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The Origin of Therapy

Therapy, at its core, is a collaborative and focused journey toward improved mental health and well-being. Rooted in the recognition that individuals may encounter challenges that affect their emotional, psychological, or interpersonal lives, therapy provides a structured and safe space for exploration, support, and growth. 


The therapeutic process is defined by the relationship between the therapist and their client but is dynamic in its use of various therapeutic approaches, techniques, and modalities that have evolved over a rich and diverse history that spans centuries and cultures. This blog delves into some of the broader shifts that have occurred over time in the history of therapy. 


The Ancient Origins of Therapy


Most cultures around the world historically perceived mental illness as an abnormality that is caused due to supernatural reasons like demonic possessions, black magic, curses, eclipses, the displeasure of god, etc. Owing to this perception, the first roots of support or treatment for mental illness were made up of magical and religious rituals like exorcisms, sacrifices, charms, prayers to god, chanting, and others.



The practice of trephining, drilling holes into the head of the person who was behaving abnormally, was a common practice during ancient times as people believed that this would let out evil spirits residing in them. And when no improvement was seen despite these practices, they would be shunned and kicked out of the community. 


However, things started to change in the times of ancient Greece, when philosophers like Descartes, Plato, and others started thinking about personhood and the deeper underlying processes that impacted how individuals behaved. Greek physicians like Hippocrates and Galen put forward the theory that the mind and body are connected and recognised that mental activity occurs in the brain and not the heart. 



They proposed that certain physical characteristics like the shape of the head or the presence of fluids like blood, yellow bile, black bile, and phlegm can determine an individual’s temperament, emotions, and mental well-being. Therefore, the means to treat mental illness would be to bring balance to the body through the use of surgical practices. 


In India, around this time, ancient literature like the Vedas and Patanjali Yoga-Sutras spoke about mental illness being caused by imbalances in the body, lifestyle, life goals, diet, culture, spirituality, and our interactions with the universe and the elements in it.



Ayurvedic practices highlighted the role of Trigunas or personality types including Sattva (intellectual, clear-minded), Rajas (emotional, passionate), and Tamas (dull, selfish), and Tridoshas or body types including Vaata (tall and lean), Kapha (short and obese), and Pitta (athletic and muscular) as being the prime factors responsible for mental illness.  


Similar to in Ancient Greece, mental illness was treated by bringing a balance in these factors. However, this was done through yogic practices, diet, meditation, self-denial, and spirituality, as compared to the Greek focus on surgical practices. 


“Lunatic Asylums” - The Growth of Institutionalisation 


At the turn of the 17th century, parish authorities started opening up madhouses and lunatic asylums around the villages and towns in Europe, the most well-known being in Bethlem, London. 



The main purpose was to become a space where the mentally ill could be segregated from the community and they functioned similarly to prisons or detention centres. Most of the patients would be chained to the walls, live in windowless rooms, and would often be kept at the asylum till the end of their lives. 


However, a new humanitarian reform spread in these asylums in the 18th century as some of the patients in these asylums got better and people realised that mental illnesses could be treated and patients could be reintegrated into society.   


The French doctor, Philippe Pinel, became the voice leading this movement and worked on unchaining patients, moving them to sunny well-ventilated rooms, and getting them back to their old lives. These changes did end up improving the recovery rates of the patients.  



In India, the first mental asylum was set up in Bombay in 1745 by the British Government and only treated Europeans. However, they did go on to set up asylums in most major cities around India, some of which would slowly start becoming accessible to the public. 


Post-independence, the Government of India has continued to build the capacity of mental hospitals, make them more accessible to the public, and also ensure their maintenance and quality through the Mental Healthcare Act and the National Mental Health Program.  


The Growth of Modern Psychotherapy 


Alongside the growth of modern psychiatry and mental hospitals, as we know them, the 18th and 19th Centuries were when modern talk therapy or psychotherapy also started to evolve. 3 core approaches developed at this time, which have been elaborated below.   


The first is Psychoanalysis, developed by Austrian neurologist Sigmund Freud and also one of the most popular styles of therapy. It examines unconscious urges, desires, and defences and explores childhood experiences as part of its approach to psychological concerns.  



The second is Cognitive Behavioural Therapy, developed by American psychologist Aaron Beck which examines how our thoughts, behaviours, and emotions interact with and influence each other. This is the style of therapy that makes use of a lot of worksheets, homework, and behavioural strategies with clients. 


The third is Humanistic-Existential Therapy, whose forerunners include Carl Rogers, Viktor Frankl, Abraham Maslow, and Irvin Yalom, amongst others. This model focuses on exploring the client's search for meaning, self-actualization, and personal growth. 


Over time, these approaches have deepened, become more culturally nuanced, and have birthed a lot of newer models of therapy that work with present-day concerns like Acceptance and Commitment Therapy (ACT), trauma-informed therapy, and others. 



In India, these models are more holistic, focusing on the mind-body connection, and also on exploring the collective nature of our social groups. There is also an integration of religious, ethnic, caste, gender, and linguistic identities in the therapeutic process.


Conclusion


As society has evolved, so too has the understanding of mental health and how therapy can contribute to personal development and healing. Whether rooted in ancient philosophies or contemporary evidence-based practices, the concept of therapy remains a beacon of hope and resilience for those navigating the intricate landscapes of the human mind. 


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