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1 Analysing psychotherapy in practice

The Oxford English Dictionary defines modern psychotherapy as “the treatment of disorders of the mind or personality by psychological or psychophysiological methods.” Administering electroconvulsive shocks would, however, hardly count as psychotherapy; the common assumption is it that, in psychotherapies, the means of healing is talk. Not all talk is therapeutic, and the history of psychotherapy involves not just formulating new psychological theories but evolving new and distinct ways of talking with clients. This book is an effort to describe and to understand these distinct ways of talking. Many psychoanalytic historiographies locate the invention of psychotherapy in Breuer’s work with a patient they called Anna O. (described in Freud and Breuer’s Studies on Hysteria, 1991/1895) at the end of nineteenth century. Anna O. found that narrating her worries and fantasies helped to relieve her symptoms and she coined the phrase “the talking cure” to describe what she was doing. Freud used her case retrospectively to document the invention of psychoanalysis, which became the first form of psychotherapy. Rather soon, however, there emerged other ways of doing and thinking about “the talking cure,” and at least since 1950s, the field of psychotherapy has been characterized by the multitude of (often rival) approaches. In psychotherapy with individual patients, client-centred psychotherapy gained influence in the 1950s (see e.g. Rogers, 1951), and cognitive-behavioural therapies have been increasingly popular since the 1970s (see e.g. Dryden, 2007). Alongside psychotherapies with individuals, group and family therapies based on psychoanalytic, system-theoretical, and later on social-constructionist ideas have been influential since the 1950s and 1960s. Each school of individual, group, or family therapy is characterized by specific theoretical ideas about mind, behaviour, and social relations, and about the ways in which these may change. While, for example, psychoanalysis and psychodynamic therapies emphasize the importance of unconscious