Vietnamization or Vietnamisation (Vietnamese: Việt hóa, Chữ Hán: 越化 or Vietnamese: Việt Nam hóa, Chữ Hán: 越南化) is the acquisition or imposition of elements of Vietnamese culture, in particular the Vietnamese language
and customs. This was experienced in some historic periods by the
non-Vietnamese populations of territories controlled or substantially
under the influence of Vietnam. As with other examples of cultural assimilation,
it could either be voluntary or forced and is most visible in the case
of territories where the Vietnamese language or culture were dominant or
where their adoption could result in increased prestige or social
status, as was the case of the nobility of Champa,
or other minorities like Tai, Chinese and Khmers. To a certain extent
Vietnamization was also administratively promoted by the authorities
regardless of eras.
Summary
Vietnamization is one of major example over cultural assimilation.
Dated back from the antiquity of ancient Vietnam, the Vietnamese
state, regardless which Governments, had initiated its attempt to
assimilate by introducing Vietnamization across the country.
Vietnamization efforts were divided into two eras:
Ancient and medieval Vietnam: judging the complicated nature of Vietnam and its country, especially Đại Việt, Vietnamese Emperors used several assimilation process; in one side, loyalty and state assimilation were done with Tai and Hmong tribes within the country; and in one side, is forced ethnic assimilation on remaining ethnics, such as Chinese, Chams, Montagnards, Malays and Khmers.
While the first one was more successful, as Tai and Hmong tribes of
Vietnam remain largely loyal to the Imperial Vietnamese dynasties, the
second one tended to be less successful, due to resistance and even
violence. To ensure total ethnic assimilation in later territory, the
Vietnamese often used brutal violence and executions.
Modern Vietnam: due to previous wars, the Vietnamese process
of forced assimilation tended to be derived by pacifying various ethnic
groups. As Vietnamese just regained their independence from France and Japan,
it found themselves vulnerable and even unthinkable break-up of
Vietnamese state. Since more than 30% Vietnamese population then were
not Vietnamese and had a tendency of supporting separatism, Vietnamese
nationalists of Vietnam independence movement, notably Việt Minh,
regardless what types, both emphasized the need for the ethnic and
cultural homogeneity of the state in the long term. This trend went
continued at the heat of Vietnam War, especially in South Vietnam while North Vietnam
also followed similar methods despite varied tactics. The promotion of
Vietnamese language in administration and society soon proved to be the
greater threat for non-Vietnamese, eventually leading them to resistance
against Vietnamese rule. Eventually, it led to en-masse ethnic
rebellions, notably in the South, where its policies were believed to
have alienated native population alike. Even after 1975, ethnic
rebellions would remain a problem for the newly-established communist
Government, but unlike the former Imperial and South Vietnamese
Governments which had struggle on maintaining unity in the south, the
Communists implemented Vietnamese nationalist fervors and employing Józef Piłsudski-based
state assimilation, judging their loyalty on the state above while do
not rule out ethnic assimilation once there were rebellions.
Subsequently, ethnic rebellions started to be weakened, though not
completely ended, such as Degar rebellion in Central Highlands in 2003.
Antiquity to medieval Vietnamization
Attempts to assimilate non-Vietnamese people began in ancient era, after decades suffering Chinese domination of Vietnam and Sinicization on Vietnamese people. By the time of ancient Văn Lang and Âu Lạc, as well as Nanyue, assimilation policy had not existed.
Using elements of previous Sinicization process, Vietnamese
dynasties began its process of Vietnamization on smaller ethnic people,
in which targeted on the first, the Tai, Muong, Chinese and other
mountainous tribes including the Hmongs. All these attempts were mostly
successful, due to being able to gain support and loyalty from these
tribes, and this would remain for most of antiquity to medieval eras.
There had been previous rebellions against it as well, such as the
rebellion of Zhuang Tai tribes led by Nùng Trí Cao, who previously fought together with the Vietnamese against the Song dynasty in fear of Vietnamization against the Zhuang people. The rebellion of Nùng Trí Cao was not able to repel the Vietnamese, but he was able to secure the border within Yunnan,
which help him establish a Tai state of Danan (Great South) and then
Nanyue. Throughout history, Nùng's relations with the Vietnamese were a
controversial one, due to mixed characteristics or both cooperations and
his resistance to submission to Vietnamization. The Nùng people
in Vietnam today was named after his surname and is still a revered
hero, while the Vietnamese Government officially acknowledged Nùng's
role on Vietnamese history.
Vietnamization process since then had remained with little interruption, with the only exception of later Fourth Chinese domination of Vietnam.
However, the repel of Chinese out from the country soon created a more
aggressive Vietnamization, as Vietnam started to attack a number of
China's allies like Lan Xang, Lan Na, Cambodia and Champa, as well as penetrating south and attacking Malays in the sea. Captured prisoners and later ethnic people, notably the Hmongs of Central Vietnam, whom unlike the Hmongs of the north, had little to no connection, set up new chapter.
Vietnamization of Chams and Khmers was the most known, and the most
brutal one. Many Chams had refused the Vietnamese authority within them,
and as for the result of the growing Trịnh–Nguyễn War and later Vietnamese Shogunate era, the Nguyễn lords decided to impose restriction of movement on Chams and Khmers, importing Chinese refugees fleeing from Qing conquest of Ming (in which many Chinese immigrants were later Vietnamized, and more successful than with Chams and Khmers).
The Vietnamization of Chams went as for the result of resistance by the
Chams, with continued from 15th century until the end of Vietnam War, was a sole evidence of the resilient of Vietnamization process; although not judge out anti-Vietnamese unrests by Chams alike.
The process of Vietnamization also penetrated to Central Highlands, creating an uneasy sense of sentiment among the Montagnards, those who remained independent tribes for many years despite previous incursions. While the former Khmer Empire
and Champa were not able to conquer and only put them as vassalage
instead, the Vietnamese were more successful, taking over the Highlands
and placed them under Vietnamese control. Nonetheless, for the first
years under the Nguyễn dynasty,
the Vietnamese Imperial Government only considered the region as its
buffer zone rather than placing assimilation, as they needed loyalty
from these people. Eventually, the process was okay since the Montagnard
ethnic tribes were loyal to the Vietnamese state, and even helped the
Vietnamese army to suppress Cham rebellion at 1830s. The process would remain until French conquest.
French Indochina from 1858–1954
With the French Empire/French Republic took over Vietnam at 1884, Vietnam went under direct rule of Paris. Nonetheless, due to the complicated nature in the region, France soon found out the only way to build their unity single French Indochina
(composed Laos, Vietnam and Cambodia) was to place a possible ethnic
assimilation under the vision of French Government. By this point, the
French soon tolerated parts of Vietnamization process, placing
Vietnamese officials in the colony and valued them; while on the same
time, buying loyalty with non-Vietnamese ethnic groups to de-Vietnamize
others, making/inviting them to establish their own community that
supportive of France whenever any attempts of Vietnamese rebellions
could occur. This was the trend of "divide and rule" policy aimed on
Vietnamization process.
For example, Chinese immigration into Vietnam visibly increased following the French colonisation of Vietnam from 1860 onwards following the signing of the Convention of Peking
whereby the rights of Chinese to seek employment overseas were
officially recognised by the Chinese, British and French authorities.
Unlike their Vietnamese predecessors, who would Vietnamize them, the
French were very receptive of these Chinese immigrants as it provided an
opportunity to stimulate trade and industry, and they generally found
employment as labourers or middlemen. The French established a special
Immigration Bureau in 1874 requiring Chinese immigrants to register with
the Chinese clan and dialect group associations and eased trade
restrictions that were previously in place.
Historians such as Khanh Tran viewed this as a divide-and-rule policy
especially upon the possible Vietnamization, and the intention of its
implementation was to minimise the chances of any internal revolt
against the French authorities.
The Chinese population nevertheless witnessed an exponential increase
in the late 19th century and more so in the 20th century; between the
1870s and 1890s, some 20,000 Chinese settled in Cochinchina. Another
600,000 arrived in the 1920s and 1930s, and peaks in the migration
patterns was especially pronounced during the 1920s and late 1940s when
the effects of fighting and economic instability arising from the Chinese Civil War became pronounced.
Both were sponsored and financed by the French authorities in an
attempt to de-Vietnamize minorities in French Indochina. This
"divide-and-rule" of France would remain in practice, and was very
successful on putting ethnic divisions, as France's de-Vietnamization
process increased ethnic awareness of non-Vietnamese people.
On the same time, France's assimilation and pacification policy
created a new group of educated elites in the country. Notably, France
brought Christianity
within the Degar community, and the Degar tribes were educated and
influenced by French system, which made them one of the most educated
minorities in the country. The Montagnards even found their community
raising its purpose, which is still relevant today. Assists from France also came to other non-Vietnamese people, though varied on times.
French Government would maintain this ethnic policy as their rule remained in Vietnam until the outbreak of First Indochina War. The war changed rapidly with the rise of Việt Minh,
an anti-colonial group that later functioned into its own army. The
Việt Minh, represented by the idea of a united Vietnamese state,
directly embraced the idea of Vietnamization process and placed
minorities on its target via loyalty to the nation. This targeted
greatly on non-Vietnamese, and even non-Buddhists, many were thought to
have sided with France against the Vietnamese, notably Hmongs, Chams,
Khmers and Degars.
When France was expelled from Vietnam, the policy of Vietnamization,
encouraged by both the communists and Republican Government, continued
resulting with forcing name changes, religious conversions and rising
Vietnamese awareness.
Both North Vietnam and South Vietnam practiced similar Vietnamization process, as both targeted on its minorities and to raise stronger Vietnamese awareness.
The most relevant was the Vietnamization process launched by the
South against its Degar population. Although the South Vietnamese and
Degars were common allies of the United States
against growing threat from communist North, the South Vietnamese,
composed by mainly ethnic Vietnamese and Vietnamized minorities like
Khmers, distrusted its Degar allies and had done very little to promote
ethnic awareness of Degars. Rather, South Vietnamese Government promoted
Vietnamness and Vietnamese nationalism, hoping to completely Vietnamize
the Degars, in which after 1975 the communist North continued.
The Americans, however, were seen as an unwanted counter against
Vietnamization process of Degar minorities, as they formed bonds with
the Montagnards while the Montagnards hated the increasing of Vietnamese
population regardless North or South alike.
Montagnards' alliance with the Americans didn't make them prefer the
South Vietnamese, as South Vietnamese Government continued to enact
Vietnamization, accused by Montagnards as ethnic genocide on them; in
which both South Vietnam and later communist Government of Vietnam
vehemently denied. Continuous Vietnamization was sponsored directly by the Southern Government without opposition from ethnic Vietnamese majority.
The Communist North Vietnamese Government, on the other hand,
attempted to use Vietnamization process for the same thing, and
inherited the previous successful Vietnamization on indigenous Tai, Lao
and Hmong tribes in the north to deal with South Vietnam, especially
Degars.
The Degars were almost opposing every Vietnamese regardless from the
South or North, had to face forced displacement by various attacks led
by both South Vietnamese and North Vietnamese armies. The Americans were
unable to prevent this, despite being ally of both Degars and South
Vietnam as Vietnamization had been practiced by both North and South
Vietnam alike. Montagnards rebelled against the South Vietnamese in 1974.
Similar to the Degars, the Chams and Khmers were too main major
other ethnic people to suffer forced Vietnamization, although
Vietnamization had been longer to them than to the Degars. The Vietnamese, already assimilated and Vietnamized the Chams since 15th century,
continued to openly discriminate the Chams due to unlimited opposition
to Vietnamization among the latter, even fiercer than with Degars due to
longer history of contact. Chams had founded the FULRO in hope to fight the much larger and more armed Vietnamese, culminating FULRO insurgency against Vietnam.
Same to Degars, Chams and Khmers also fought both North and South
Vietnamese Government, and later unified communist Government of
Vietnam, and their resistance against Vietnamization process remained.
The end of Vietnam War forced ethnic minorities, mostly in the
south, to face forced Vietnamization, or to give up. FULRO became a
united force for almost every ethnic minorities of Southern Vietnam
against the Vietnamese, composed both Khmers, Chams, Degars and Hmongs
(mostly Hmong Christians). The level of insurgency against unified Vietnam came tenser at 1980s after the Vietnamese invasion of Cambodia,
received arms and ammunitions against the Vietnamese forces.
Cambodians, majority of ethnic Khmers, whom suffered previous
discrimination and Vietnamization process, also attempted to resist
Vietnamization. Both these resistances eventually ended in complete failure at 1990s, as Vietnam enacted Đổi mới reforms and normalization of relations between Vietnam to China
and the West, who used to support de-Vietnamization process. The
normalization of relations allowed Vietnam to be free on ongoing
Vietnamization process.
Despite the collapse of FULRO and weakening the insurgency,
Vietnamization process had been the cause of 2001 and 2004 Degar
rebellions in Central Highlands, aimed on the same accusation of
Vietnamization.
Since then, ongoing Vietnamization forced Degar refugees to flee
Vietnam en-masse. In the same thing, Cham and Khmer refugees also
attempted to flee from Vietnam due to Vietnamization, even it is not
large like the situation of Degar refugees.
Vietnamese nationalism (Vietnamese: chủ nghĩa dân tộc Việt Nam / chủ nghĩa quốc gia Việt Nam, Chữ Hán: 主義民族越南 / 主義國家越南) is a form of nationalism that asserts the Vietnamese people are an independentnation and promotes cultural unity in Vietnam.
It encompasses a broad range of ideas and sentiments harbored by the
Vietnamese people for many centuries to preserve and defend the national identity of the Vietnamese nation.
Vietnamese is recognized as the only language in the country. Vietnamese nationalism focuses on the nation's military history, although there are cultural and civil aspects to it as well.
Some modern nationalist concepts in Vietnam focus on China, where anti-Chinese sentiment
in Vietnam has been fueled in various forms, from the Vietnamese
believing they were defending visages of Sinitic civilization from
Manchus and Mongols during the Mongol Invasions of Vietnam, or to promoting Baiyueism. Nationalism that promoted anti-French
views has been prominent in the past. Vietnam's current socialist
government-sponsored form is also regarded as a synthesis of nationalism
and communism.
A Đồng Khánh period text regarding the demographics of the Hưng Hóa Province referring to the ethic groups as "Hán (Vietnamese)" (漢), "Thanh" (清), and "Thổ"
(土). This indicates that during the beginning of the period of French
domination the Vietnamese still maintained the "Hoa-Di distinction"
while the indigenous peoples and the subjects of the Manchu Qing (Thanh)
dynasty were viewed as "less civilised".
During the age of the ancient states like Âu Lạc and Nanyue,
nationalism among the population was weak, as there was no centralised
Vietnamese nation. However, nationalism grew following the Chinese millennium
in Vietnam. Several attempts against Chinese occupation resulted in
many wars that happened throughout thousand years of Chinese rule, after
which Vietnam finally regained independence in the 10th century
following the battle of Bạch Đằng. Lý Thường Kiệt's famous declaration of Vietnam's independence, Nam quốc sơn hà (Mountains and Rivers of the Southern Country), is a patriotic and nationalistic poem that still lives on in Vietnamese society generations later. Nguyễn Trãi's Bình Ngô đại cáo is considered the other declaration of Vietnam's independence against the Chinese Dynasties.
In the 17th century, in the North during the time of the Trịnh
Lords, the Trịnh mandated that the Chinese entering the country had to
strictly follow Vietnamese customs and refrain from contacts with the
local Vietnamese populace in the cities.
However, in the south, the Nguyễn Lords favoured the Chinese, allowing
many Chinese to settle in new conquered land from the Khmer Kingdom. The
immigrated Chinese scholars even became Nguyễn Lord officials.
After defeating the Tay Son, The Nguyễn Lord formed the Nguyen
Dynasty. The Nguyen Dynasty completed the Vietnamese "March to the
South" or Nam tiến. Over the span of 700 years, starting from the Lý dynasty, the dynasty gradually invaded and colonised the entire state of Champa and parts of the Khmer Empire. Under the Nguyễn dynasty
(the dynasty most sinicized and influenced by the teachings of
Confucius), they attempted to assimilate all of the ethnic minorities in
the territories that they had captured by forcing them to adopt
sinicised Vietnamese customs. Copying the Chinese idea of Central Plain,
the Nguyễn dynasty saw themselves as belonging to a superior culture, unlike the Indianised states of Champa and the Khmer Empire. They saw themselves as carrying out a civilising mission against the minorities who were seen as barbarians.
Considering themselves as superior due to being sinicised, members of
the Vietnamese royalty looked down upon those that were non-Vietnamese
as inferior.
Later on, after the Nguyễn dynasty began ruling Vietnam, the
dynasty had been using the Vietnamisation concepts on the non-Vietnamese
people. During the nam tiến period of the Nguyễn Dynasty, Emperor Gia Long
stated that "Hán di hữu hạn" (漢夷有限, "the Vietnamese and the barbarians
must have clear borders") when differentiating between Khmer and the
Vietnamese. Emperor Minh Mạng,
the son of Gia Long, stated with regards to the Vietnamese forcing the
ethnic minorities to follow Sino-Vietnamese customs that "We must hope
that their barbarian habits will be subconsciously dissipated, and that
they will daily become more infected by Hán [Civilised] customs." The Nguyễn Dynasty under that influence once saw themselves as "Hán nhân" (Civilised people).
After the Third Indochina War in 1979, Vietnamese nationalists focused on anti-China sentiment. Anti-China beliefs became more popular because of South China Sea/Vietnam
East Sea dispute. As for the French invasion, many resistances came
around but failed, which culminated in the formation of communist Vietnam. However, Vietnamese nationalism changed to focus on an independent, unified Việt Nam.
Economy
There
has been a growing movement among Vietnamese by boycotting Chinese
products, using Vietnamese-made products instead. This is called "made
in Vietnam" to counter with "made in China"
Culture
Despite being part of Sinosphere cultural influence and sharing many cultural aspects such as Confucianism, and having Chữ Nôm and Chữ Hán as its former writing script, Vietnamese nationalists mostly refuse to accept Chinese influence on Vietnam. They have a belief that the Vietnamese already had a profound culture before Chinese influence i.e Đông Sơn, rice cultivating, dominated by Austroasiatic peoples. Adding with the interactions and later conquests of Indianized Kingdom of Champa,
Vietnamese nationalists believe it is a major cross-road of two
civilizations rather than one, being at crossroads between Indic and
Sinic.
Vietnamese textbooks also refer to the influence of China but reject Chinese elements in Vietnamese nation.[1]
The current north Vietnam was part of the land of Bai Yue tribes, so
they believe the similarities are because of the Chinese culture was
influenced by the culture of Bai Yue tribes (Bách Việt) when their land
was conquered by the Han Chinese.
Military
For
much of its history being razed by wars, the Vietnam developed its
nationalism based on its successful history of warfare. Many Vietnamese
generals are seen as nationalistic heroes in Vietnamese society, such as
Trần Hưng Đạo, the famous general who stood up to the mighty Mongol Empire by successfully repelling the three Mongol invasions of Vietnam in 1258, 1285, 1287–88 and Nguyễn Huệ, a revered Emperor and general who defeated the Qing Dynasty of China in the Battle of Ngọc Hồi-Đống Đa,
considered to be one of the greatest military victories in Vietnamese
history. Both Trần Hưng Đạo and Nguyễn Huệ have several streets named
after them and statues erected to honor them, and both are listed as
being among the greatest generals in history.
Vietnam also heavily honors its long lists of generals in ancient
Vietnamese history that fought against Chinese expansionism, such as
the Trưng Sisters and Lady Triệu, who were female generals that led major independent movements against Chinese occupation. Ngô Quyền is well honored for being the first to successfully defeat the Southern Han of China at the Battle of Bạch Đằng in 938 and establishing Vietnamese independence, Lê Hoàn for defeating the Song dynasty at the same river in 981, and Lê Lợi who liberated Vietnam by defeating the Ming dynasty and founding the Lê dynasty.
A sense of pride has also developed in the Vietnamese resistance in the 20th century. Ho Chi Minh is regarded as the founder of modern Vietnam after his victories against the Japanese during World War II and against the French in the First Indochina War, declaring the Democratic Republic of Vietnam. Võ Nguyên Giáp
is also recognized as one of most successful generals in current
Vietnamese history, emerging victorious in not only the two
aforementioned wars, but also in the Vietnam War, that allowed the unification of the country, and the Sino-Vietnamese War against the Chinese due to the Vietnamese invasion of Cambodia.
Education
Vietnamese national pride is heavily promoted in Vietnamese textbooks, especially of its development and its heroism.
Many Vietnamese stories are still heavily mentioned in the youth
education system and among the older generations which have been
regarded as a major factor that keeps Vietnamese nationalism alive.
The ideology of "Greater Vietnam" is a popular concept among some
popular Vietnamese nationalist parties that claim the territory of Lưỡng Quảng (Guangxi and Guangdong), as well as Laos, Cambodia or territories of the ancient Baiyue
as part of greater Vietnamese sovereignty. The idea is just a newly
developed ideology following the beginning of 20th century, but has
gained popularity in the aftermath of 2014 Vietnam anti-China protests.
According to Vietnamese nationalist groups, these territories
have been traditionally Vietnamese until expansionism from foreign
powers claimed them, and Vietnam must retake it. Because of this,
Vietnam had carried a long-time conquests and conflicts with neighboring
countries, as well as assimilations and even genocides due to its
irredentist sentiment.
Confucianism in the United States dates back to accounts of missionaries
who traveled to China during the early 19th century. Since the second
half of the 20th century, it has had increased scholarly interest. Confucianism is often studied under the umbrella of Chinese philosophy, and American scholars of Confucianism generally teach in university philosophy or religion
departments. Whether Confucianism should be categorized as a religion,
philosophy, or tradition has been controversial in U.S. academia.
Contemporary discussion of Confucianism in the U.S. centers on
questions about its modern relevance in America and its ability to be
studied and practiced outside China and East Asia. Major topics discussed by scholars of Confucianism in the U.S. include Confucian humaneness (ren), ritual (li), Confucianism in global cultural dialogue, and its relationship to universal values.
Compared to Buddhism
(another East Asian tradition which has been widely popularized and
practiced in the U.S.), Confucianism has received little attention
beyond a small circle of academic specialists. Apart from occasional lectures on Confucianism, Confucius Institutes across the United States have little influence in promoting Confucian philosophy or Confucianism as a way of life.
The association of Confucianism with historical and political
expressions which endorsed hierarchical relationships and suppressed
individual rights may have prevented it from achieving a wider influence
in the U.S. because it is seen as conflicting with American (and
universal) values of democracy and human rights. Contemporary American
scholars of Confucianism are exploring the possibility of a dialogue
between Confucianism and universal values, and applying Confucian
teachings to modern American life.
History
The history of Confucianism in the U.S. can be separated into three periods.
1830s to early 1900s
Since the 1830s, a number of missionaries traveled to China to spread Christianity and wrote accounts of Confucianism. Among them were Elijah Coleman Bridgman (1801-1861), Samuel Wells Williams (1812-1884), and Arthur Henderson Smith (1845-1932). In addition to their missionary work, they studied the Chinese language and familiarized themselves with Chinese culture. Williams' 1848 book, The Middle Kingdom, was the first comprehensive scholarly work on China by an American. He spoke highly of Confucius, and considered the Analects incomparable to any other book in history with the exception of the Bible. During the 1870s, institutions devoted to China studies and Confucianism began to take root at Yale and Harvard Universities and the University of California.
Early 20th century
The
general attitudes of American scholars toward Confucianism during this
period can be grouped into two strands. One group (heavily influenced by
Max Weber)
viewed it as inferior to Western, Christian-based culture and the
reason for the stagnation of contemporary Chinese society. Another
school of thought, represented by Sinologist H. G. Greel, affirmed the
value of interpersonal bonds (ren lun) in Confucianism and
regarded Confucius as one of the most important figures in human
history. Greel argued that Confucianism played a constructive role in
influencing the Age of Enlightenment, examining Confucianism in detail in Confucius and the Chinese Way (1949) and Birth of China (1936).
China
In
comparison to a growing interest in Confucianism in the U.S., the 1905
abandonment of the civil-service-examination system posed a major
challenge to the significance of Confucianism in China (since the
examination was largely based on mastery of classical Confucian texts).
The 1911 collapse of the Qing dynasty and the New Culture Movement, led by Chinese students and intellectuals, also dealt major blows to traditional Chinese values, practices and language.
Chinese intellectuals became increasingly drawn to liberalism or
Marxism as they tried to develop a model of what a new China should look
like. Some, such as Liang Shuming (1893-1988), Zhang Junmai (1886-1969) and Xiong Shili (1885-1968), continued to defend Confucianism as a solution to China's ills.
Late 20th century
Confucian scholarship flourished during the late 20th century. A number of New Confucian
scholars from mainland China emigrated to the U.S. after the founding
of the People's Republic of China, including Zhang Junmai (Carson Chang) and He Lin. Their proteges, such as Tu Weiming, Cheng Chungying, Yu Ying-shih, and Liu Shuxian, established a new emphasis on Confucian study in the United States.
The period also saw growing American interest in Confucianism and
Chinese culture, marked by watershed events such as the founding of the
PRC and the Korean War.
The work of Mou Zongsan also informed Confucian scholarship in America
during this period. Mou is known as part of the second generation of New
Confucians; contemporaries include Tang Junyi and Xu Fuguan. Confucian
scholars who came to the U.S. engage with Western philosophers such as
Hegel and Kant, re-interpreting classical texts and responding to global
democratization and the rule of law characterizing the second half of
the century. A number of institutions devoted to the study of China and
Confucianism emerged during this period, including the John King Fairbank
Center of Harvard University and the University of Hawaii. Prominent
American scholars of Confucianism in the U.S. during this period include
William Theodore de Bary, Benjamin Schwartz, Thomas A. Metzger, David Hall, and Roger T. Ames.
Contemporary scholarship
Philosophy
The
controversy about categorizing Confucianism as a philosophy is tied to
the controversy surrounding Chinese philosophy and the issue of
translation. The Chinese word for philosophy (zhe xue) is a translation from the Japanese which came into existence during the early 20th century. Hu Shih's Outline of a History of Chinese Philosophy (1918) and Feng Youlan's History of Chinese Philosophy (1934)
established the concept of Confucianism as a philosophy. Controversies
about categorizing Confucianism as philosophy stem from China and the
West; Western philosophers question Confucianism's metaphysical
sophistication, and objections from China argue that categorizing
Confucianism as philosophy violates key aspects of the tradition.
Tradition
More
than a subject of theoretical inquiry, Confucianism is related to
practices that seek to improve oneself and one's world. Contemporary
Confucian scholars in the U.S. differ about the inheritance of rituals
(the historical practice of Confucian traditions), emphasizing
Confucianism's practical aspects in orienting one's ethical life: the
way one perceives (and acts) in the world. The view of Confucianism as a
tradition challenges the way it should be practiced today. In Contemporary Confucian Political Philosophy,
Stephen Angle writes: "It may not be as easy to know how to practice
Confucianism today as it once was", because "pre-twentieth century
Chinese society had various well-trodden paths to follow, based in part
in a deeply ingrained ritualization of life".
Angle also argues that the practice of Confucianism in modern times can
benefit from "critical modern innovations like broad political
participation, the rule of law, and the active rooting out of social
oppression."
Whether Confucianism can be categorized as a religion is
controversial. According to Bin Song of Boston University, it is "deeply
spiritual, but not religious."
American Confucian scholars Philip J. Ivanhoe, Robert Cummings Neville, and Tu Weiming
agree about Confucianism's religious aspect. Ivanhoe describes
Confucian spirituality as a means of integrating oneself into the larger
patterns of life embedded in society and nature: "Cultivating the self
in order to take one’s place in this universal scheme describes the
central task of life".
Neville lists three criteria for a religious tradition—a cosmology, a
body of rituals, and a path of spiritual perfection—and believes that
all three apply to Confucianism.
Tu defines Confucian religiosity as communal self-transformation and a
faithful response to the transcendent, characterizing it as the
Confucian prescription "for learning to be fully human". Confucianism believes that the ultimate meaning of life is realizable through ordinary daily existence.
Ruism
Bin Song
uses the term "Ruism" instead of "Confucianism". According to Song,
"Confucianism" implies the absolute authority of Confucius' teachings
and "no one in the Ru tradition would have ever dared to critique
Confucius in any conceivable way."
He believes that the term "Ruism" better captures the spirit of
criticism he sees in the teachings of great Ru thinkers such as
Confucius, Mencius, and Wang Yangming.
Song seeks to the shed light on the spiritual dimension of Ruism, which
encourages autonomy and criticism and departs from religious dogmatism.
Philosophical schools
Robert
Cummings Neville proposes that scholars of Confucianism in the U.S.
fall into three major categories: interpretive philosophers who are
devoted to translation, bridging philosophers who compare Confucianism
with Western thought, and normative philosophers who aim to promote
Confucianism's contemporary significance in global cultural
conversations.
Although there are no sharp divisions between the philosophical
schools, the primarily-interpretive philosophers were generally trained
as historians and textual critics; normative thinkers were generally trained as philosophers.
Interpretive philosophers
William Theodore de Bary has taught East Asian thought for many years at Columbia University,
and has trained many scholars of Chinese philosophy in the United
States and Canada. He has led the Columbia University Seminar on
Neo-Confucianism, edited the Sources of Chinese Tradition (1960) and edited and contributed to a number of conference volumes, including Self and Society in Ming Thought (1970) and The Unfolding of Neo-Confucianism (1975).
Bridging philosophers
Herbert Fingarette's Confucius: The Secular as Sacred
has been an important book on Chinese philosophy for Western
philosophers. Fingarette's thesis is that the Confucian notion of ritual
to make social relations possible and to be the medium of ethics. David Shepherd Nivison
of Stanford University also contributed to the solution of contemporary
Western philosophical problems. Nivison's major work was The Ways of Confucianism: Investigations in Chinese Philosophy (1996). Philip J. Ivanhoe,
an American historian of Confucianism and a philosophy professor,
relates Confucian thought to contemporary philosophical problems
(primarily ethics). Ivanhoe's book Confucian Moral Self Cultivation (1993) studies six thinkers: Confucius, Mencius, Xunzi, Zhu Xi, Wang Yangming, and Dai Zhen, showing the contemporary relevance of their thought.
Normative philosophers
Normative philosophers identify some Chinese school (such as Confucianism or Daoism) as central to their own heritage; their main philosophic intent is neither interpretation nor comparison, but the normative engagement of contemporary philosophical problems. Philosophers in this category include Roger T. Ames, David Hall, Tu Weiming, and Chung-ying Cheng. Roger T. Ames and David Hall, professors at the University of Hawaii, collaborated on three books: Thinking Through Confucius (1987), Anticipating China (1995), and Thinking from the Han
(1998). Ames and Hall contrast Western and Chinese cultures and distill
each into certain essential characteristics. Western culture is based
on transcendent ordering principles; Chinese culture is based on
"correlative thinking", identifying classifications which are themselves
correlated.
Boston Confucians
Origin
The Boston Confucians
are a group of philosophers who believe that Confucianism is a portable
tradition which can be applied to contexts outside its
pre-modern-Chinese origin. Attendees of a 1992 Confucian-Christianity
conference began to refer to Robert Cummings Neville, a Confucian
scholar and Christian theologian from Boston University, and his
colleagues as "Boston Confucians." Although the term "Boston Confucianism" was used as "affectionate teasing and tongue-in-cheek self-description,"
it came to be used as "a semi-serious label" for the view that
"Confucianism is not limited to East Asian ethnic application" and "has
something genuinely interesting and helpful to bring to contemporary
philosophical discussions".
In addition to Neville, major figures of Boston Confucianism are John
Berthrong and Tu Weiming. Bin Song has published a series of articles in
the Huffington Post about the contemporary relevance of Ruism.
Among Boston Confucians, the "North-of-the-Charles" school (Tu Weiming
and his Harvard colleagues) emphasizes "Mencian humaneness and expresses
with new subtlety the Confucian worry that the Christian creation myth
has some objectionable literal commitments to God as a being separate
from the world".
Humanity (Ren)
The classical Confucian term ren
(benevolence or humaneness) is central to the Confucian ideal as seen
by the Boston Confucians, although different members have nuanced
disagreements about its implications. Tu Weiming understands ren
as supreme self-cultivation and the fullest manifestation of humanity.
Tu's interpretation of humanity is in line with Mencius' notion of the
inherent goodness of human nature and the continuity of that nature with
the development of civilization. Tu notes the "gradual process of
extension of love," and the expression of our humanity that "ren is most exemplified in our caring toward our relatives (qin qin)."
He spells out the spiritual dimension in the attainment of humaneness,
an "inseparability of the Human Way and the Way of Heaven."
Robert Neville, agreeing with Tu on the central importance of humanity in Confucian thought, echoes Xunzi's
concern that people need rituals to achieve humanity because they are
selfish by nature. Xunzi is less confident about the readiness of human
nature to develop full-fledged morality, emphasizing the importance of
environment and rituals to "set aright" the inborn nature of humanity. Neville compares the Confucian concept of ren
and the Christian notion of love, noting an agreement between Confucius
and Christians that the capacity for love is inborn and definitive of
what it means to be human.
Ritual propriety (Li)
The
interpretation of ritual propriety in Boston Confucianism stems from
two strands of Confucian thinking. Tu Weiming's Mencian tradition is
that humans' feelings about what is appropriate is inborn, but Neville
emphasizes Xunzi's ritual propriety; human endowments are undetermined,
and we must learn to approach moral perfection through rituals.
For Tu, humanity (ren) is the inner essence of human nature; the heavenly principle (tian li) must express itself in external social relations through ritual propriety. He disagrees that li refers only to structured ceremonies, saying that "it points to a concrete way whereby one enters into communion with others".
Neville emphasizes the need for ritual propriety to act as a corrective
for emotion: "Our feelings can provide emotive power in all directions,
but need learned discrimination to find appropriate objects and
appropriate responses." He sees ritual propriety as necessary to achieve ren.
Dialogue
The
idea of civilized dialogue is advanced by Tu Weiming about
Confucianism's contemporary global relevance. Tu identifies the
twenty-first century as a new Axial Age, in which cultural and religious pluralism can foster constructive dialogue between traditions and civilizations. The concept of dialogue between civilizations was also a response to the theory of the "clash of civilizations" proposed by Samuel P. Huntington,
who argued that international conflict in the post-Cold War era was
primarily caused by conflicts between cultural and religious identities.
In contrast, Tu is hopeful that with "tolerance, recognition, and
respect" the possibility exists for two partners in dialogue to "take
the other as reference" and learn from each other.
Tu sees Confucianism as having unique value in dialogue between
civilizations, which must exist to sustain its relevance as a living
tradition. He proposes that the development of Confucianism can be
separated into three epochs: classical Confucianism (traced back to
early thinkers such as Confucius, Mencius, and Xunzi), Neo-Confucianism (during the Song and Ming dynasties), and 20th-century New Confucianism.
The defining characteristic of the latter is its participation in
global civilizational dialogue. Tu sees Confucian humanism as an
important spiritual resource in responding to global challenges such as
the ecological crisis, social alienation, anomie and egoism.
Confucianism would also benefit from participation in such a dialogue;
according to Tu, "If the well-being of humanity is its central concern,
Confucian humanism in the third epoch cannot afford to be confined to
East Asian culture. A global perspective is needed to universalize its
concerns. Confucians can benefit from dialogue with Jewish, Christian,
and Islamic theologians, with Buddhists, with Marxists, and with
Freudian and post-Freudian psychologists.".
Tu believes that New Confucianism must respond to four challenges from
the West: (1) scientific inquiry, (2) democracy, (3) Western religiosity
and its sense of transcendence, and (4) the Freudian psychological exploration of human nature.
Controversy
Bryan Van Norden, in his review of the book Boston Confucianism,
questions the originality of Boston Confucians' argument about the
portability of Confucian tradition. Van Norden suggests that the
portability of Confucianism had already been widely acknowledged before
the book was published. The emergence of Neo-Confucianism in the Song
and Ming dynasties and the spread of Confucianism to other parts of Asia
were examples of Confucianism as an evolving, portable tradition.
According to Van Norden, "Neville's label is original, but the concept
is not."
Stephen C. Angle, a Confucian philosopher and professor of philosophy and East Asian studies at Wesleyan University,
writes in his essay "American Confucianism: Between Tradition and
Universal Values" that Boston Confucianism has had a limited impact in
promoting Confucian values and practices in the U.S.
The Chinese Confucian world has criticized Tu Weiming's use of Western
religious concepts and terminology in describing Confucianism, which
they consider inappropriate.
Progressive Confucianism
Progressive Confucianism
is a term coined by Stephen C. Angle which sheds light on
Confucianism's engagement with universal values such as democracy and
human rights. Angle gives the term a two-dimensional meaning; it
describes the core Confucian commitment to individual and collective
moral progress, and believes that ethical insight can lead to
progressive political change (which leads to greater realization of our
potential for virtue). It is influenced by Mou Zongsan's
idea of "self-restriction", which connects morality and the rule of
law. Major concerns of Angle's Progressive Confucianism include human
rights, the rule of law, and gender equality. His prescription of
Confucianism for progressive political change is in line with "a kind of
constitutional democracy," but he stresses that Progressive
Confucianism is more than constitutional democracy. Angle offers a
creative Confucian interpretation of ritual (an aspect of Confucianism
often criticized for its association with hierarchical relationships, filial piety
and oppression), writing that "Progressive Confucians must stand
against oppression, notwithstanding historical Confucian complacency
concerning many types of oppression".
For Angle, trogressive changes in political institutions and social
relationships is compatible with Confucianism and essential to upholding
its essence: "the ideal of all individuals developing their capacities
for virtue—ultimately aiming at sagehood—through their relationships
with one another and with their environment."
Critiques
Tongdong Bai, a professor of philosophy at Fudan University, wrote about Angle's Progressive Confucianism that there may be more alternatives to Confucian political institutions than liberal democracy. Bai said that contemporary Confucian political thinkers, such as Daniel A. Bell, Jiang Qing
and himself, "don't believe that history ends with liberal democracy,"
but would "try to offer alternatives, such as a hybrid regime that
combines democratic elements with meritocratic elements."
Bao Wenxin, a researcher at the Shanghai Academy of Social Sciences,
wrote that the layers of meaning embedded in the Chinese word
"progressive" (进步) may have rendered the label of Progressive
Confucianism a vague one. Bao suggests that Angle's argument that
Progressive Confucianism promotes collective moral progress may not be
as evident in traditional Confucianism before the 20th century.
According to Leigh Jenco, Angle's creation of a modernized Confucianism
is almost ironic: "Confucianism becomes relevant and 'modern' only to
the extent that it can incorporate certain prior commitments to such key
values as rule of law and human rights".
Psychotherapy (also psychological therapy, talk therapy, or talking therapy) is the use of psychological methods, particularly when based on regular personal interaction, to help a person change behavior, increase happiness, and overcome problems. Psychotherapy aims to improve an individual's well-being and mental health, to resolve or mitigate troublesome behaviors, beliefs, compulsions, thoughts, or emotions, and to improve relationships and social skills.
Numerous types of psychotherapy have been designed either for
individual adults, families, or children and adolescents. Certain types
of psychotherapy are considered evidence-based for treating some diagnosed mental disorders; other types have been criticized as pseudoscience.
There are hundreds of psychotherapy techniques, some being minor
variations; others are based on very different conceptions of
psychology. Most involve one-to-one sessions, between the client and therapist, but some are conducted with groups, including families.
Psychotherapists may be mental health professionals
such as psychiatrists, psychologists, mental health nurses, clinical
social workers, marriage and family therapists, or professional
counselors. Psychotherapists may also come from a variety of other
backgrounds, and depending on the jurisdiction may be legally regulated, voluntarily regulated or unregulated (and the term itself may be protected or not).
Definitions
The term psychotherapy is derived from Ancient Greekpsyche (ψυχή meaning "breath; spirit; soul") and therapeia (θεραπεία "healing; medical treatment"). The Oxford English Dictionary
defines it as "The treatment of disorders of the mind or personality by
psychological means...", however, in earlier use it denoted the
treatment of disease through hypnotic suggestion. Psychotherapy is often dubbed as a "talking therapy" or "talk therapy", particularly for a general audience, though not all forms of psychotherapy rely on verbal communication.
Children or adults who do not engage in verbal communication (or not in
the usual way) are not excluded from psychotherapy; indeed some types
are designed for such cases.
The American Psychological Association adopted a resolution on the effectiveness of psychotherapy in 2012 based on a definition developed by American psychologist John C. Norcross: "Psychotherapy is the informed and intentional application of clinical methods and interpersonal stances
derived from established psychological principles for the purpose of
assisting people to modify their behaviors, cognitions, emotions, and/or
other personal characteristics in directions that the participants deem
desirable". Influential editions of a work by psychiatrist Jerome Frank
defined psychotherapy as a healing relationship using socially
authorized methods in a series of contacts primarily involving words,
acts and rituals—which Frank regarded as forms of persuasion and rhetoric. Historically, psychotherapy has sometimes meant "interpretative" (i.e. Freudian) methods, namely psychoanalysis, in contrast with other methods to treat psychiatric disorders such as behavior modification.
Some definitions of counseling
overlap with psychotherapy (particularly in non-directive
client-centered approaches), or counseling may refer to guidance for
everyday problems in specific areas, typically for shorter durations
with a less medical or "professional" focus. Somatotherapy refers to the use of physical changes as injuries and illnesses, and sociotherapy to the use of a person's social environment to effect therapeutic change. Psychotherapy may address spirituality
as a significant part of someone's mental / psychological life, and
some forms are derived from spiritual philosophies, but practices based
on treating the spiritual as a separate dimension are not necessarily
considered as traditional or 'legitimate' forms of psychotherapy.
Delivery
Psychotherapy may be delivered in person (one on one, or with couples, or in groups), over the phone, via telephone counseling, or via the internet. There have also been developments in computer-assisted therapy, such as virtual reality therapy
for behavioral exposure, multimedia programs to each cognitive
techniques, and handheld devices for improved monitoring or putting
ideas into practice.
The Australian Victoria state Government's Health Agency has
awarded no mental health app with scores greater than 3 stars out of 5
for effectiveness. One reason for this is that online cognitive behavioural therapy
programs have poor "adherence" compared to face-to-face programs. That
means that many users do not "stick to" the program as prescribed. They
may uninstall the app or skip days, for instance.
Most forms of psychotherapy use spoken conversation. Some also use various other forms of communication such as the written word, artwork, drama, narrative story or music. Psychotherapy with children and their parents often involves play,
dramatization (i.e. role-play), and drawing, with a co-constructed
narrative from these non-verbal and displaced modes of interacting.
Psychotherapists traditionally may be mental health professionals
like psychologists and psychiatrists; professionals from other
backgrounds (family therapists, social workers, nurses, etc.) who have
trained in a specific psychotherapy; or (in some cases) academic or
scientifically trained professionals.
Psychiatrists are trained first as physicians, and as such they may prescribe prescription medication;
and specialist psychiatric training begins after medical school in
psychiatric residencies: however, their specialty is in mental disorders
or forms of mental illness. Clinical psychologists have specialist doctoral degrees in psychology with some clinical and research components. Other clinical practitioners, social workers,
mental health counselors, pastoral counselors, and nurses with a
specialization in mental health, also often conduct psychotherapy. Many
of the wide variety of psychotherapy training programs and institutional
settings are multi-professional. In most countries, psychotherapy
training is completed at a postgraduate level, often at a master's
degree (or doctoral) level, over four years, with significant supervised
practice and clinical placements. Mental health professionals that
choose to specialize in psychotherapeutic work also require a program of
continuing professional education after basic professional training.
A listing of the extensive professional competencies of a
European psychotherapist was developed by the European Association of
Psychotherapy (EAP) in 2013.
As sensitive and deeply personal topics are often discussed
during psychotherapy, therapists are expected, and usually legally
bound, to respect client or patient confidentiality. The critical
importance of client confidentiality—and
the limited circumstances in which it may need to be broken for the
protection of clients or others—is enshrined in the regulatory
psychotherapeutic organizations' codes of ethical practice.
Examples of when it is typically accepted to break confidentiality
include when the therapist has knowledge that a child or elder is being
physically abused; when there is a direct, clear and imminent threat of
serious physical harm to self or to a specific individual.
Europe
As of
2015, there are still a lot of variations between different European
countries about the regulation and delivery of psychotherapy. Several
countries have no regulation of the practice or no protection of the
title. Some have a system of voluntary registration, with independent
professional organizations, while other countries attempt to restrict
the practice of psychotherapy to 'mental health professionals'
(psychologists and psychiatrists) with state-certified training. The
titles that are protected also vary. The European Association for Psychotherapy
(EAP) established the 1990 Strasbourg Declaration on Psychotherapy,
which is dedicated to establishing an independent profession of
psychotherapy in Europe, with pan-European standards. The EAP has already made significant contacts with the European Union & European Commission towards this end.
Given that the European Union
has a primary policy about the free movement of labor within Europe,
European legislation can overrule national regulations that are, in
essence, forms of restrictive practices.
In Germany, the practice of psychotherapy for adults is
restricted to qualified psychologists and physicians (including
psychiatrists) who have completed several years of specialist practical
training and certification in psychotherapy. As psychoanalysis,
psychodynamic therapy, and cognitive behavioral therapy meet the
requirements of German health insurance companies, mental health
professionals regularly opt for one of these three specializations in
their postgraduate training. For psychologists, this includes three
years of full-time practical training (4,200 hours), encompassing a
year-long internship at an accredited psychiatric institution, six
months of clinical work at an outpatient facility, 600 hours of
supervised psychotherapy in an outpatient setting, and at least 600
hours of theoretical seminars. Social workers may complete the specialist training for child and teenage clients.
Similarly in Italy, the practice of psychotherapy is restricted to
graduates in psychology or medicine who have completed four years of
recognised specialist training.
Sweden has a similar restriction on the title "psychotherapist", which
may only be used by professionals who have gone through a post-graduate
training in psychotherapy and then applied for a licence, issued by the National Board of Health and Welfare.
Legislation in France restricts the use of the title
"psychotherapist" to professionals on the National Register of
Psychotherapists,
which requires a training in clinical psychopathology and a period of
internship which is only open to physicians or titulars of a master's
degree in psychology or psychoanalysis.
Austria and Switzerland (2011) have laws that recognize multi-disciplinary functional approaches. The government and Health and Care Professions Council
considered mandatory legal registration but decided that it was best
left to professional bodies to regulate themselves, so the Professional Standards Authority for Health and Social Care (PSA) launched an Accredited Voluntary Registers scheme. Counseling and psychotherapy are not protected titles in the United
Kingdom. Counsellors and psychotherapists who have trained and qualify
to a certain standard (usually a level 4 Diploma) can apply to be
members of the professional bodies who are listed on the PSA Accredited
Registers.
United States
In
some states, counselors or therapists must be licensed to use certain
words and titles on self-identification or advertising. In some other
states, the restrictions on practice are more closely associated with
the charging of fees. Licensing and regulation are performed by various
states. Presentation of practice as licensed, but without such a
license, is generally illegal. Without a license, for example, a practitioner cannot bill insurance companies. Information about state licensure is provided by the American Psychological Association.
In addition to state laws, the American Psychological Association requires its members to adhere to its published Ethical Principles of Psychologists and Code of Conduct. The American Board of Professional Psychology examines and certifies "psychologists who demonstrate competence in approved specialty areas in professional psychology".
Canada
Regulation of psychotherapy is in the jurisdiction of, and varies among, the provinces and territories.
In Quebec,
psychotherapy is a regulated activity which is restricted to
psychologists, medical doctors, and holders of a psychotherapy permit
issued by the Ordre des psychologues du Québec, the Quebec order of
psychologists. Members of certain specified professions, including social workers, couple and family therapists, occupational therapists, guidance counsellors, criminologists, sexologists, psychoeducators,
and registered nurses may obtain a psychotherapy permit by completing
certain educational and practice requirements; their professional
oversight is provided by their own professional orders. Some other
professionals who were practising psychotherapy before the current
system came into force continue to hold psychotherapy permits alone.
On 1 July 2019, Ontario's Missing Persons Act came into effect,
with the purpose of giving police more power to investigate missing
persons. It allows police to require (as opposed to permit) health
professionals, including pyschotherapists, to share otherwise
confidential documents about their client, if there is reason to believe
their client is missing.
Some have expressed concern that this legislation undermines
psychotherapy confidentiality and could be abused maliciously by police, while others have praised the act for how it respects privacy and includes checks and balances.
Psychotherapy can be said to have been practiced through the ages, as
medics, philosophers, spiritual practitioners and people in general
used psychological methods to heal others.
In the Western tradition, by the 19th century, a moral treatment movement (then meaning morale or mental) developed based on non-invasive non-restraint therapetic methods. Another influential movement was started by Franz Mesmer (1734–1815) and his student Armand-Marie-Jacques de Chastenet, Marquis of Puységur (1751–1825). Called Mesmerism or animal magnetism, it would have a strong influence on the rise of dynamic psychology and psychiatry as well as theories about hypnosis. In 1853, Walter Cooper Dendy
introduced the term "psycho-therapeia" regarding how physicians might
influence the mental states of patients and thus their bodily ailments,
for example by creating opposing emotions to promote mental balance.Daniel Hack Tuke cited the term and wrote about "psycho-therapeutics" in 1872, in which he also proposed making a science of animal magnetism. Hippolyte Bernheim and colleagues in the "Nancy School" developed the concept of "psychotherapy" in the sense of using the mind to heal the body through hypnotism, yet further. Charles Lloyd Tuckey's 1889 work, Psycho-therapeutics, or Treatment by Hypnotism and Suggestion popularized the work of the Nancy School in English. Also in 1889 a clinic used the word in its title for the first time, when Frederik van Eeden and Albert Willem van Renterghem in Amsterdam renamed theirs "Clinique de Psycho-thérapeutique Suggestive" after visiting Nancy. During this time, travelling stage hypnosis became popular, and such activities added to the scientific controversies around the use of hypnosis in medicine.
Also in 1892, at the second congress of experimental psychology, van
Eeden attempted to take the credit for the term psychotherapy and to
distance the term from hypnosis.
In 1896, the German journal Zeitschrift für Hypnotismus,
Suggestionstherapie, Suggestionslehre und verwandte psychologische
Forschungen changed its name to Zeitschrift für Hypnotismus,
Psychotherapie sowie andere psychophysiologische und psychopathologische
Forschungen, which is probably the first journal to use the term. Thus psychotherapy initially meant "the treatment of disease by psychic or hypnotic influence, or by suggestion".
Freud, seated left of picture with Jung seated at the right of the picture. 1909
Sigmund Freud visited the Nancy School and his early neurological practice involved the use of hypnotism. However following the work of his mentor Josef Breuer—in particular a case where symptoms appeared partially resolved by what the patient, Bertha Pappenheim, dubbed a "talking cure"—Freud began focusing on conditions that appeared to have psychological causes originating in childhood experiences and the unconscious mind. He went on to develop techniques such as free association, dream interpretation, transference and analysis of the id, ego and superego. His popular reputation as the father of psychotherapy was established by his use of the distinct term "psychoanalysis", tied to an overarching system of theories and methods, and by the effective work of his followers in rewriting history. Many theorists, including Alfred Adler, Carl Jung, Karen Horney, Anna Freud, Otto Rank, Erik Erikson, Melanie Klein and Heinz Kohut,
built upon Freud's fundamental ideas and often developed their own
systems of psychotherapy. These were all later categorized as psychodynamic, meaning anything that involved the psyche's conscious/unconscious influence on external relationships and the self. Sessions tended to number into the hundreds over several years.
Some therapeutic approaches developed out of the European school of existential philosophy.
Concerned mainly with the individual's ability to develop and preserve a
sense of meaning and purpose throughout life, major contributors to the
field (e.g., Irvin Yalom, Rollo May) and Europe (Viktor Frankl, Ludwig Binswanger, Medard Boss, R.D.Laing, Emmy van Deurzen)
attempted to create therapies sensitive to common "life crises"
springing from the essential bleakness of human self-awareness,
previously accessible only through the complex writings of existential
philosophers (e.g., Søren Kierkegaard, Jean-Paul Sartre, Gabriel Marcel, Martin Heidegger, Friedrich Nietzsche). The uniqueness of the patient-therapist relationship thus also forms a vehicle for therapeutic inquiry. A related body of thought in psychotherapy started in the 1950s with Carl Rogers. Based also on the works of Abraham Maslow and his hierarchy of human needs, Rogers brought person-centered psychotherapy
into mainstream focus. The primary requirement was that the client
receive three core "conditions" from his counselor or therapist:
unconditional positive regard, sometimes described as "prizing" the
client's humanity; congruence [authenticity/genuineness/transparency];
and empathic understanding.
This type of interaction was thought to enable clients to fully
experience and express themselves, and thus develop according to their
innate potential. Others developed the approach, like Fritz and Laura Perls in the creation of Gestalt therapy, as well as Marshall Rosenberg, founder of Nonviolent Communication, and Eric Berne, founder of transactional analysis. Later these fields of psychotherapy would become what is known as humanistic psychotherapy today. Self-help groups and books became widespread.
During the 1950s, Albert Ellis originated rational emotive behavior therapy (REBT). Independently a few years later, psychiatrist Aaron T. Beck developed a form of psychotherapy known as cognitive therapy.
Both of these included relatively short, structured and present-focused
techniques aimed at identifying and changing a person's beliefs,
appraisals and reaction-patterns, by contrast with the more long-lasting
insight-based approach of psychodynamic or humanistic therapies. Beck's
approach used primarily the socratic method, and links have been drawn between ancient stoic philosophy and these cognitive therapies.
Cognitive and behavioral therapy approaches were increasingly combined and grouped under the umbrella term cognitive behavioral therapy (CBT) in the 1970s. Many approaches within CBT are oriented towards active/directive yet collaborative empiricism
(a form of reality-testing), and assessing and modifying core beliefs
and dysfunctional schemas. These approaches gained widespread acceptance
as a primary treatment for numerous disorders. A "third wave" of
cognitive and behavioral therapies developed, including acceptance and commitment therapy and dialectical behavior therapy, which expanded the concepts to other disorders and/or added novel components and mindfulness
exercises. However the "third wave" concept has been criticized as not
essentially different from other therapies and having roots in earlier
ones as well. Counseling methods developed include solution-focused therapy and systemic coaching.
Postmodern psychotherapies such as narrative therapy and coherence therapy
do not impose definitions of mental health and illness, but rather see
the goal of therapy as something constructed by the client and therapist
in a social context. Systemic therapy also developed, which focuses on family and group dynamics—and transpersonal psychology, which focuses on the spiritual facet of human experience. Other orientations developed in the last three decades include feminist therapy, brief therapy, somatic psychology, expressive therapy, applied positive psychology and the human givens
approach. A survey of over 2,500 US therapists in 2006 revealed the
most utilized models of therapy and the ten most influential therapists
of the previous quarter-century.
There are hundreds of psychotherapy approaches or schools of thought. By 1980 there were more than 250; by 1996 more than 450;
and at the start of the 21st century there were over a thousand
different named psychotherapies—some being minor variations while others
are based on very different conceptions of psychology, ethics (how to
live) or technique. In practice therapy is often not of one pure type but draws from a number of perspectives and schools—known as an integrative or eclectic approach. The importance of the therapeutic relationship, also known as therapeutic alliance, between client and therapist is often regarded as crucial to psychotherapy. Common factors theory addresses this and other core aspects thought to be responsible for effective psychotherapy.
Sigmund Freud (1856–1939), a Viennese neurologist who studied with Jean-Martin Charcot
in 1885, is often considered the father of modern psychotherapy. His
methods included analyzing his patient's dreams in search of important
hidden insights into their unconscious minds. Other major elements of
his methods, which changed throughout the years, included identification
of childhood sexuality, the role of anxiety as a manifestation of inner
conflict, the differentiation of parts of the psyche (id, ego,
superego), transference and countertransference (the patient's
projections onto the therapist, and the therapist's emotional responses
to that). Some of his concepts were too broad to be amenable to
empirical testing and invalidation, and he was critiqued for this by
Jaspers. Numerous major figures elaborated and refined Freud's
therapeutic techniques including Melanie Klein, Donald Winnicott, and
others. Since the 1960s, however, the use of Freudian-based analysis for
the treatment of mental disorders
has declined substantially. Different types of psychotherapy have been
created along with the advent of clinical trials to test them
scientifically. These incorporate subjective treatments (after Beck),
behavioral treatments (after Skinner and Wolpe) and additional
time-constrained and centered structures, for example, interpersonal
psychotherapy. In youth issue and in schizophrenia, the systems of
family treatment hold esteem. A portion of the thoughts emerging from
therapy are presently pervasive and some are a piece of the tool set of
ordinary clinical practice. They are not just medications, they
additionally help to understand complex conduct.
Psychotherapies are categorized in several different ways. A distinction can be made between those based on a medical model and those based on a humanistic model.
In the medical model, the client is seen as unwell and the therapist
employs their skill to help the client back to health. The extensive use
of the DSM-IV,
the diagnostic and statistical manual of mental disorders in the United
States is an example of a medically exclusive model. The humanistic or
non-medical model in contrast strives to depathologise the human
condition. The therapist attempts to create a relational environment
conducive to experiential learning and help build the client's
confidence in their own natural process resulting in a deeper
understanding of themselves. The therapist may see themselves as a
facilitator/helper.
Therapies are sometimes classified according to their duration; a
small number of sessions over a few weeks or months may be classified
as brief therapy (or short-term therapy), others, where regular sessions take place for years, may be classified as long-term.
Some practitioners distinguish between more "uncovering" (or "depth")
approaches and more "supportive" psychotherapy. Uncovering
psychotherapy emphasizes facilitating the client's insight into the
roots of their difficulties. The best-known example is classical
psychoanalysis. Supportive psychotherapy
by contrast stresses strengthening the client's coping mechanisms and
often providing encouragement and advice, as well as reality-testing and
limit-setting where necessary. Depending on the client's issues and
situation, a more supportive or more uncovering approach may be optimal.
These psychotherapies, also known as "experiential", are based on humanistic psychology
and emerged in reaction to both behaviorism and psychoanalysis, being
dubbed the "third force". They are primarily concerned with the human
development and needs of the individual, with an emphasis on subjective meaning, a rejection of determinism, and a concern for positive growth rather than pathology. Some posit an inherent human capacity to maximize potential, "the self-actualizing tendency"; the task of therapy is to create a relational environment where this tendency might flourish. Humanistic psychology can, in turn, be rooted in existentialism—the belief that human beings can only find meaning by creating it. This is the goal of existential therapy. Existential therapy is in turn philosophically associated with phenomenology.
Person-centered therapy,
also known as client-centered, focuses on the therapist showing
openness, empathy and "unconditional positive regard", to help clients
express and develop their own self.
Humanistic Psychodrama (HPD) is based on the human image of humanistic psychology.
So all rules and methods follow the axioms of humanistic psychology.
The HPD sees itself as development-oriented psychotherapy and has
completely moved away from the psychoanalytic catharsis theory.
Self-awareness and self-realization are essential aspects in the
therapeutic process. Subjective experiences, feelings and thoughts and
one's own experiences are the starting point for a change or
reorientation in experience and behavior in the direction of more
self-acceptance and satisfaction. Dealing with the biography of the
individual is closely related to the sociometry of the group.
Gestalt therapy,
originally called "concentration therapy", is an
existential/experiential form that facilitates awareness in the various
contexts of life, by moving from talking about relatively remote
situations to action and direct current experience. Derived from various
influences, including an overhaul of psychoanalysis, it stands on top
of essentially four load-bearing theoretical walls: phenomenological method, dialogical relationship, field-theoretical strategies, and experimental freedom.
A briefer form of humanistic therapy is the human givens approach, introduced in 1998–99.
It is a solution-focused intervention based on identifying emotional
needs—such as for security, autonomy and social connection—and using
various educational and psychological methods to help people meet those
needs more fully or appropriately.
Insight-oriented psychotherapies focus on revealing or interpreting unconscious processes. Most commonly referring to psychodynamic therapy, of which psychoanalysis is the oldest and most intensive form, these applications of depth psychology encourage the verbalization of all the patient's thoughts, including free associations,
fantasies, and dreams, from which the analyst formulates the nature of
the past and present unconscious conflicts which are causing the
patient's symptoms and character problems.
Behavior therapies use behavioral techniques, including applied behavior analysis (also known as behavior modification), to change maladaptive patterns of behavior to improve emotional responses, cognitions, and interactions with others. Functional analytic psychotherapy
is one form of this approach. By nature, behavioral therapies are
empirical (data-driven), contextual (focused on the environment and
context), functional (interested in the effect or consequence a behavior
ultimately has), probabilistic (viewing behavior as statistically
predictable), monistic (rejecting mind-body dualism and treating the person as a unit), and relational (analyzing bidirectional interactions).
Cognitive therapy focuses directly on changing the thoughts, in order to improve the emotions and behaviors.
Cognitive behavioral therapy attempts to combine the above two approaches, focused on the construction and reconstruction of people's cognitions, emotions and behaviors.
Generally in CBT, the therapist, through a wide array of modalities,
helps clients assess, recognize and deal with problematic and
dysfunctional ways of thinking, emoting and behaving.
Interpersonal psychotherapy (IPT) is a relatively brief form of psychotherapy (deriving from both CBT and psychodynamic approaches) that has been increasingly studied and endorsed by guidelines for some conditions. It focuses on the links between mood and social circumstances, helping to build social skills and social support. It aims to foster adaptation to current interpersonal roles and situations.
Exposure and response prevention (ERP) is primarily deployed by therapists in the treatment of OCD. The American Psychiatric Association
(APA) state that CBT drawing primarily on behavioral techniques (such
as ERP) has the "strongest evidence base" among psychosocial
interventions.
By confronting feared scenarios (i.e., exposure) and refraining from
performing rituals (i.e., responsive prevention), patients may gradually
feel less distress in confronting feared stimuli, while also feeling
less inclination to use rituals to relieve that distress. Typically, ERP
is delivered in "hierarchical fashion", meaning patients confront
increasingly anxiety-provoking stimuli as they progress through a course
of treatment.
Systemic therapy
seeks to address people not just individually, as is often the focus of
other forms of therapy, but in relationship, dealing with the
interactions of groups, their patterns and dynamics (includes family therapy and marriage counseling). Community psychology is a type of systemic psychology.
The term group therapy was first used around 1920 by Jacob L. Moreno, whose main contribution was the development of psychodrama,
in which groups were used as both cast and audience for the exploration
of individual problems by reenactment under the direction of the
leader. The more analytic and exploratory use of groups in both hospital
and out-patient settings was pioneered by a few European psychoanalysts
who emigrated to the US, such as Paul Schilder,
who treated severely neurotic and mildly psychotic out-patients in
small groups at Bellevue Hospital, New York. The power of groups was
most influentially demonstrated in Britain during the Second World War,
when several psychoanalysts and psychiatrists proved the value of group
methods for officer selection in the War Office Selection Boards. A
chance to run an Army psychiatric unit on group lines was then given to
several of these pioneers, notably Wilfred Bion and Rickman, followed by S. H. Foulkes, Main, and Bridger. The Northfield Hospital
in Birmingham gave its name to what came to be called the two
"Northfield Experiments", which provided the impetus for the development
since the war of both social therapy, that is, the therapeutic community
movement, and the use of small groups for the treatment of neurotic and
personality disorders. Today group therapy is used in clinical settings
and in private practice settings.
Expressive psychotherapy is a form of therapy that utilizes artistic
expression (via improvisational, compositional, re-creative, and
receptive experiences) as its core means of treating clients. Expressive
psychotherapists use the different disciplines of the creative arts as
therapeutic interventions. This includes the modalities dance therapy, drama therapy, art therapy, music therapy, writing therapy, among others. This may include techniques such as affect labeling.
Expressive psychotherapists believe that often the most effective way
of treating a client is through the expression of imagination in
creative work and integrating and processing what issues are raised in
the act.
Postmodernist
Also known as post-structuralist or constructivist. Narrative therapy
gives attention to each person's "dominant story" through therapeutic
conversations, which also may involve exploring unhelpful ideas and how
they came to prominence. Possible social and cultural influences may be
explored if the client deems it helpful. Coherence therapy posits multiple levels of mental constructs that create symptoms as a way to strive for self-protection or self-realization. Feminist therapy
does not accept that there is one single or correct way of looking at
reality and therefore is considered a postmodernist approach.
Other
Transpersonal psychology addresses the client in the context of a spiritual understanding of consciousness. Positive psychotherapy
(PPT) (since 1968) is a method in the field of humanistic and
psychodynamic psychotherapy and is based on a positive image of humans,
with a health-promoting, resource-oriented and conflict-centered
approach.
Hypnotherapy is undertaken while a subject is in a state of hypnosis.
Hypnotherapy is often applied in order to modify a subject's behavior,
emotional content, and attitudes, as well as a wide range of conditions
including: dysfunctional habits, anxiety, stress-related illness, pain management, and personal development.
Psychedelic therapy are therapeutic practices involving psychedelic drugs, such as LSD, psilocybin, DMT, and MDMA. In psychedelic therapy, in contrast to conventional psychiatric medication
taken by the patient regularly or as needed, patients generally remain
in an extended psychotherapy session during the acute psychedelic
activity with additional sessions both before and after in order to help
integrate experiences with the psychedelics.Psychedelic therapy has been compared with the shamanic
healing rituals of indigenous people. Researchers identified two main
differences: the first is the shamanic belief that multiple realities
exist and can be explored through altered states of consciousness, and
second the belief that spirits encountered in dreams and visions are
real. The charitable initiative Founders Pledge has written a research report on cost-effective giving opportunities for funding psychedelic-assisted mental health treatments.
Body psychotherapy, part of the field of somatic psychology,
focuses on the link between the mind and the body and tries to access
deeper levels of the psyche through greater awareness of the physical body and emotions. There are various body-oriented approaches, such as Reichian (Wilhelm Reich) character-analytic vegetotherapy and orgonomy; neo-Reichian bioenergetic analysis; somatic experiencing; integrative body psychotherapy; Ron Kurtz's Hakomi psychotherapy; sensorimotor psychotherapy; Biosynthesis psychotherapy; and Biodynamic psychotherapy. These approaches are not to be confused with body work
or body-therapies that seek to improve primarily physical health
through direct work (touch and manipulation) on the body, rather than
through directly psychological methods.
Some non-Western indigenous
therapies have been developed. In African countries this includes
harmony restoration therapy, meseron therapy and systemic therapies
based on the Ubuntu philosophy.
Psychotherapy needs to be adapted to meet the developmental needs of
children. Depending on age, it is generally held to be one part of an
effective strategy to help the needs of a child within the family
setting. Child psychotherapy training programs necessarily include courses in human development.
Since children often do not have the ability to articulate thoughts and
feelings, psychotherapists will use a variety of media such as musical
instruments, sand and toys, crayons, paint, clay, puppets,
bibliocounseling (books), or board games. The use of play therapy is often rooted in psychodynamic theory, but other approaches also exist.
In addition to therapy for the child, sometimes instead of it,
children may benefit if their parents work with a therapist, take
parenting classes, attend grief counseling, or take other action to resolve stressful situations that affect the child. Parent management training is a highly effective form of psychotherapy that teaches parenting skills to reduce their child's behavior problems.
In many cases a different psychotherapist will work with the care taker of the child, while a colleague works with the child.
Therefore, contemporary thinking on working with the younger age group
has leaned towards working with parent and child simultaneously, as well
as individually as needed.
Research on computer-supported and computer-based interventions has
increased significantly over the course of the last two decades. The following applications frequently have been investigated:
Tele-therapy / tele-mental health: In teletherapy classical
psychotherapy is provided via modern communication devices, such as via
videoconferencing.
Virtual reality: VR is a computer-generated scenario that simulates experience. The immersive environment, used for simulated exposure, can be similar to the real world or it can be fantastical, creating a new experience.
Computer-based interventions (or online interventions or internet interventions):
These interventions can be described as interactive self-help. They
usually entail a combination of text, audio or video elements.
Computer-supported therapy (or blended therapy): Classical psychotherapy is supported by means of online or software application elements. The feasibility of such interventions has been investigated for individual and group therapy.
Effects
Evaluation
There is considerable controversy about whether, or when, psychotherapy efficacy is best evaluated by randomized controlled trials or more individualized idiographic methods.
One issue with trials is what to use as a placebo treatment group or non-treatment control group.
Often, this group includes patients on a waiting list, or those
receiving some kind of regular non-specific contact or support.
Researchers must consider how best to match the use of inert tablets or
sham treatments in placebo-controlled studies in pharmaceutical trials. Several interpretations and differing assumptions and language remain.
Another issue is the attempt to standardize and manualize therapies and
link them to specific symptoms of diagnostic categories, making them
more amenable to research. Some report that this may reduce efficacy or
gloss over individual needs. Fonagy and Roth's opinion is that the
benefits of the evidence-based approach outweighs the difficulties.
There are several formal frameworks for evaluating whether a
psychotherapist is a good fit for a patient. One example is the
Scarsdale Psychotherapy Self-Evaluation (SPSE).
However, some scales, such as the SPS, elicit information specific to
certain schools of psychotherapy alone (e.g. the superego).
Many psychotherapists believe that the nuances of psychotherapy
cannot be captured by questionnaire-style observation, and prefer to
rely on their own clinical experiences and conceptual arguments to
support the type of treatment they practice. Psychodynamic therapists
increasingly believe that evidence-based approaches are appropriate to
their methods and assumptions, and have increasingly accepted the
challenge to implement evidence-based approaches in their methods.
A pioneer in investigating the results of different psychological therapies was psychologist Hans Eysenck, who argued that psychotherapy does not produce any improvement in patients. He held that behavior therapy
is the only effective one. However, it was revealed that Eysenck (who
died in 1997) falsified data in his studies about this subject,
fabricating data that would indicate that behavioral therapy enables
achievements that are impossible to believe. Fourteen of his papers were
retracted by journals in 2020, and journals issued 64 statements of
concern about publications by him. Rod Buchanan, a biographer of
Eysenck, has argued that 87 publications by Eysenck should be retracted.
Outcomes in relation with selected kinds of treatment
Large-scale international reviews of scientific studies have concluded that psychotherapy is effective for numerous conditions.
One line of research consistently finds that supposedly different
forms of psychotherapy show similar effectiveness. According to The
Handbook of Counseling Psychology: "Meta-analyses of psychotherapy
studies have consistently demonstrated that there are no substantial
differences in outcomes among treatments". The handbook states that
there is "little evidence to suggest that any one psychological therapy
consistently outperforms any other for any specific psychological
disorders. This is sometimes called the Dodo bird verdict after a scene/section in Alice in Wonderland where every competitor in a race was called a winner and is given prizes".
Further analyses seek to identify the factors that the psychotherapies have in common that seem to account for this, known as common factors theory; for example the quality of the therapeutic relationship, interpretation of problem, and the confrontation of painful emotions.
Outcome studies have been critiqued for being too removed from
real-world practice in that they use carefully selected therapists who
have been extensively trained and monitored, and patients who may be
non-representative of typical patients by virtue of strict
inclusionary/exclusionary criteria. Such concerns impact the replication of research results and the ability to generalize from them to practicing therapists.
However, specific therapies have been tested for use with specific disorders, and regulatory organizations in both the UK and US make recommendations for different conditions.
The Helsinki Psychotherapy Study was one of several large
long-term clinical trials of psychotherapies that have taken place.
Anxious and depressed patients in two short-term therapies
(solution-focused and brief psychodynamic) improved faster, but five
years long-term psychotherapy and psychoanalysis gave greater benefits.
Several patient and therapist factors appear to predict suitability for
different psychotherapies.
A 2014 meta analysis over 11,000 patients reveals that
Interpersonal Psychotherapy (IPT) is of comparable effectiveness to CBT
for depression but is inferior to the latter for eating disorders.
For children and adolescents, interpersonal psychotherapy and CBT are
the best methods according to a 2014 meta analysis of almost 4000
patients.
Mechanisms of change
It is not yet understood how psychotherapies can succeed in treating mental illnesses.
Different therapeutic approaches may be associated with particular
theories about what needs to change in a person for a successful
therapeutic outcome.
In general, processes of emotional arousal and memory
have long been held to play an important role. One theory combining
these aspects proposes that permanent change occurs to the extent that
the neuropsychological mechanism of memory reconsolidation is triggered and is able to incorporate new emotional experiences.
Adherence
Patient adherence to a course of psychotherapy—continuing to attend sessions or complete tasks—is a major issue.
The dropout level—early termination—ranges from around 30% to
60%, depending partly on how it is defined. The range is lower for
research settings for various reasons, such as the selection of clients
and how they are inducted. Early termination is associated on average
with various demographic and clinical characteristics of clients,
therapists and treatment interactions. The high level of dropout has raised some criticism about the relevance and efficacy of psychotherapy.
Most psychologists use between-session tasks in their general
therapy work, and cognitive behavioral therapies in particular use and
see them as an "active ingredient". It is not clear how often clients do
not complete them, but it is thought to be a pervasive phenomenon.
From the other side, the adherence of therapists to therapy
protocols and techniques—known as "treatment integrity" or
"fidelity"—has also been studied, with complex mixed results.
In general, however, it is a hallmark of evidence-based psychotherapy
to use fidelity monitoring as part of therapy outcome trials and ongoing
quality assurance in clinical implementation.
Adverse effects
Research on adverse effects
of psychotherapy has been limited, yet worsening of symptoms may be
expected to occur in 3% to 15% of patients, with variability across
patient and therapist characteristics.
Potential problems include deterioration of symptoms or developing new
symptoms, strains in other relationships, social stigma, and therapy
dependence. Some techniques or therapists may carry more risks than others, and some client characteristics may make them more vulnerable. Side-effects from properly conducted therapy should be distinguished from harms caused by malpractice.
General critiques
Some critics are skeptical of the healing power of psychotherapeutic relationships. Some dismiss psychotherapy altogether in the sense of a scientific discipline requiring professional practitioners, instead favoring either nonprofessional help or biomedical treatments.
Others have pointed out ways in which the values and techniques of
therapists can be harmful as well as helpful to clients (or indirectly
to other people in a client's life).
Many resources available to a person experiencing emotional
distress—the friendly support of friends, peers, family members, clergy
contacts, personal reading, healthy exercise, research, and independent
coping—all present considerable value. Critics note that humans have
been dealing with crises, navigating severe social problems and finding
solutions to life problems long before the advent of psychotherapy.
On the other hand, some argue psychotherapy is under-utilized and
under-researched by contemporary psychiatry despite offering more
promise than stagnant medication development. In 2015, the US National Institute of Mental Health allocated only 5.4% of its budget to new clinical trials of psychotherapies (medication trials are largely funded by pharmaceutical companies), despite plentiful evidence they can work and that patients are more likely to prefer them.
Some Christians, such as theologian Thomas C. Oden,
have argued that successful therapeutic relationships, based on true
acceptance of the client as a human being without contingency, require a
theological assumption, an ontological acceptance of God.
Further critiques have emerged from feminist, constructionist and discourse-analytical sources. Key to these is the issue of power.
In this regard there is a concern that clients are persuaded—both
inside and outside the consulting room—to understand themselves and
their difficulties in ways that are consistent with therapeutic ideas. This means that alternative ideas (e.g., feminist, economic, spiritual) are sometimes implicitly undermined.
Critics suggest that we idealize the situation when we think of therapy
only as a helping relationship—arguing instead that it is fundamentally
a political practice, in that some cultural ideas and practices are
supported while others are undermined or disqualified, and that while it
is seldom intended, the therapist–client relationship always
participates in society's power relations and political dynamics. A noted academic who espoused this criticism was Michel Foucault.
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