Key points

• Psychiatry and psychology follow and reflect the ideas that dominate a given period in history.
• Psychology trends reflect societal values, not just science.
• Question whether the latest trends may have their roots in the way we happen to see the world at the moment.

Let’s start by saying that I am actually referring to both psychology and psychiatry in this blog entry, but I couldn’t fit both terms in the title.

Psychiatry and psychology want to see themselves as entirely empirical and scientific, independent of external influences, but in reality, they are not immune to the prevailing values in the wider society. In fact, they have always tended to follow and reflect the ideas that dominate a given period in history. What follows is a heterogeneous list that includes a number of ideological trends in the history of the West since the Enlightenment, as well as a few more mundane and recent political developments, conceptually paired with some key stages in the history of the psychological sciences.

Ideological Trends and Their Corresponding Impact on Psychiatry and Psychology

• Rational and humanistic views during the Enlightenment: Pinel and Esquirol’s “Moral Therapy,” which stressed the effectiveness of a rational and humane approach in the treatment of insanity
• Emphasis on social discipline and morality during the 19th century: The Asylum Movement, which saw a therapeutic value in discipline and order
• Prominent presence of sensuality in art and culture at the beginning of the 20th century: Birth of psychoanalysis, which shared with contemporary art its magical view of the world, as well as a preoccupation with sex
• Modernism and Futurism in the 1930s: Development of modern and technologically novel interventions, such as ECT, to treat mental illness
• New Deal in the U.S. and social democracy in Europe after WWII: A social approach in psychotherapeutic theories
• Technological optimism in the 1950s: Development of the first effective psychiatric drugs
• Liberation movements during the 1960s: "Anti-psychiatric" psychiatrists
• Liberal political consensus, also during the 1960s: Predominance of the “tabula rasa*”* approach in psychology, in which nurture won against nature
• Neoliberalism in the 1980s: Emphasis on evolutionary mechanisms in psychology as factors predetermining our inescapably selfish behavior
• Political emphasis on social inclusion in the present time: Drive towards facilitating the social inclusion of the mentally ill and fighting stigma
• Postmodernism and technological pessimism, also in the present time: Mistrust of medical technology and those who practice it. Re-emergence of alternative therapies. Evidence-based interventions as the defensive refuge for psychological and psychiatric technology

Links Are Ideological, Not Just Chronological or Circumstantial

It needs to be stressed that these links are ideological and not mere practical consequences or by-products of the predominant ways of thinking in society at a given time. The Asylum Movement did not emerge only because the intolerant Victorian society needed to lock away those who did not conform to the norm; in fact, Victorians thought that discipline was therapeutic and that the asylum had a beneficial effect on insanity. Futurism and Modernism were predominant cultural trends in Italy at the time when Ugo Cerletti developed ECT. These cultural trends created an ideological context in which modern technology—including ECT—was regarded as something essentially positive for humanity.

Other ideological correlations in the list are perhaps more obvious. Pinel was a contemporary of Rousseau and other apologists for reason and humanism during the European Enlightenment. The belief in the inherent dignity of man and the power of reason were the main driving forces behind the “Moral Therapy” revolution. Psychoanalysis was born in Vienna at approximately the same time as Gustav Klimt was painting his sensual portraits in that city and the “Vienna Secession” movement was breaking up with conservative tradition in art. Much later, the advent of social-democracy after the horrors of WWII gave psychoanalysis a more social flavor. The 1960s and the failure of the Vietnam War created a liberal political consensus in Western academic circles, which postulated a belief in men of all races and classes being equal. Any differences between them, therefore, had to be the result of nurture (education and family relationships) rather than nature. In contrast, the more recent neoliberal political attitudes have tended to regard humans as essentially selfish and competitive. In this political atmosphere, evolutionary psychologists and sociobiologists have attempted to find in our genetic code the biological program governing this selfishness, which they understand to be the result of natural selection.

The next time you feel tempted to believe that the beliefs of a given psychological school or psychiatric approach represent The Truth, pause and reflect on whether this latest trend may be the result of the way we happen to think and see the world at the moment.

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