Psychoanalysis and psychotherapy: an historical perspective.

I have reviewed the historical unfolding of psychoanalytic (or dynamic) psychotherapy as a therapeutic application of psychoanalytic theory directed towards patients not considered appropriate for proper psychoanalysis. I have divided this history into three phases. The first phase that I call the prehistory of dynamic psychotherapy is the period of Freud's development of psychoanalysis as a distinctive therapy for mental illness and its clear differentiation from the varieties of suggestive therapies in vogue at the time. The second phase (from the 40s to the late 70s) is the period of the development of psychoanalytically-based expressive and supportive psychotherapies related to but clearly separate from proper psychoanalysis in terms of specific techniques, goals, and the portions of the psychopathological spectrum against which each is directed. I call it the period of psychoanalytic consensus. The third current phase, from the late 70s to date, I call the period of fragmented consensus. The leading protagonists in the forging of the second phase consensus, brought to its fullest expression in the landmark publications of 1954, have now diverged widely in their perspectives on these issues as expressed in a 1979 Symposium, 25 years after.