Source: Marks, S. (2017) "Psychotherapy in Historical Perspective," History of the Human Sciences, 30(2), 3–16.
Tags: Daniel Hack Tuke, moral therapy, SAR psychotherapy, Erwin Stransky, Jungian analysis, Erich Neumann, Francis Reitman, art therapy, analytic abstinence, Applied Behavioural Analysis, ABA, autism, neurodiversity, therapeutic relationship, behaviour modification
Difficulty: Intermediate | Prerequisites: Parts 1 and 2 of these notes. Familiarity with the basic principles of psychoanalysis, behaviourism, and the distinction between different therapeutic schools.
This final section covers the specific articles introduced in the special issue. Each article recovers a forgotten figure, a neglected practice, or an overlooked debate. Taken together, they demonstrate that the history of psychotherapy is far more diverse than standard accounts suggest. They also show how therapy has always been entangled with politics, culture, and ethical controversy, from the use of imagination in Victorian asylums to the present-day debate over Applied Behavioural Analysis for autism. This material is useful for understanding how historical case studies illuminate broader themes about power, knowledge, and the ethics of intervention.
The special issue recovers overlooked figures and practices: Daniel Hack Tuke's early use of "psycho-therapeutic" in Victorian England, Stransky's politically-motivated SAR therapy in interwar Vienna, Jungian analysts in Mandate Palestine, Francis Reitman's art-based approach to psychosis, debates over analytic abstinence, and the controversy surrounding ABA for autism. Each case shows that therapy is shaped by its political and cultural moment, and that the boundaries of acceptable intervention are constantly contested.
Daniel Hack Tuke (1827–1895)
An English asylum alienist and descendant of the Quaker founders of moral therapy at the York Retreat. Tuke was among the first English-language users of the term "psycho-therapeutic" (shortly after its coinage in continental Europe). He described how "the Imagination" could mediate between mind and body, and between patient and doctor, for the purposes of treatment.
Think of it as: one of the earliest people in England to theorise what we now call the therapeutic relationship, emphasising suggestion, hypnotism, and the doctor-patient bond.
Subordination-Authority-Relation (SAR) psychotherapy
A therapeutic approach invented by Erwin Stransky (1877–1962) in interwar Vienna. SAR therapy aimed to cure neurosis by recreating a hierarchical, authoritarian social structure within the consulting room. The patient was to be subordinated to the therapist's authority. It was explicitly designed to reflect Stransky's right-wing political views.
In simple terms, this means: a therapy that tried to cure people by making them obey, modelled on the therapist's ideal of an authoritarian society.
Applied Behavioural Analysis (ABA)
A therapy for autism rooted in behaviourism and operant conditioning. ABA aims to modify behaviour through systematic reinforcement and, historically, the use of aversives (punishments). It has become deeply controversial: many autistic self-advocates regard it as a form of abuse rather than a legitimate therapeutic intervention.
Think of it as: the dominant behavioural therapy for autism, now at the centre of a fierce ethical and political debate between clinicians and the people they claim to treat.
Analytic abstinence
A principle in psychoanalytic therapy holding that the analyst should refrain from gratifying the patient's desires or forming a personal relationship with them. The concept has been debated for over a century, with implications for how the therapeutic relationship is understood: how much warmth, self-disclosure, or emotional engagement is appropriate?
In simple terms, this means: the idea that a therapist should remain neutral and withhold personal involvement, and the long-running argument about whether that helps or harms.
Neurodiversity movement
A social and political movement, led primarily by autistic self-advocates, which frames neurological differences (including autism) as natural human variation rather than pathology. Neurodiversity activists resist therapeutic interventions that aim to "normalise" autistic behaviour, arguing that autism is an indissoluble aspect of identity.
Think of it as: the argument that autism is a difference to be accepted, not a disease to be cured.
Sarah Chaney's article recovers Tuke's thought, which has been largely overlooked despite his significant publication record.
Tuke described "the Imagination" as a mechanism that could mediate between mind and body, and between patient and doctor.
He saw the physician-patient relationship as central to treatment, prefiguring modern emphasis on the therapeutic relationship.
Suggestion and hypnotism were key techniques. Tuke believed they could treat not only mental symptoms but also physical ailments.
Tuke's work shows that the boundaries between mental and physical treatment, and between psychological and somatic explanation, were blurred from the very beginning of psychotherapeutic thinking in England.
David Freis's article examines SAR therapy in interwar Vienna, a practice that competed directly with psychoanalysis in Freud's own city.
Stransky designed SAR therapy to reflect his right-wing political worldview. He attempted to recreate a hierarchical, authoritarian society in miniature within the consulting room.
The goal was to cure neurosis through the subordination of the patient to the therapist's authority.
SAR had a short shelf life, but it reveals something important: therapeutic techniques are not politically neutral. A therapist's ideology can be built directly into the structure of treatment.
Most historical examples of politically-motivated therapy lean socialist or liberal (e.g. Wilhelm Reich's free clinics, Freud's social-justice-oriented work). SAR is a rare documented case of a therapy designed to serve a right-wing agenda.
Martin Liebscher's article traces the transplantation of Jungian analytic debates from Europe to Mandate Palestine in the 1930s and after.
Key figures: Erich Neumann (a mentee of Carl Jung), Margarete Braband-Isaac (1892–1986), and Max M. Stern (1895–1982). The latter two have been largely "forgotten or deleted from the historical record."
The research was funded by the Philemon Foundation, an independent non-profit devoted to editing and publishing Jung's works. This addresses a scholarly imbalance: Freudian texts have been far more accessible than Jungian ones.
The article demonstrates how psychotherapeutic traditions are shaped by migration, exile, and continued correspondence with colleagues in the country of origin.
Connor Cummings's article traces the career of Hungarian psychiatrist Francis Reitman (resettled in the UK in 1938), from his training in Budapest to his work at the Maudsley Hospital and then the Netherne Hospital's famous art therapy studio.
Reitman eschewed clear binaries between somatic/biological and psychological explanations of mental disorder. He drew on eclectic sources: drug-induced coma treatments, psychoanalysis, and the analysis of patients' art.
At Netherne, Reitman analysed the artistic output of hundreds of patients and published two books: Psychotic Art (1950) and Insanity, Art and Culture (1954).
He was cautious about over-interpreting individual artworks and refused to use art as a diagnostic tool.
Reitman's work raises an epistemological question: how does the study of individual therapeutic cases generate broader theories about the mind? The "case" functions both as a particular story and as evidence for general claims.
Ulrich Koch's article traces the debate over analytic abstinence across more than a century of psychotherapeutic practice.
The question is whether the therapist should remain neutral and withhold personal involvement, or whether warmth and engagement are therapeutically necessary.
Koch shows that these internal professional debates have had a life beyond the consulting room. Arguments about abstinence and emotional restraint were taken up by social theorists (the Frankfurt School, Christopher Lasch) to inform narratives about cultural decline and narcissism in the postwar Western world.
This is a good example of how psychotherapeutic ideas circulate into wider cultural and political discourse.
Patrick Kirkham's article charts the invention and implementation of Applied Behavioural Analysis (ABA) for autism, rooted in behaviourism and operant conditioning.
ABA historically used aversives (punishments) as part of its method, which has fuelled intense controversy.
Many autistic self-advocates now reject ABA entirely, framing it as a form of abuse rather than therapy. Their argument:
Autism is an indissoluble aspect of identity, not a set of behaviours to be corrected.
Autism is an "ontological fact" that demands societal recognition, not clinical elimination.
Attempting to change autistic behaviours is itself abusive, particularly when aversives are involved.
Autistic self-advocates resist the "optional ontology" of behaviourism (which treats the self as a collection of modifiable behaviours) and instead adopt a framework drawn from neuroscience and cognitive psychology.
This is a direct, real-world example of Hacking's looping effect and Shamdasani's concept of resistance to therapeutic ontologies (covered in Part 2 of these notes).
The ABA controversy is ongoing and directly relevant to current clinical practice, education policy, and disability rights. Understanding the historical roots of ABA in operant conditioning, and the ethical objections raised by those it targets, is essential for anyone working in clinical psychology, special education, or disability services. The debate is not abstract: it determines how autistic children are treated in schools and clinics today.
Students often assume that all therapies are designed to help the client on the client's own terms. SAR psychotherapy is a counterexample: its goals were explicitly political, and the client's subordination was the mechanism of "cure."
It is common to treat the neurodiversity critique of ABA as a fringe position. In fact, it represents a substantial and organised movement among autistic self-advocates, with roots in disability rights and civil rights frameworks.
Students sometimes assume that art therapy has always been a well-established field. Reitman's work shows that the use of art in therapeutic contexts was pioneered through individual initiative and remained epistemologically uncertain: he himself refused to treat art as a diagnostic tool.
The debate over analytic abstinence is sometimes presented as settled. It is not. Questions about how much personal engagement is appropriate in therapy remain live and contested.
⚠️ Be able to name and briefly describe each of the key figures/contributions introduced in the special issue: Tuke, Stransky (SAR), Neumann/Braband-Isaac/Stern (Jungian), Reitman (art therapy), Koch (analytic abstinence), Kirkham (ABA/autism).
⚠️ SAR psychotherapy is a particularly useful example in essays about the relationship between politics and therapeutic practice. It is the rare case of a therapy explicitly designed to serve a right-wing agenda.
⚠️ The ABA controversy is exam-relevant as a case study for Hacking's looping effect, the ethics of behaviour modification, and the concept of resistance to therapeutic ontologies.
⚠️ Know the epistemological question Reitman's work raises: how does the study of individual cases generate broader theories about the mind?
True or false: Daniel Hack Tuke coined the term "psychotherapy."
Fill in the blank: Stransky's SAR therapy aimed to cure neurosis through the _______ of the patient.
True or false: Francis Reitman used patients' art as a diagnostic tool.
Fill in the blank: Autistic self-advocates who resist ABA draw on frameworks from _______ and _______ psychology to defend an alternative model of mind.
True or false: The debate over analytic abstinence has been fully resolved in contemporary psychotherapy.
Q: What does Erwin Stransky's SAR psychotherapy reveal about the relationship between political ideology and therapeutic technique?
A: SAR therapy demonstrates that a therapist's political worldview can be directly embedded in the structure of treatment. Stransky designed his therapy to replicate a hierarchical, authoritarian social order within the consulting room, aiming to cure neurosis through the patient's subordination. This is a rare documented case of a therapy explicitly serving a right-wing agenda, and it counters the assumption that political engagement in therapy is exclusively a left-wing or liberal phenomenon.
Q: How does the neurodiversity movement's critique of ABA illustrate the concepts of "optional ontologies" and the "looping effect"?
A: ABA is rooted in a behavioural ontology that treats autism as a set of modifiable behaviours. Autistic self-advocates reject this framework, treating autism instead as an intrinsic aspect of identity (an "ontological fact"). They resist the ontology offered by behaviourism and generate an alternative drawn from neuroscience. This is the looping effect in reverse: instead of accepting the category imposed by experts, the classified group pushes back, refusing the terms on which they have been described and creating their own framework for self-understanding.
Q: Why is Daniel Hack Tuke significant in the history of psychotherapy?
A: Tuke was among the first in England to use the term "psycho-therapeutic" and to theorise the mechanisms by which psychological means could treat both mental and physical ailments. He emphasised the centrality of the doctor-patient relationship, the role of suggestion and hypnotism, and the mediating function of "the Imagination." His work shows that key themes of modern psychotherapy, such as the therapeutic relationship and the mind-body connection, were present from the earliest English-language discussions of the field.
Q: What epistemological question does Francis Reitman's art-based approach raise?
A: Reitman's work raises the question of how the study of individual therapeutic cases (in this instance, patients' artworks) can generate broader theories about the nature of the mind and mental illness. He was cautious about over-interpreting any single artwork and refused to use art as a diagnostic tool, yet he used his analysis of hundreds of patients' outputs to develop wider claims about psychotic experience. This reflects a fundamental tension in clinical knowledge: the gap between the individual case and the general theory.
The ABA debate connects directly to disability studies and the social model of disability: the argument that disability is created by society's failure to accommodate difference, not by the individual's impairment. The discussion of analytic abstinence links to training in psychotherapy and counselling, where questions about boundaries, self-disclosure, and emotional engagement remain central. Stransky's SAR therapy connects to political psychology and the study of authoritarianism. Reitman's work connects to art therapy and the broader question of how creative practices can serve clinical ends.
Related Terms / Search Tags: Daniel Hack Tuke, psycho-therapeutic, moral therapy York Retreat, SAR psychotherapy, Erwin Stransky, interwar Vienna, Jungian analysis Palestine, Erich Neumann, Philemon Foundation, Francis Reitman, art therapy, Netherne Hospital, psychotic art, analytic abstinence, therapeutic relationship, ABA autism, Applied Behavioural Analysis, neurodiversity, operant conditioning, behaviour modification ethics, looping effect autism, optional ontologies, disability rights