The "Splendid Isolation" of Aaron T. Beck

The "therapeutic relationship:" emergence, eclipse, and transformations of a social technology

This essay situates the history of "the relationship" as a therapeutic technology within the broader context of changing social relations in the twentieth-century United States. More specifically, it outlines the emergence and subsequent diffusion of practices that aim to cultivate a social bond between therapist and patient that may serve as a psychotherapeutic tool. The article highlights the transformations of this technology as its institutional and epistemic foundations became challenged. Initially conceived as an "artificial" social relation designed to help with "personal adjustment," the therapeutic relationship was soon also deployed by non-experts and became a model for more healthful social relations. More recently, it has been fashioned as collaborative and combined with a range of other methods.

Training the Next Generation of Clinical Psychological Scientists: A Data-Driven Call to Action

The central goal of clinical psychology is to reduce the suffering caused by mental health conditions. Anxiety, mood, psychosis, substance use, personality, and other mental disorders impose an immense burden on global public health and the economy. Tackling this burden will require the development and dissemination of intervention strategies that are more effective, sustainable, and equitable. Clinical psychology is uniquely poised to serve as a transdisciplinary hub for this work. But rising to this challengerequires an honest reckoning with the strengths and weaknesses of current training practices. Building on new data, we identify the most important challenges to training the next generation of clinical scientists. We provide specific recommendations for the full spectrum of stakeholders-from funders, accreditors, and universities to program directors, faculty, and students-with an emphasis on sustainable solutions that promote scientific rigor and discovery and enhance the mental health of clinical scientists and the public alike.

Insomnia, Medicalization, and Expert Knowledge

Historians have clearly articulated the ways in which sleeplessness has long been part of the human condition. As an object of medical expertise and public health intervention, however, insomnia is a much more recent invention, having gained its status as a pathology during the 1870s. But while insomnia has attracted considerable and concerted attention from public health authorities allied with sleep medicine specialists, this phenomenon is not well explained by classical medicalization theory, in part because it is the sleepless sufferers, not the medical experts, who typically have the authority to diagnose insomnia. The dynamics of insomnia's history are better described as those of a boundary object, around which concepts and practices of biomedicine and psychology coalesce to frame contemporary notions of self-medicalization and self-experiment.

A Historical and Theoretical Review of Cognitive Behavioral Therapies: From Structural Self-Knowledge to Functional Processes

This paper critically examines the historical conceptualization of cognitive behavioral psychotherapy approaches (CBT) as a direct clinical counterpart of the cognitive revolution. The main "second wave" cognitive psychotherapies, either standard cognitive therapy (CT) or constructivist, in spite of their differences, share a common conceptualization of psychopathological factors as superordinate structural cognitive content belonging to the self: self-beliefs, self-schemata, personality organizations and so on. On the other hand, rational emotive behavior therapy (REBT) is an exception given that in REBT self-knowledge is not the core psychopathological tenet, being rather a derivate mechanism. Moreover, in non clinical cognitive science cognition is conceived as a regulatory function that operates retroactively and not in a hierarchically super- ordered fashion centered on the self. A historical review suggests that in both CT and constructivist model the structuralistic model of self-centered cognition may have emerged for both cultural and scientific reasons: self-centered cognitive models may be more readily understandable to clinicians as they allow for a straightforward identification of operationalizable self-beliefs. The emergence of new "third wave" process-centered CBT approaches may represent a comeback to functionalism, where cognition is considered again a regulatory function and not a structure. In addition, REBT's interest in dysfunctional evaluations not focused on the self presaged this clinical and scientific turning point toward functionalism.

Cruzando el Rubicón: del psicoanálisis a la terapia cognitiva

Resumen En este trabajo nos proponemos describir algunas de las causas que llevan a Aaron T. Beck a abandonar el psicoanálisis y a participar de la creación de la terapia cognitiva. Para ello, describiremos los trabajos de investigación desarrollados por Beck entre los años 1959 y 1962. En ellos se empiezan a procesar los datos que darán lugar a la caída de la hipótesis explicativa psicoanalítica de la depresión. Dentro de este análisis incluiremos algunos elementos que consideramos esenciales para entender este proceso de cambio: la obtención de un subsidio para investigar la depresión y la aparición de colaboradores como Marvin Hurvich y Seygmour Feshbach, cuyas nuevas herramientas y metodologías ayudaron a Beck a poner a prueba la hipótesis psicoanalítica de la depresión. Por último, incluiremos cuestiones referidas a las políticas de investigación del Instituto Nacional de Salud Mental, así como motivos personales y de la política institucional.

Psychotherapy in historical perspective

This article will briefly explore some of the ways in which the past has been used as a means to talk about psychotherapy as a practice and as a profession, its impact on individuals and society, and the ethical debates at stake. It will show how, despite the multiple and competing claims about psychotherapy's history and its meanings, historians themselves have, to a large degree, not attended to the intellectual and cultural development of many therapeutic approaches. This absence has the potential consequence of implying that therapies have emerged as value-free techniques, outside of a social, economic and political context. The relative neglect of psychotherapy, by contrast with the attention historians have paid to other professions, particularly psychiatry, has also underplayed its societal impact. This article will foreground some of the instances where psychotherapy has become an object of emerging historical interest, including the new research that forms the substance of this special issue of History of the Human Sciences.