The Therapeutic Self: Clinical Psychology and Psychotherapy Culture.

The Therapeutic Self: Clinical Psychology and

Psychotherapy Culture

World War II War Neurosis26-40% of all casualties had mental health problems

Preventive Measures for Battle or Operational fatigue, Combat exhaustion, Psychoneuroses

• Fixed tours of duty.• leadership training• creating rest camps• encouraging solidarity between troop

members• providing decent food • distribution of self-help literature in mass

fashion to soldiers

American Medical Association, War Medicine 5 (1944)

Letting off Steam to Shrink Resentment War Medicine (1944)

From the Cartoon Booklet, “The Story of Mack and Mike”

Menninger Clinic, 1925 Topeka KansasDrs. Charles F., Karl and William Menninger

From Mental Illness to Mental Health

William MenningerBrigadier General

US Surgeon General’s OfficeNeuropsychiatry Division

“Team” Treatment – psychiatrists,clinical psychologists, and

social workers.

“For every four men wounded,one fellow blew his stack.”

Innovations:Milieu TherapyGroup Therapy

And Open Hospital

October,1948

Continuum Model of Mental Health

Mental Health Legislation• 1946 –National Mental Health Act, which

called for the establishment of a National Institute of Mental Health.

• 1949 –NIMH was formally established; it was one of the first four NIH institutes. Robert Felix, public health psychiatrist, was first director. (3 million dollar budget).

• 1956- Operating Budget of 18 million dollars• 1964 -60 % of NIMH funding given to

psychologists, sociologists, anthropologists, epidemiologists. Only 15% to psychiatrists.

Veterans Administration Medical Centers& Training in Clinical Psychology

Post World War II: 60% of Cases were NeuropsychiatricIntense Personnel Shortages: Training became most pressing problemFour year Training program in Clinical Psychology launched in 1946 –to train 200 individuals at 20 different universities (freefor students if they worked at VA hospitals)By 1949, there were 700 students at 41 UniversitiesMore psychologists now outside the University than inside.

Carl Rogers (1902-1987)• Clinical Psychologist, Teacher’s College at Columbia University,

training as clinical psychologist• 1928 – Child Study Department of Rochester Society for the

Prevention of Cruelty to Children, Rochester, NY. Ohio State University

• 1939 –The Clinical Treatment of the Problem Child (book)• 1940 – Ohio State University• 1942- Counseling and Psychotherapy: Newer Concepts in Practice

(book)• Trained staff at USO (United Service Organization) to counsel

soldiers, and wrote counseling manual, “Counseling with returned servicemen” (1946). Simple techniques to train new clinicians. Sensitive, non-judgmental clinical help for selfhood, individuality, maturity,freedom, and democracy

• 1945 Set up Counseling Center at the University of Chicago

JESSIE TAFT c. 1916

Jessie Taft (1882-1960)“The Women’s Movement in the Point of View of Modern Social Consciousness” 1913 Dissertation in PhilosophyUniversity of Chicago

Director, University ofPennsylvania School ofSocial Work, 1934

Jessie Taft and Virginia Robinson based at University of Pennsylvania School of Social Work

Taft was engaged in a “constant effort to comprehend and respond overtly to the salient feelings and impulses of the hour as present living realities, which a child, like an adult, usually seeks to deny consciously.” (Taft, 1931, p. 94).

The process required, “the most sensitive self-conscious activity of understanding and response plus a readiness to accept and carry to the end the losing role.” (underlining in original, p. 108).

Jessie Taft, “Experiment in a therapeutically limited relationship with a Seven Year Old Girl” Psychoanalytic Review, 1932

Carl Rogers

Technique of Client/or Person-centered Counseling

Non-directive model – early 1940s“Reflecting Feeling” Therapist as Mirror

The adoption of the Client’s perceptual frame ofreference, along with an accepting attitude (empathy, 1948)

One client described the process: “we were mostly me working together on my situation as I found it.” Rogers: “The two selves have somehow become one while remaining two.”(Rogers, 1951, p. 38).

Again, if I can really understand how he hates his father, or hates the company, or hates Communists – if I can catch the flavor of his fear of insanity, or his fear of atom bombs, or of Russia – it will be of the greatest help to him in altering those hatreds and fears and in establishing realistic and harmonious relationships with the very people and situations toward which he has felt hatred and fear. We know from our research that such empathic understanding – understanding with a person, not about him – is such an effective approach that it can bring about major changes in personality.

Carl Rogers, 1952 “Barriers and Gateways to Communication”, p. 47

University of Minnesota, Duluth, 1956

Eliza – Computer Program 1966• http://www.masswerk.at/elizabot/• Designed by Joseph Weizenbaum• dialogue between a human user and a

computer program representing a mock Rogerian psychotherapist.

Rational-Emotive TherapyPsychologist

Albert Ellis, 1955

Aaron T. Beck (1921—Cognitive Therapy

Fritz Perls

Gestalt Therapy (1973)

Stuart Smalley (Al Franken) from Saturday Night Live

“not a licensed therapist”