produces irritable and quick to anger as temperament ; choleric type.
• Black bile: gives melancholia ; melancholic type.
• Slime: slow, dull, secondary responding ; phlegmatic type

Galenus recognized that man’s psychic personality was closely related to his physical constitution. Treatment was also a continuation of the line of Hippocrates. The patient had to rest a lot and engage exclusively in pleasant things, such as bathing, singing, dancing and massage. In difficult cases, he sometimes resorted to more drastic means such as venesection and vomiting.

Sectioning the human body was not allowed in his time, so he examined the anatomy of monkeys and pigs. Through his scientific examination of the nervous system, he was able to bring attention to the role of the brain in mental functioning.

At this time, the first distinction was made between temporary and chronic mental disorders. Illusions and hallucinations were also understood as different. Cicero pointed out that physical complaints could be the result of mental disorders, thus laying the foundation for psychosomatics.

120 B.C. Roman physician Asclepiades of Bithynia advocated humane treatments for people with mental disorders and freed them from incarceration to treat them with natural therapy, such as diets and massages.

100 B.C.
The Dead Sea Scrolls established the distinction between the two “temperaments” in human nature. The Dead Sea Scrolls comprise a collection of manuscripts of more than 900 documents discovered in 11 caves in a West Bank locality on the northwest coast of the Dead Sea. The documents are written in the Hebrew, Aramaic and Greek languages. They date from about 250 BC to about 50 AD. They were probably hidden in the caves around 68 AD. More about the Dead Sea Scrolls.

60 A.D.
in the New Testament distinguished between the human spirit (by which one makes contact with God), the soul (self-awareness and personality) and the body (as the vehicle of the soul and spirit).

400 A.D.
Augustine began his early and influential writing on the human will, a central topic in ethics. Philosophers of the 18th and 19th centuries such as Immanuel Kant, Arthur Schopenhauer and Friedrich Nietzsche would elaborate on this theme. In his work, he also described his personal development, introducing the autobiographical method of inquiry.

Psychiatry in the Middle Ages

In the early Middle Ages, the insane, who were considered “simpletons of God,” were lovingly cared for within the family or housed in a monastery or hospice. As cities grew, that changed. In many a city, a sturdy cage was attached to the town hall or at a gateway, in which ‘raving’ patients were locked up.

According to medieval man, insanity was a punishment from god or the work of the devil. Insanity was therefore fought primarily by exorcising the devil in many ways. The most peaceful way was a pilgrimage. Intensive prayers were made with the patient. If that did not help, beatings were made. The patient was flogged in blood and in some cases killed. Late in the Middle Ages, women possessed by the devil were labeled witches and drowned or burned.

In the Middle Ages, people distinguished four different psychiatric syndromes: Insania (to which mania and melancholia belonged), Frenesis (madness with fever), Epilepsy (falling sickness or moonsickness), Rabis (rabies).

500
With the fall of the Roman Empire, Greek and Roman civilization came to an end, the economy collapsed and intellectual life was at a low ebb. The influence of the church grew enormously. The church was made independent of the state and was the main element of unity. Nature was seen as a reflection of the Divine will and was beyond the reach of human reason. Systematic observation, as the Greeks did, did not fit into this system.

In the early Middle Ages, the mentally ill were treated humanely. The clergy took it upon themselves to care for and cure the sick in their monasteries. In addition to nursing, treatment consisted of praying, touching relics or drinking home-brewed potions when the moon was waning. This also gave rise to pilgrimages to the places where these relics were kept. There were also doctors who performed treatments. These doctors were still strongly influenced by Galenus in their thinking.

Treatment consisted of a mixture of faith, magic and science. Bleeding, vomiting, trepanation, herbs and, if this did not help, a mild form of exorcism. In treatment, the doctor assumed that something had entered the body that also had to leave before the patient could be healed. The mentally ill from their own community are not locked up or locked out. The family remains liable and takes care of the sick person as long as possible (family nursing). Justice considers accountability and legal capacity.

Mental patients from outside the community were often the object of ridicule and ill treatment. They were put out of town and given to pilgrims.

800
Muhammad ibn Zakariya al-Razi (865 – 925), known in the Western tradition as Rhazes, was an influential Persian physician, philosopher and scholar during the Golden Age of Islam, and one of the first in the world to write about mental illness and psychotherapy. As chief physician of the Baghdad hospital, he was also the director of one of the world’s first psychiatric departments. Two of his works in particular, El-Mansuri and Al-Hawi, provide descriptions and treatments for mental illness.

One of the first psychiatric hospital wards was built by Arab Muslims in Baghdad, followed by Cairo in 800 and Damascus in 1270. In Islam, the mentally ill were considered incapacitated but deserved humane treatment and protection.

1100
The Persian physician and philosopher Avicenna claimed that the three parts of the brain perform five distinct cognitive processes: common sense, imagination, reflection, estimation and memory. He recognized “physiological psychology” in the treatment of diseases involving emotions, and developed a system for associating changes in heart rate with inner feelings.

1234
Franciscan monk Bartholomew Anglicus (ca. 1203 – 1272) described a condition similar to depression in his encyclopedia De Proprietatibus Rerum. He prescribed music and activities for depressed patients, and “delusional” patients sleep and human-friendly shackles. Remarkably, he did not see demons as the culprit of mental illness.

1250
Theologian Thomas Aquinas examined the nature of the soul in relation to the body (body-mind problem).

1300-1500
In the late Middle Ages, the church spread the idea that the deranged were possessed by the devil. The disturbed were plagued by cramps and convulsions and behaved insanely with foam on their mouths. A person possessed by the devil could only be helped by exorcising the devil. At first this was done in a gentle way, by prayer and laying on of hands. But later, private devil exorcists came to use increasingly harsh methods. Especially women were suspected of being possessed by the devil; they were called witches. The Inquisition was created and prosecuted, convicted and sentenced the mentally disturbed and also healthy people on suspicion of witchcraft.

Psychiatry and the Renaissance

Only very slowly did the Middle Ages come to understand that insanity could not be explained by demon possession. The church, too, began to resist demonic exorcism. With the Renaissance in Europe and the revival of the scientific method, mental symptoms were once again seen as connected to the body. European thinkers began to turn away from religious explanations for psychiatric symptoms. Early people who supported Renaissance ideas included Paracelsus, Cornelius Agrippa and Johannes Wier.

Although the persecution of witches continued in some European countries until 1750, the first asylums also appeared to protect those “tormented by madness” from themselves and others. There were no more insane asylums in Europe by the early 16th century. There were, however, thousands of leprosy hospitals. In these hospitals now began the institutionalized nursing, or rather confinement, of the mentally disturbed. In those days, if the insane were dangerous to themselves or others, they were chained in a dungeon. If not, the “miserable cranksinniche persons” were given shelter, sometimes for a sum of money.

The institutions took in both beggars and the mentally disturbed. The institutes’ only treatment was to put the residents to work. About the same time, more specialized institutions for the mentally disturbed emerged. Treatment in these institutions: starving, scaring people, scaring them to death and bloodletting.

1409
In 1409, the first psychiatric hospital was opened in Valencia, Spain: the “Hospital of the Innocently Insane.”

1513
The first foundation was established in Stockholm. The first foundations in the monasteries of Haina, Merxhausen and Hofheim in Germany were opened by Phillippus the Magnificent, son of Landgrave William the Second.

1524
Marko Marulić publishes Psichiologia de ratione animae humanae (The psychology of human thought). This is the oldest known literary reference to the concept of psychology.

1547
The first institutions in England opened. The Bethlehem Hospital in Bishopsgate, outside London’s Wall, began admitting psychiatric patients. This asylum became one of London’s biggest tourist attractions into the 19th century. For a fee, lunatics could be viewed as in a modern-day zoo.

1563
The first to recognize that witches had a “disease in the head” was Johannes Wier, a court physician from Germany. Johannes Wier protested against the persecution of witches. According to Wier, the women who were executed were not witches, but unhappy women suffering from melancholy. They did not need punishment, but treatment.

1560
The first foundation in Turkey was established.

1562
The first insane asylum in the Netherlands opened in Amsterdam

1607
The second insane asylum in the Netherlands was opened in The Hague under the name Dol- en Pesthuis.

1621
In his Anatomy of Melancholy, Robert Burton argues that behind depression is aggression and suggests a therapeutic program of exercise, music, medication and nutrition with an emphasis on the importance of discussing problems with a close friend, or, if one is not available, with a doctor.

1637
The philosopher Descartes made the distinction between the human mind as thinking substance and the body as spatial substance. In doing so, he was the first to establish a clear link between the “mind” and (self-)consciousness. He distinguished the (self_consciousness) from the brain, where, according to him, intelligence resides.

1656
King Louis XIV of France founded the Pitié-Salpêtrière Hospital in Paris for prostitutes and the mentally handicapped.

1664
English physician Thomas Willis publishes Pathologicae cerebri, et nervosi generis specimen, an important book on the pathology and neurophysiology of the brain. In the book, he developed a new theory of the cause of epilepsy and related disorders, contributing to the development of psychiatry.

1672
Willis published the anatomical treatise De Anima Brutorum, in which he described psychology in terms of brain function.

1690
The English philosopher John Locke published An Essay Concerning Human Understanding. He described the human mind as an unwritten page (tabula rasa), which is later filled by experience.

1709
George Berkeley published An Essay Toward a New Theory of Vision, claiming that the mental ideas people have are formed exclusively from other ideas and not from physical objects.

1713
Jakob Bernoulli published an important work for the development of statistics: Ars Conjectandi.

1724
Plagued by guilt over the Salem witch trials, influential English minister Cotton Mather broke with superstition by favoring physical explanations for mental illness over demonic explanations.

1732
Christian Wolff first used the terms psychology and consciousness in his book psychologia empirica. A second book on psychology called psychologia rationalis followed in 1734.

1745
Julien Offray de la Mettrie published his book Histoire naturelle de l’âme, in which he argues that physical phenomena are the effect of organic changes in the brain and nervous system.

1748
David Hume published An Inquiry Concerning Human Understanding, in which he addressed, among other things, the reliability of testimony.

1754
Étienne Bonnot de Condillac, in his Traité des sensations, held that sense perceptions are the only source of knowledge.

1758
English physician William Battie published Treatise on Madness, which called for treating both rich and poor psychiatric patients to make psychiatry a respectable profession.

1765
Gottfried Wilhelm von Leibniz posthumously published the book Nouveaux essais sur l’entendement humain, a powerful statement for the empirical method of inquiry.

1777
Scottish physician William Cullen published the book First Line in the practice of Physic, in which he used the term neurosis in defining mental illness.

1781
Immanuel Kant published his Kritik der reinen Vernunft, in which he attempts to answer the questions What do we know? and How do we know?

Beginnings of modern psychiatry

The re-embracing of the scientific method, the focus on individual dignity and the political belief in freedom and human rights caused increasing concern for the mentally disturbed.

By the late 18th century, the naturalistic vision of Hippocrates was once again on the rise. Attention was again given to anatomy and physiology, and physical treatment of the mentally disturbed was again recommended by physicians. Because mental illness was thought to result from faulty thought processes, shackles were replaced and asylum doctors focused on bringing the mentally ill patient to his senses.

The so-called “moral treatment” began. More attention was paid to the patient’s needs and fears. All kinds of social forms of therapy were instituted. People began to talk in a friendly and understanding manner to the patient, who was now believed to have become ill from too much tension.

Disadvantages of moral treatment were mass confinement and moralizing. Tension as a cause of becoming ill led to double seclusion. Patients were put into an institution in large groups and the institution was built far from the stresses of the city. It was assumed that environmental change led to improvement. The relationship between the sick person and his physician was like that of master and servant. The sick person had to submit to the will of his physician because he alone knew what was good for him. The asylum doctor set a “good example” to the patients.

Moral treatment was called moral treatment in England and traitement morale in France. In the Netherlands people spoke of moral treatment. J.L.C. Schroeder van der Kolk (1797-1862) applied this treatment in the Buitengasthuis in Amsterdam and in the dulhuys in Utrecht, among other places.

1785
Italian physician Vincenzo Chiarugi helped introduce humanitarian reforms in institutions, such as banning shackles as a means of restraining psychiatric patients. Chiarugi also separated the mentally ill from criminals. This, contrary to expectations, led to more order and peace among the patients.

His advocacy of “moral treatment,” Moral Treatment , was overlooked until the 20th century, in which his work is considered a landmark in the history of psychiatry.

1789
King George III of England suffered a serious mental illness. The medics of the time were puzzled. His periodically better periods provided the idea that perhaps mental illness could be cured.

A contemporary scientific theory is that he suffered from the disease porphyria. However, this theory is being challenged by researchers at St. George’s, University of London, who, after a lengthy analysis of King George III’s letters, concluded that he most likely suffered from a mood disorder.

1793
French physician Philippe Pinel was appointed to the Bicêtre asylum in southern Paris. He is considered the father of modern psychiatry. Pinel was the first physician to keep a medical history of his patients. He viewed the patient from a medical perspective and treated the patient lovingly and benevolently.

His essay“Memoir on Madness” has been hailed as a foundational text of modern psychiatry. In it, Pinel argues for the careful psychological study of people through time, points out that madness is not always continuous and advocates the decriminalization of the mentally ill. He emphasized the classification of mental disorders, from which the ICD and the DSM were eventually born. In 1809, he published the first description of dementia praecox (schizophrenia).

According to legend, Pinel also freed mentally ill people from their chains and began Moral Treatment. In reality, Pinel allowed shackles to be turned a blind eye when other means failed. It was Jean-Baptiste Pussin who replaced iron handcuffs with fabric straitjackets at Bicêtre (in 1797) after Pinel left for the Salpêtrière. Pinel followed Pussin’s example three years later, after he brought Pussin to the Salpêtrière. It is now acknowledged that Italian Vincenzo Chiarugi was releasing mental patients from their shackles even before Pinel.

1796
The York Retreat in England removed the shackles and followed the Moral Treatment.

Psychiatry in the 19th century

The word “psychiatry” was first used in 1808. It would take several more decades before the word became established and psychiatry was considered a separate scientific discipline. At the beginning of the nineteenth century, people still spoke of asylum doctors or aliens. Later they became psychiatrists. The relationship between the disturbed and the practitioner became that of doctor-patient, nursing became entirely focused on medical-bodily care.

In the 19th century, scientific thinking focused primarily on the organic causes of psychiatric syndromes. It was assumed that every psychiatric condition had an (identifiable) biological cause. Psychiatrists began to regard mental disorders as (brain) diseases rather than disorders of the mind. The focus of diagnosis was placed on pathological-anatomical abnormalities of the brain, on disorders of the function of the nervous system and on changes in the composition and action of the body’s fluids. This period of the medical or organic-somatic model lasted until the 1960s.

German psychiatrist Wilhelm Griesinger first came up with biological statements such as “Geisteskranken sind Gehirnkranken” (“mental diseases are brain diseases”). He was followed by such great names as Wilhelm Wundt as the founder of empirical psychology and Emil Kraepelin who was the first to categorize mental disorders.

1808
German physician Johann Christian Reil coined the term “psychiatry.”

1812
Physician Benjamin Rush became one of the first American advocates of humane treatment for the mentally ill with the publication of Medical Inquiries and Observations Upon Diseases of the Mind, the first American textbook on psychiatry. He is considered “the father of American psychiatry.” The logo of the American Psychiatric Association bears Rush’s portrait.

Anna Hunt Marsh, a mental health pioneer in the U.S., started the Brattleboro Retreat, the first independent private mental health care facility, in Vermont. Treatment methods emphasized fresh air, physical activity, educational enrichment, therapeutic farm and kitchen work, and support staff.

1818
Johann Spurzheim publishes Observations sur la phrénologie, ou la Naissance de l’Homme on phrenology, the idea that the shape of the skull reveals personality traits.

1820
Wilhelm Griesinger (1817 -1868) wrote the first modern textbook of psychiatry,“Pathologie und Therapie der Psychischen Krankheiten.” He argued that every mental illness has a physiological cause. He initiated reforms in the treatment of the mentally ill and it made changes in the existing institutional system. He believed in integrating the mentally ill into society and proposed combining short-term hospitalization with help in patients’ ordinary surroundings.
In the preface to the first issue of the leading psychology magazine he started, Archiv für Psychiatrie und Nervenkrankheiten, Griesinger wrote: “Psychiatry has undergone a transformation in its relation to the rest of medicine. … This transformation rests primarily on the realization that patients with so-called ‘mental illnesses’ are in reality individuals with diseases of the nerves and brain, ….”

1822
George Combe brings phrenology to America with his publication Essays on Phrenology, Or An Inquiry into the Principles and Utility of the Systemof Drs. Gall and Spurzheim, and into the objections Made Against It.

1821
The element lithium was first isolated from lithium oxide and described by English chemist William Thomas Brande.

1840
Friedrich August Rauch published in America the book Psychology, or A View of the Human Soul; including Anthropology.

1841
The first Insane Diseases Act went into effect. This law contained provisions concerning the institutions and the manner of admission and discharge. Each province was henceforth obliged to ensure sufficient nursing facilities for its own mental patients. The institutions were placed under the supervision of inspectors. This law rapidly reorganized the institutional system in the Netherlands. Because of the control, only the efficient institutions remained. The theoretical model of psychiatry was based on the separation between inside and outside. There was a clear separation between person and world. The disease was in the person himself and not caused by the environment. We also find this strict separation in psychoanalysis.

The forerunner of the Royal College of Psychiatrists, then known as the Association of Medical Officers of Asylums and Hospitals for the Insane, was founded in England.

1842
James Braid developed the technique of hypnosis based on the ideas of Franz Anton Mesmer.

1844
The Association of Medical Superintendents of American Institutions for the Insane (AMSAII), the forerunner of the American Psychiatric Association (APA), was founded in Philadelphia, Pennsylvania.

1845
In England and Wales, the Lunacy Act 1845 and the County Asylums Act 1845 were passed.

1851
Dr. Samuel Cartwright, a prominent physician and one of the leading authorities of his day on the medical care of slaves, identified two mental disorders: Drapetomia, the “disease” by which slaves run away, and Dysaethesia Aethiopica, a theory of the cause of laziness among slaves. Today they are both considered examples of scientific racism.

1852
French physician Bénédict Augustin Morel published Traite des Maladies Mentales (2 vols.); in the second ed. (1860) the term “dementia praecox” was added, for patients suffering from “stupor” (melancholy). In 1857 he published Traité des Dégénérescences, promoting the understanding of mental illnesses based on the theory of degeneration, which became an influential concept in psychiatry for the rest of the century.

1855
Herbert Spencer published two volumes of his Principles of Psychology.

1859
Charles Darwin published The origin of the species.

Josef Breuer published Traite Clinique et Therapeutique de L’Hysterie.

1860
Gustav Theodor Fechner starts empirical psychology. Fechner’s most important work was the book Elemente der Psychophysik. In the book, he starts with Spinoza’s idea that physical facts and the perception of these facts, although not reducible to each other, are two aspects of one reality. Fechner’s discovery consists in formulating a mathematical connection between these two facts. The connection that Fechner discovered later became known as Weber-Fechner’s law and can be described as follows: Sensation is proportional to the logarithm of the stimulus.

1861
Paul Broca discovered an area in the left hemisphere of the brain of great importance for speech. His discovery marks the start of neuropsychology.

1867
Henry Maudsley published Physiology and Pathology of the Mind.

1868
Dutch physiologist Franciscus Cornelis Donders published Over den snelheid van psychische processen.

1874
Wilhelm Wundt, known as one of the founding fathers of empirical psychology, published Grundzüge der Physiologischen Psychologie, the first textbook on experimental psychology.in which he argued that psychiatry is a branch of medical science that, like the other natural sciences, should be investigated by observation and experimentation. He had a major influence on the development of psychology as an independent and empirical science. He was the first to elevate his field to a scientific level.
Following Fechner, Wundt believed that psychological phenomena through measurable stimuli and human reactions to them could be investigated by experimental methods. Until then, psychology had been a largely theoretical-philosophical subject, in which all sorts of conceptions about the workings of the human mind and human behavior were posited without being systematically tested in practice.

1875
William James opened a laboratory for experimental psychology in America. At first, it was intended primarily for demonstration classes.

1883
German psychiatrist Emil Kraepelin was a student of Wundt. Like his teacher, Kraepelin believed that the main cause of psychiatric disorders was a biological and genetic defect. He published a classification system in 1883 that allowed him to determine the organic causes of mental disorders. In some mental disorders, he saw a certain group of symptoms (called syndromes) as so regular , that they had to have an underlying cause. Each mental illness he considered different from all others, with its own genesis, symptoms, course and outcome. Kraepelin’s classification became the basis for today’s diagnostic categories an important starting point in the creation of the Diagnostic and Statistical Manual of Mental Disorders (DSM) still used today . In his Lehrbuch fur studierende und Artze, the syndromes that emerged in the course of that century received their written expression.

Kraepelin distinguished 2 major groups of mental disorders: Dementia praecox (former term for schizophrenia) and Manic-depressive Psychosis. He believed that a chemical imbalance was the cause of schizophrenia and that manic-depressive disorder was caused by an irregularity in metabolism. His theories dominated psychiatry at the beginning of the twentieth century.

1879
Lightner Witmer first used the term clinical psychology (clinical psychology).

1884
William James published What is an emotion?

Era of psychoanalysis

Late in the 18th century and through the 19th century, different viewpoints emerged in France and Austria that assumed that mental illness was caused by psychological dysfunction. Many people in Western Europe suffered from “hysterical” symptoms. These symptoms could not be explained from the brain, by the somatic-anatomical model.

Around 1910, materialist clinical psychiatry gained an important counterpart in the form of Freudian psychoanalysis. Freud conceived of hysteria as a sexual disorder, as a conflict between a repressing and a repressed agency, in which the conversion phenomena were seen as distorted substitutes for sexual gratification, which could not be obtained by normal means.

Freud developed psychoanalysis to treat these “neurotic” patients. Psychiatry soon became the specialty known for this treatment. Psychoanalysis thus became the first treatment for unadmitted psychiatric patients. It also created a dichotomy, which continues to this day, between biological psychiatry and psychotherapy.

Psychoanalysis was the main treatment method in psychiatry of non-admitted people in the first half of the 20th century. In retrospect, it was used even for conditions in which it seemed to do little good. Empirical evidence of its efficacy was scarce because psychoanalysts largely shunned experimentation, and because analytic interventions and their outcomes are inherently difficult to study. Nevertheless, many case studies outlined that psychoanalysis worked, and the empirical research seems to support this.

1885
Hermann Ebbinghaus published Über das Gedächtnis, describing experiments he did on himself.

1886
Sigmund Freud opened his practice in Vienna.

1887
George Trumbull Ladd publishes Elements of Physiological Psychology, the first American work containing the results of the new experimental psychology.

Under the leadership of Granville Stanley Hall, the first American Journal of Psychology is published.

1889
James Mark Baldwin publishes the first volume of his Handbook of Psychology.

The first international psychology congress takes place in Paris.

1890
William James publishes Principles of Psychology

1893
The first Dutch psychology research center opened at the University of Groningen.

1895
Sigmund Freud and Josef Breuer of Austria published Studies on Hysteria, based on the case of Bertha Pappenheim (known as Anna O.), in which the Talking Cure (psychoanalysis) was developed.

Freud was one of the most influential and controversial thinkers of the 20th century. His work and theories helped shape modern views on childhood, personality, memory, sexuality, conflict and therapy.

Freud and Breuer’s paths later parted because of Freud’s psychosexual explanations. More on Freud’s psychosexual development.

1896
Kraepelin created a clinical definition of “dementia praecox,” later reformulated as schizophrenia.

Edward Titchener publishes An Outline of Psychology.

1899
Sigmund Freud published “The Interpretation of Dreams(Die Tramdeutung), which can be seen as the start of Psychoanalysis. He established the discipline of psychoanalysis and psychotherapy in a systematic theory of the relationship between conscious and unconscious psychological processes.

1900
Russian neurologist Vladimir Bekhterev discovered the role of the hippocampus in memory.

1901
Kraeplin and German psychiatrist Alois Alzheimer identified the first case of what later became known as Alzheimer’s disease.

Sigmund Freud published The Psychopathology of Everyday Life.

1902
Swiss-born psychiatrist Adolf Meyer became director of the New York State Psychiatric Institute and influenced American psychiatry with his “common sense,” keeping detailed patient records; he coined the term “mental hygiene.”

1905
French psychologists Alfred Binet and Theodore Simon developed the Binet-Simon test that they used to select students who needed extra help. They assessed intellectual ability with this first standardized psychological test.

1906
The first conditioning studies were published by Russian physiologist Ivan Pavlov.

1908
The term”Schizophrenia” was coined by Swiss psychiatrist Paul Eugen Bleuler. It comes from the Greek “split brain,” a misnomer for the disease.

1909
In September, Sigmund Freud visited Clark University and influenced American psychiatric science.

1910
Sigmund Freud founded the International Psychoanalytical Association (IPA), with Carl Jung as its first president and Otto Rank as its first secretary.

Boris Sidis opened the Sidis Psychotherapy Institute (a private hospital) at Maplewood Farms in Portsmouth, NH to treat psychiatric patients using the latest scientific methods.

1911
Alfred Adler left Freud’s Psychoanalytic Group to form his own school of thought. He accused Freud of placing too much emphasis on sexuality and basing his theories on his own childhood.

The American Psychoanalytic Association (APsaA) was founded.

Eugene Bleuler redefined “dementia praecox” as “schizophrenia.”

1912
Max Wertheimer publishes Experimental Studies of the Perception of Movement, one of the founding articles in Gestalt psychology. The German word gestalt stands for “total image,” where the whole is more than the sum of its constituent parts. For example, a table is more than four beams and a board, and the human personality is more than the sum of its individual describable and measurable characteristics. The psychology of perception assumes that human beings experience more than the sum of individual sensory stimuli.

1913
Rise of behaviorism: John Watson published his manifesto Psychology as the behaviorist views it. With this he opposed the psychology of the day, which relied largely on introspection and focused on the study of consciousness and mental life. In its place came behaviorism and experimental research, with an emphasis on observability and objectivity.
Early behaviorists devoted themselves largely to animal research. Classical behaviorism is called S-R behaviorism (S = stimulus = stimulus; R = response = reaction). It was a very mechanistic behaviorism that looked for how stimuli could elicit behavior and how it could be influenced. The learning processes were called conditioning. This view was very much influenced by the reflex physiology of Ivan Pavlov and others. In addition to Watson, an important early behaviorist included Edward Thorndike

Carl Jung perceived Freud’s approach as too dogmatic and authoritarian; in his view, Freud did not pose as a scientist but more as a dominant church father. He referred to Freud’s inability to recognize religion and spirituality and developed his own theories. His new school of thought became known as Analytic Psychology.
The collective unconscious is what distinguishes Jung from Freud. He calls the contents of the collective unconscious archetypes, inherited unconscious psychic material common to the entire human species.

The British Psychoanalytical Society was founded by Ernest Jones, who became Freud’s biographer.

Jacob L. Moreno was a pioneer in Viennese psychotherapy, emphasizing spontaneity and interaction; later these became known as Psychodrama and Sociometry.

1914
Sigmund Freud published On Narcissism: An Introduction.

1917
Sigmund Freud published Introduction to Psychoanalysis, and Mourning and Melancholia.

1920
Swiss psychiatrist Hermann Rorschach developed the Rorschach Inkblot Test.

John Watson and Rosalie Rayner conducted the Little Albert experiment, which used classical conditioning to make a little boy afraid of white rats.

1921
Sigmund Freud published Group Psychology and the Analysis of the Ego.
More on Freud’s Id, ego and superego.

1923
German pharmacologist Otto Loewi and English neuroscientist Sir Henry Dale discovered Acetylcholine, the first neurotransmitter to be described, winning the Nobel Prize in 1936.

1924
German neuropsychiatrist Hans Berger discovered human electroencephalography.

Otto Rank published Trauma of Birth, which used the term “pre-oedipal,” causing Sigmund Freud to break his ties with him.

1926
The Société Psychanalytique de Paris was founded with the support of Sigmund Freud; the Nazis closed it in 1940.

1927
Austrian psychiatrist Manfred Sakel developed Insulin shock therapy as a treatment for psychosis, which was not discontinued until the 1970s.

Austrian physician Julius Wagner-Jauregg won the Nobel Prize for his invention of malaria therapy for neurosyphilis (then called General paresis of the insane). He started the treatment in 1917.

1928
The Indian Association for Mental Hygiene was founded.

Jean Piaget published Judgement and Reasoning in the Child.

1933
Hungarian psychiatrist Sándor Ferenczi published an article in which he saw memories of sexual abuse as a child as true and gave a psychological explanation for it, causing Sigmund Freud to break his ties with him.

1935

The neurologist and later Nobel laureate Egas Moniz performed the first systematic experiments in lobotomy at the University of Lisbon, cutting the frontal cortex and the rest of the brain.

The Indian division of the Royal Medico-Psychological Association was formed as a result of the efforts of Dr. Banarasi Das.

1938
Italian neurologist Ugo Cerletti and Italian psychiatrist Dr. Lucio Bini discovered Electroconvulsive Therapy (ECT) in the treatment of schizophrenia.

Burrhus Skinner published The Behavior of Organisms: An Experimental Analysis, in which he introduced behavioral analysis.

The Dutch Institute of Practicing Psychologists is founded (NIPP). Later the name is changed to Nederlands Instituut van Psychologen (NIP).

1939
Heinz Hartmann made an impressive contribution to defining normality and health in psychoanalytic terms in the piece “Psychoanalysis and the Concept of Health.” He was the founder of”ego psychology,” which holds that the ego has its own energy and motives.

1942
Swiss psychiatrist Ludwig Binswanger started Existential Therapy.

The controversies between Sigmund Freud’s daughter Anna Freud and Melanie Klein, founder of Object Relations Theory, caused the British Psychoanalytical Society to be permanently divided into three camps.

Carl Rogers published Counseling and Psychotherapy, stating that respect for the client and a nonjudgmental approach are the basis for effective treatment of mental illness.

The Myers-Briggs Type Indicator (MBTI) personality test was developed. The Myers-Briggs Type Indicator (MBTI) is a system for classifying people’s personality differences. The model was developed based on theories by Carl Gustav Jung

1943
Abraham Maslow describes his Pyramid of Maslow in the article A Theory of Human Motivation. According to his theory, humans would strive to satisfy the needs placed higher in the hierarchy only after the lower-level needs were satisfied. Maslow’s hierarchy of needs is as follows:

1. Organic or bodily needs, these physiological needs are related to the homeostasis of the organism and bodily balance. These include needs for sleep, food, drink and excretion of feces. Maslow also classifies sex and other bodily needs such as sport and comfort under this.
2. Need for safety and security, the individual starts to seek security in an organized small or large group. This may include the neighborhood, family or business. Typical examples include housing, work and relationships. An attempt is made to accommodate this through a comprehensive system of social security.
3. Need for social contact, need for friendship, love and positive-social relationships.
4. Need for appreciation, recognition and self-respect, which increase competence and esteem in group settings; attach importance to status in social context.
5. Need for self-actualization or self-actualization, is the need to develop and appreciate his personality and his mental growth potential. The social environment cannot be eliminated as a supportive basis of this actualization trend.
6. Need for self-transcendence. In the later stages of his life, he nuanced his view of self-actualization and emphasized self-transcendence.

1945
Radical behaviorism: B.F. Skinner distinguished two forms of conditioning: respondent conditioning (cf. Pavlov) involving mainly physiological reflexes, and operant conditioning. Skinner’s research focused entirely on operant conditioning. To predict behavior, one must have a view of the organism and its context. This context includes biological characteristics, (learning) history, and the current situation. Behavior analysis (and thus psychology) is actually considered part of biology.

Critique of Freud: German-American Karen Horney writes “Our Inner Conflicts. According to Horney, neuroses were caused not only by childhood emotional conflicts but mainly by relationships with people. She initially followed Freud’s theory on this but later introduced nuances. She founded an alternative psychoanalytic society there, which became a formidable competitor to the classical law-abiding Freudians. An important difference from Freud was also her focus on the psychology of women.

1946
Mary Jane Ward published the novel The Snake Pit, which was filmed in 1948 and caused reform in American state psychiatric institutions.

1947
The Indian Psychiatric Society was established. On the recommendation of the Bhore Commission, the All India Institute of Mental Health was established in 1946, which became the National Institute of Mental Health and Neurosciences (NIMHANS) in Bangalore in 1974.

1950
The World Psychiatric Association was founded.

1952
Melanie Klein first publishes Object RelationsTheory. In object relations theory, individual development is described in terms of the various relationships the child has in the course of its development with the major attachment objects, especially the father and the mother. The central idea is that the representations of the earliest relationships with the primary caregivers – usually the parents – are re-searched in the later relationships.

The anti-psychiatry

By the 1960s, the perception of the mentally disturbed person had clearly changed, both inside and outside psychiatry. Psychiatry had come out of its ivory tower; psychiatric institutions were organized differently; more accessible to ordinary people. And the “madman” had begun to speak for himself. As a counterpart to Freud and the scientific approach to psychiatry, Antipsychiatry emerged.

Antipsychiatry did not exist for long, but it contributed to democratization in psychiatry. The total of social shifts, socialization and democratization processes, caused individual-medical and at the same time authoritarian model to be changed.

The term antipsychiatry was first used in 1967 by South African psychiatrist David Cooper. Stimulating influences for this group formation and theories came from Michel Foucault, Ronald D. Laing and Thomas Szasz, among others, and for antipsychiatry in the Netherlands from Jan Foudraine and Kees Trimbos.

As a counterpart to Freud and the scientific approach to psychiatry, Antipsychiatry emerged. Antipsychiatry opposes

• Institutional psychiatry and institutionalism in general.
• Psychiatry as a social control tool in the hands of those in power.
• The medical model.
• The negative valuation of insanity and madness.

1954
Michel Foucault publishes Maladie mentale et personnalité, about medicine, psychiatry and madness. In the original version, Foucault leaned toward Sigmund Freud’s psychoanalysis and the phenomenological and existential Daseinsanalyse. In a 1962 reissue, he retraced his steps: from a historical point of view, “madness” is a social construction.

1960
Professor of psychiatry Thomas Szasz publishes “The Myth of Mental Illness”.He starts from the following: what are called mental illnesses are in fact life problems and interpersonal conflicts, which should be experienced and solved as such. Help may be given, but not in the form of a doctor helping a patient. The disease role here is harmful and also dangerous for the patient: it robs him of his personal responsibility and freedom.

Foucault publishes Histoire de la folie à l’âge classique: Folie et déraison that examines “madness” since the Renaissance. His outline is a critique of psychology and psychiatry and the way the disciplines look at their history. They describe their emergence related to the ‘discovery’ of their object of research: the ‘mental illness’(maladie mentale) and an increasingly ‘humane’ treatment of the patient. The mentally ill becomes as something that existed eternally and is discovered in modern times. Foucault, on the other hand, argues that ‘madness’ is not fixed but determined by the historical period. He sees three phases:

1. The Renaissance represented madmen in art as possessors of a specific form of wisdom, namely knowledge of the limits of our world. In literature, they demonstrated the limit of what humans are and what they pretended to be.
2. The Classical Period (17th – 18th centuries): While once insane people were tolerated on the margins, now they are locked up in institutions along with prostitutes, vagrants and other fringe figures. “The Great Confinement” sees abnormalities as the result of moral mistakes. Prostitutes, vagrants and lunatics were seen as persons who voluntarily chose their lifestyle. Within these institutions, the image of madness emerged as a real category that could be studied and cured.
3. Modern Age (19th century -) we lock up and observe “madmen” to cure them and protect society. Therapy also evolves.

Foucault disputes that this transition to specialized institutions is a moral step forward. For him, the “enlightened” treatment of patients is as cruel as the previous treatment.

1961
Ervin Goffman wrote Asylums (Asylums), essays on the social situation of the mentally ill and other residents. The book was one of the first sociological studies of the social situation of the mentally ill in psychiatric hospitals and made an important contribution to the understanding of social aspects of mental illness.
The book consists of four essays: “Characteristics of Total Institutions” (1957); “The Moral Career of the Mental Patient” (1959); “The Underlife of a Public Institution: A Study of Ways of Making Out in a Mental Hospital”; and “The Medical Model and Mental Hospitalization: Some Notes on the Vicissitudes of the Tinkering Trades.” The first three essays focus on the experiences of patients; the last on the interactions between health care providers and patients.
Goffman is particularly concerned with the details of psychiatric hospitalization and with the nature and effects of the process he calls “institutionalization.” He describes how institutionalization socializes people into the role of a good patient, who must be “boring, harmless and unremarkable,” which makes people with severe mental illnesses seem even more chronically untreatable in contrast.

Institutions have a profound impact on people’s interactions, yet even in such places, people find ways to redefine their roles and reclaim their identities.
Asylums helped with mental health reform, leading to a reduction in the number of large psychiatric hospitals and the people confined in them. It also influenced the anti-psychiatry movement.

1975
The movie One Flew Over the Cuckoo’s Nestcame out and defined the face of psychiatry for an entire generation. Especially the electroshock treatment and the threat of lobotomy in the film left an indelible impression. The film was based on Ken Kesey’s 1962 novel of the same name. Kesey wanted to make it clear that psychiatric patients were not sick but merely different from others. The novel and the film reflected a climate that was dominated by anti-psychiatry.

Classification, medication and empirically proven therapy

An official classification attempt of psychiatric disorders was made in the mid-twentieth century. The classification was intended to bring unity to the many interpretations of diagnoses. That way it was easier for psychologists and psychiatrists to compare patients and exchange information. If you wanted to know whether a particular treatment worked for depression, at least every researcher had to have the same understanding of the term “depression.

Emotional complaints were first categorized and diagnosed, and then treated by sharply focusing on the specific characteristic symptoms of the diagnosis.

The era of drug treatment in psychiatry began about the same time, with the accidental discovery of the antipsychotic effect of chlorpromazine (Chlorpromazine). Haloperidol (Haldol), followed, this time as a result of a deliberate search for other antipsychotics. At the same time, the first effective antidepressant imipramine (Tofranil), an accidental discovery, was introduced. Finally, the first tranquilizers of the benzodiazepine type followed in 1960. During these years, the relapse prophylactic effect of lithium salts in bipolar disorder also became known.

Cognitive therapy was defined and empirically proven. Psychiatric patients from now on were almost all treated as outpatients (not hospitalized), often with both medication and some form of psychotherapy.

1944
Methylphenidate was synthesized. This led to the development of Ritalin in the 1960’s.

1948
The ability of lithium carbonate to stabilize mood disorders (manic depression) was demonstrated by Australian psychiatrist John Cade. It became the first effective drug to treat mental illness.

1952
The first DSM, “Diagnostic and Statistical Manual of Mental Disorders,” appears. The DSM was created to create unambiguous definitions a person must meet to have a particular mental disorder. It was revised in 1968, 1980/7, 1994, 2000 and 2013. More about the DSM.

The first published clinical trial with chlorpromazine, the first antipsychotic (invented by Henri Laborit, Jean Delay and Pierre Deniker), was conducted at Sainte-Anne Hospital Center in Paris. Known in Europe as Largactil, it was brought to Montreal by Heinz Lehman and called Thorazine.

The first monoamine oxidase inhibitor (MAOI) antidepressant was discovered.

1953
Russian-born Chicago physiologist Nathaniel Kleitman discoveredRapid eye movement sleep (REM), founding modern sleep research.

French psychiatrist Jacques Lacan broke with IPA and founded the Société Française de Psychanalyse.

1954
James Olds and Peter Milner of McGill University discovered the reward system in the brain.

Roger Sperry of Caltech began researching split brains.

1955
Meprobamate enters the U.S. market under the name Miltown, the very first mass-market psychopharmaceutical and soon one of the best-selling drugs. Read more about Miltown

1956
Gregory Bateson, John Weakland, Donald deAvila Jackson and Jay Haley established the “double bind” theory of schizophrenia, according to them, Schizophrenia stems from situations in which a person receives different or conflicting messages in the brain.

The English translation of The Standard Edition of the Complete Psychological Works of Sigmund Freud was published in 24 volumes (1956-74).

1957
Arvid Carlsson showed that dopamine is a neurotransmitter in the brain.

The first tricyclic antidepressant (TCA), imipramine, was discovered in the pineal gland.

1958
Nathan Ackerman designed a diagnostic model involving the whole family. This was the first systems therapy described, looking not at an individual’s problems, but how they are related in a system (in this case, the family).
He was inspired by the founder of attachment theory John Bowlby, who at this time was already working with families in group therapy.

Aaron B. Lerner of Yale University isolated the hormone melatonin, which was found to regulate sleep-wake rhythms.

1959
Don Jackson founded the Mental Research Institute (MRI) to research and treat families. A year later, Nathen Ackerman, a child psychiatrist, founded the Family Therapy Institute in New York.

1960
The first benzodiazepine, chlordiazepoxide, was introduced under the trade name Librium.

Paul Meehl used the diathesis-stress model to explain schizophrenia. Read more about this model.

1963
United States President John F. Kennedy introduced legislation charging the National Institute of Mental Health with Community Mental Health Centers for people discharged from state psychiatric clinics.

Medard Boss started Daseinsanalysis.

1964
Ronald David Laing published Sanity, Madness and the Family, in which he claimed that the roots of schizophrenia lie in the “family relationship,” where people play dark games with each other.

1967
Emergence of cognitive behavioral therapy, the most widely used therapy of today. Aaron Temkin Beck changed classical behavioral therapy about the same time as Albert Ellis and supplemented it with cognitive concepts, which he applied especially to psychotherapy for depression.

At its core is the assumption that so-called irrational cognitions (thoughts) cause dysfunctional behavior, such as avoidance behavior or aggression. The techniques used in cognitive behavioral therapy focus on changing the content of these irrational cognitions. In addition, techniques from classical behavior therapy are used. In cgt, however, these are in the service of changing cognitions.

From an experimental tradition, clinical psychologists have empirically validated the use of cognitive behavioral therapy for depression, anxiety and other disorders. Standardized therapy can now be implemented by following a book; targeted symptom improvement documents success or failure. This empiricism came at the expense of analytic and dynamic therapies. Emotional symptoms were first categorized and diagnosed, then treated by focusing on the specific characteristic symptoms of the diagnosis.

1968
Humanistic psychology or Third Force Psychology was a reaction to behaviorism and psychoanalysis. The movement was founded by Carl R. Rogers and Abraham H. Maslow. The humanistic school of psychology is more philosophical than psychological. It is originally an American movement that is also influential in Europe.

Humanistic psychology takes a positive view of human nature. It is based on the idea that humans have an innate urge to self-actualize; humans can see beyond their animal instincts and engage in creative activities that improve both their well-being and that of society. Humanistic psychology is primarily concerned with developmental theory, psychotherapy and training of healthy and mentally ill clients.

1970
The U.S. Food and Drug Administration (FDA) approved lithium as a drug for acute mania.

The US Controlled Substances Act was passed, placing LSD, DMT, psilocybin, mescaline and marijuana on List I (no accepted medical use).

1972
The Dutch Association for Ambulatory Mental Health Care is founded. All ambulatory mental health institutions in the Netherlands are merged into 58 Regional Institutions for Ambulatory Mental Health Care (Riaggs) in the 1980s.

American psychologist David Rosenhan published the Rosenhan Experiment, a study of the validity of psychiatric diagnoses.

1973
The Dutch Society for Psychiatry and Neurology is split into two separate societies. This is the result of the division of the specialty of nerve and soul diseases into the specialties of psychiatry and neurology established in 1971.

The American Psychiatric Association removed homosexuality as a mental disorder from the DSM.

The Caucus of Gay, Lesbian and Bisexual Members of the American Psychiatric Association was officially established. A primary function of the organization was to represent the interests of the APA in the area of LGBT mental health. In 1985, the Caucus changed its name to association of Gay and Lesbian Psychiatrists.

1974
Salvador Minuchin developed structural family therapy, a systems therapy that addresses problems within a family by mapping the relationships between family members, or between subgroups of the family.

1975
Margaret Mahler further elaborates the object relation theory in the separation-individuation phase of children, assuming that the process of separation from the mother in the first three years of life is crucial for personality development.

1977
The ICD-9 was published by the WHO. The ICD-9 was an international attempt to bring unity to the very broad diagnostic landscape of psychiatry. The ICD (International Classification of Diseases) is the World Health Organization’s (WHO) internationally standardized classification system of diagnoses that records all disease states and diagnoses worldwide. It also includes mental disorders. In America and the Netherlands, we use the DSM as a guideline for mental disorders. However, most European countries use the ICD.

George Engel is developing the biopsychosocial model. This is an extension of a medical model about human functioning, in which attention is paid not only to biomedical aspects, but also to psychological and social factors that help determine illness and the healing process.

Psychological and social aspects are ignored in the biomedical model, even though they are an important part of being sick. Behavior and environment influence the onset, course and perception of illness. And illness, or being ill, also affects psychological well-being and social relationships.

Engel has therefore extended this biomedical model to include psychological and social aspects. This makes it possible to also observe psychological and social aspects, and treat them in the treatment of diseases

Andrey Lichko published Psychopathies and Accentuations of Character of Teenagers.

1980
The 1980 DSM-III received international acclaim. The DSM-III was the first classification in which no assumption of the causes of diseases was made.It was largely descriptive in nature.

The DSM-III was characterized by: (a) a descriptive and causally theoretical approach; (b) explicit criteria for the various diagnoses; (c) a hierarchy of syndromes also defined in the criteria; and (d) a multi-axial system of classification.

The adoption of a descriptive approach is one of the main reasons why in DSM-III the hitherto important main category of “neurotic disorders” disappeared. Neurotic disorders were dispersed into affective disorders, anxiety disorders, somatoform disorders, dissociative disorders and sexual disorders.

1982
India launched the National Mental Health Program (NMHP).

1983
The European Psychiatric Association was founded.

1987
The Indian Mental Health Act was drafted by Parliament. It came into force in April 1993 in all states and union territories of India. The Act replaced the Indian Lunacy Act of 1912, which had earlier replaced the Indian Lunas Asylum Act of 1858.

1988
Fluoxetine (trade name Prozac), the first selective serotonin reuptake inhibitor (SSRI) antipressant, was released as a drug and soon became the most widely prescribed.

The American Neuropsychiatric Association was founded.

1990
The use of the “blood-oxygen level” (BOLD) in MRI was first discovered by Dr. Seiji Ogawa. This allowed viewing not only anatomy but also brain activity, something that makes psychological research possible. Kenneth Kwong successfully applied BOLD with MRI to human brain activity and published the findings in 1992.

1991
John Bowlby and Mary Ainsworth published Attachment Theory. Attachment theory focuses on a child’s bond with parents or caregivers, and its disruption through separation, deprivation and loss. Interaction with the environment shapes a child emotionally and cognitively.

1992
The ICD-10 appeared. This version was given a much more comprehensive classification of mental disorders that gained worldwide consensus.

1994
Jeffrey Young developed Schema-focused therapy, a new form of psychotherapy (cgt) for patients with mental disorders, which until then were considered difficult to treat. Schema-focused treatment emphasizes the importance of discovering the origins of childhood problems and the dysfunctional schemas and coping styles learned as a result.

The appetite-suppressing hormone leptin was discovered.

1996
Bill Clinton, president of the United States, signed the Mental Health Parity Act, which requires that psychiatric conditions be treated by health insurers the same as any other medical or surgical illness; in 2008, President George W. Bush signed an amended version.

2000
Researchers at the Human Genome Project published a rough map of the complete human genome.

Psychiatry of today and the future

Despite an abundance of investment, pharmaceutical innovation dried up in 2000. No new types of psychiatric drugs have been discovered to date. Brain research is essential, but it is clear that we are nowhere near analyzing and treating human psychology at the neural level. The distinction between medical and psychological research is likely to become less sharp in coming years, however, as certain genetic or other biological differences are found to be related to psychological vulnerabilities.

The release of the DSM-5 in 2013 generated much controversy. It is perhaps time to recognize that many people with mental health problems, probably most, seek treatment not for their symptoms but for a mixture of the unpleasant feelings, dissatisfaction, stormy relationships, unconscious self-sabotage, dissociative reactions and other woes that cannot be easily reduced to DSM diagnostic criteria. The convenient idea that people’s feelings can be distilled into a “problem list” may not be so convenient after all.

Over the past century, many different approaches to treatment have emerged. The struggle between different methods will continue. We are better off embracing diversity rather than making a choice. A robust psychiatry of the future will be inclusive, from the cellular basis of behavior, to individual psychology, to family dynamics and systems therapy, and finally to social phenomena that affect everyone.

2002
The European Brain Council was established in Brussels.

The term for schizophrenia in Japan was changed from Seishin-Bunretsu-Byō 精神分裂病 (split-brain disease) to Tōgō-shitchō-shō 統合失調症 (integration disorder) to reduce stigma.

The American Society of Endocrinologists wrote up best practices for transgender children, including prescribing puberty-suppressing drugs followed by hormone therapy starting at about age 16

2008
Deep brain stimulation (Deep Brain Stimulation), which became known in the 1990s as a remedy for Parkinson’s disease, also appears to be a therapy for depression and OCD. Other psychiatric applications are being investigated.

2011
Leo Rangell died. He was honorary president of the International & the American Psychoanalytic Association, and championed an inclusive theory for psychiatry, to bring together all the new schools of thought that emphasized one approach at the expense of all others, and divided the profession into camps. “Is it acceptable,” he wrote in The Road to Unity in Psychoanalytic Theory, “for a patient to have an Oedipal conflict, or a problem with his self-healing capacity, depending on which therapist he visits?”

2013
The DSM-5 was published by the American Psychiatric Association. There is much discussion about this version. Read more about the DSM-5.

Research Domain Criteria (RDoC) of the National Institute of Mental Health (NIMH) emerged as a direct critique of the DSM-5. This is a framework for integrally examining mental disorders based on neuroscience. Instead of categories, RDoC focuses on so-called domains. Behavior is seen on a spectrum, from normal to abnormal.

Sources include:

• Wikipedia
• History of madness in Western Europe
• history of psychiatry 1800-present in a nutshell

Also read: The 25 most influential psychological studies