PSYCHIATRY AND PSYCHOLOGY

Roger Smith

"Psychology" denotes simultaneously an expert occupation and the character, mind, feelings, and behavior of individuals. "Psychiatry" denotes the medical specialty concerned with mental illness. The words themselves and the aspects of life they refer to, considered as distinct domains and classes of activity, are modern. The history of psychology and psychiatry encompasses a huge diversity of views about human nature and social relations, and that diversity was present even after psychology and psychiatry became professional occupations in the twentieth century.

Psychology as an occupation is an academic discipline, usually but not always understood to be a natural science, and a cluster of applied specialties. Described this way, psychology is overwhelmingly a twentieth-century phenomenon, a characteristic feature of Western modernity. In the sense of an individual's mental life, however, everyone has a psychology, and it is possible to talk about the psychology of people anywhere and in any period of history. All the same, an intense focus on people's psychology, rather than on other dimensions of the human world, is in fact distinctive of the twentieth-century West.

Psychology and psychiatry are distinct occupations, to the extent that the latter requires a medical qualification and is part of the medical profession. Nevertheless, there is considerable overlap of interest. Clinical psychology has been the largest area of employment for psychologists since about 1950; psychiatry has made significant contributions to psychological ideas, for example, of the emotions. In between psychology and psychiatry lies the history of psychoanalysis, the history of the considerable but controversial impact of the Viennese physician Sigmund Freud on European self-consciousness in the twentieth century.

PSYCHOLOGY AND MODERNITY

The modern history of psychology and psychiatry is bound up with the rise, beginning about 1880, of the professions in the human sciences, the creation of service occupations offering expertise in human affairs—economics, political science, the management sciences, planning, and so on. These professions, and the social, legal, and governmental arrangements that support them, function to offer rational guidance or control in all aspects of human affairs. This contrasts with earlier ages in which it was thought right for order to stem from the interests of rulers, tradition, fate, or God. Psychology and psychiatry are therefore part of what the German sociologist Max Weber analyzed as the rationalization of the modern world.

Like so much European social history, the history of psychology and psychiatry varies considerably with local circumstance. As occupations participating in modernization, psychology and psychiatry fit the pattern in which modern social systems spread outward from Western Europe, in interaction with North America, to southern and eastern Europe. Nowhere in Europe, however, was the scale of development and size of the growing human science professions on a par with the United States. Although many European ideas had earlier crossed the Atlantic and informed American developments, after 1945 Western European psychologists often looked to American leadership in the development of the field as a natural science. Russia shared in Western developments in both psychology and psychiatry in the three decades before the 1917 revolution. Thereafter the Soviet system made any activity concerned with individual consciousness, capacities, and conduct a politically sensitive matter. Whatever the historical diversity, at the end of the twentieth century, psychology and psychiatry were deeply embedded in the experience and expectations of people and in the institutional arrangements of all European countries. Marriage guidance, counseling, market research, child care, education, self-development and self-identity, anxiety, mental breakdown, criminality, aging: every aspect of individual experience and relations between people had its socially embedded psychological or psychiatric reality.

The history of psychology is at one and the same time about what people are thought to share by virtue of a common nature, and how they are thought to differ by virtue of group or individual characteristics. Psychology has never been neutral, because classifying people by difference is the way social values are embedded in policy and action. European countries sought world empires, struggled for national or ethnic dominance, and ordered society by class and gender, and this involved drawing on as well as reinforcing psychology. Psychology provided the language with which to debate similarity and difference. Arguments about what people owe to an original nature as opposed to civilization, or to nature as opposed to nurture, have been a recurrent part of European as well as North American political discourse.

Much of what we associate with psychology is new. In the twentieth-century West there was a marked emphasis on individual qualities and individual subjective experience as the basic fabric on which society is built and in relation to which values must be judged. This stress on the value of individual people and their psychological world correlates with the spread of democracy in politics and competitive individualism in economic life. For example, voting in democratic societies is designed to decide issues according to the sum of individual preferences. Critics therefore draw on descriptions of earlier ways of life in which what was of value in a person was not individual feelings or preferences but rather her or his place in civic society, in God's plan, or in the progress of humanity.

In this regard the Renaissance appears to mark a decisive shift. Early Christians stressed the life and salvation of the individual soul, and Roman law recognized the dignity and responsibility of the individual person. In Europe between 1450 and 1650, however, there is evidence for a new self-consciousness about how subjective life distinguishes people as individuals. The portrait and the self-portrait became genres of painting; autobiography, letters, diaries, and religious interrogation of the soul spread as forms of communication with other people and—more distinctively—with one's self; and essays and philosophy emphasized individual experience as authority for knowledge. In the eighteenth century, the novel began to provide people with a way to fashion their own lives and sensibility. This culminated in romanticism, the Europe-wide culture that established a lasting commitment to individual feeling and creativity and set up the image of artistic genius as a model. If early-nineteenth-century language stressed the richness of the human soul in Christian terms, it also valued the emotional and sensuous experience of embodied individuals.

Romantic ideals shaped human beings as psychological subjects during a century in which the industrial revolution and rapid urban growth gave rise to mass society in cities from Glasgow to Petersburg. When the individual acquired unprecedented freedom and lost identity through city life, psychology came into its own. Italian and French psychologists of the crowd, most popularly Gustave Le Bon, described how in the mass individuals lose autonomy and act by imitation. Social psychology began around 1900 to study the determinants of human relationships. The spread—however uneven—of economically liberal, democratic, and urban society in Europe was accompanied by forms of knowledge and power expressed through the psychology of the individual. When men and women collapsed or degenerated under the strain of the new conditions, or were perhaps ill-equipped at birth to cope, psychiatry provided a social response.

The crystallization of psychology and psychiatry as areas of activity at the end of the nineteenth century also depended on the increasing social authority of the natural sciences. The natural sciences, especially physiology, became the basis for what was claimed as expert knowledge about normal and abnormal individual capacities. Liberal and radical social thinkers turned to psychology and psychiatry in order to replace faith about the soul and God's will with facts about the mind and behavior. Conservative observers feared that the new sciences encouraged materialism, religious unbelief, and social upheaval if not revolution. The acceptance of Charles Darwin's theory of evolution in the second half of the century set such hopes and fears within a framework of belief about natural progress and the place of humanity in the universe. When the communist Soviet state was established in 1917, for a few years some intellectuals thought that the time had arrived when all prejudice about human nature inherited from the past could be thrown away. It was possible, they dreamed, "to engineer the human soul" (in words used at a writers' congress in 1934) and use psychology as the technology to create a new, free man. But for every believer in the inevitable march of scientific progress there was a pessimist who feared the cost. The reported figures for degeneracy, the evidence of alcohol and drug abuse, prostitution, venereal disease, mental deficiency, crime, and class and racial backwardness at the end of the nineteenth century gave substance to these fears and much of the content to modern psychology and psychiatry.

EARLY VIEWS OF HUMAN NATURE

There was no area of learning and no occupation called psychology (or psychiatry) in the Renaissance and early modern periods. There was, however, a rich language for individual character, the language of the humors, temperaments, spirits, and passions, which had originated with the ancient Greeks and been modified by Christian values. This was the language about people used by Shakespeare and Rabelais. It was used both by educated people, including physicians, and by the common people, and it provided a way to describe both human nature in general and individual differences. The language expressed a belief that treated disorders—body and soul were closely linked—as an imbalance in the humors and spirits. Description was as concerned with the moral and religious dimensions of human existence as with physical well-being, since all dimensions were equally real in a world ordained by God. Writers thought it natural to correlate order and disorder in the world and in the individual, to compare the macrocosm and the microcosm, and the body politic (the state) and the body physical. Astrology and magic appeared as reasonable ways of forecasting and intervening in human affairs.

In the second half of the seventeenth century, educated elites began to be skeptical about substantial parts of this belief system, though it retained a large popular following through to the twentieth century. New ideas favored a nonmagical, mechanical ordering of nature and the separation of the soul and the body as different entities (though practical knowledge, not least of madness and passion, held them together). The French philosopher René Descartes championed the idea that the body is fully a machine, and the Englishman John Locke wrote that individual knowledge and character is constructed piecemeal from experienced sensations. These steps seemed to render the study of human nature as much of concern to teachers and natural philosophers (the word "scientist" was not yet invented) as to theologians. Most provocatively, Locke introduced the argument that it is consciousness and memory, the product of experience, rather than a soul, which gives a person his or her identity.

Belief spread that the universe is ordered according to the laws revealed by Isaac Newton at the end of the seventeenth century, and known through experience in the manner analyzed by Locke. This gave intellectual content to the European culture present in the period between Louis XIV and the French Revolution and known to historians as the Enlightenment. Many observers then and later thought of this period as the beginning of the modern secular age, the age in which Europeans sought and made progress on the basis of knowledge about nature and human nature alike. The "Enlightenment project," as twentieth-century social critics called it, culminated later in great social movements, both in the marxist form claimed as authority for communism and in the liberal form developed under capitalism, to advance scientific knowledge of human beings and human affairs. In the eighteenth century, meanwhile, the argument that human nature becomes what it is through experience, and through the pleasures and pains of experience leading to one action rather than another, encouraged belief that education and social reform would lead people out of superstition, barbarism, and tyranny. But there remained a vast gap between the aspirations of the educated theorists of progress and the predominantly rural population of Europe. Yet, while Enlightenment ideas were restricted to small aristocratic circles in central and eastern Europe, there were settings where what the eighteenth-century Scotsman Adam Smith identified as commercial society flourished and supported "the science of Man" (to use the contemporary expression). In cities like Edinburgh, London, Amsterdam, Bordeaux, Paris, and Geneva, and later in emerging provincial industrial cities like Birmingham and Lyon, social mobility, new wealth, and literacy opened up society to new and sometimes radical ideas.

In this intellectual and social context, a few writers, like the academic at the Prussian university of Halle, Christian Wolff, and the French-Swiss philosophe, Charles Bonnet, began to differentiate psychology as a branch of knowledge. Their interests were philosophical, religious, and moral rather than scientific in the later restricted sense of the term. The Scottish universities taught about the human mind and the formation of character under the rubric of moral philosophy, and they increasingly did so in a manner that separated the subject from theology and hence created more secular ways of thinking about human nature. David Hume's A Treatise of Human Nature, published in 1739–1740, was a work in this vein, though it was too skeptical and un-Christian to attract an audience when published. In London and in prerevolutionary Paris, the reformist Jeremy Bentham developed systematically the opinion that all individual action pursues pleasure or avoids pain, and hence that a calculus of pleasures and pains will make possible a new social order. In the East Prussian center of Königsberg, J. F. Herbart propagated a science of psychology in the service of government in the early nineteenth century. Psychology became differentiated as a branch of knowledge.

Responses to madness and abnormal behavior in the eighteenth century also became less focused on the soul or nonmaterial events and more on the disordered mind. Although it remained common to refer to disordered spirits, Locke's work suggested a view of madness as the wrong working of reflection on experience, a jumbling in the mind of the right order of sensations. Humoral theory continued in practice to underlie much ordinary care, and this was still the case when special homes and asylums for those with mental disorder began to be common in the late eighteenth century. Experience with what, from an educated European perspective, appeared to be abnormal people, gained through travel and encountering different customs, or simply through interacting with children and peasants, sharpened questions about what makes people the way they are. Debates about the origin of language, the state of mankind before civilization, and the effects of education were lively and open-ended, treating psychological ideas as part of discourse about social progress. All this helped shape a modern psychological language; for example, reference to the emotions rather than the passions became common in English in the second half of the eighteenth century.

Contemporary observers of polite society were struck by a new delicacy, reflected in the new fiction, about individual feelings. An interest in sensibility, or claims about the faculty of perceiving beauty, attracted essayists, moralists, and physicians to psychological expression. There was renewed enthusiasm for the ancient and Renaissance art of physiognomy, the art of reading the soul's character from the face. The work of the Swiss pastor Johann Kaspar Lavater was celebrated, and the fashion for the cut-out profile of a person's head, the silhouette, spread through all homes with cultural aspirations. In Paris around 1800, the Austrian physician Franz Joseph Gall elaborated phrenology, the study of individual character by correlating the shape of the head with the underlying brain and mental faculties (like philoprogenitiveness, a polite term for the reproductive instinct). Many people in western Europe and North America learned to anticipate the creation of a science of human nature, accessibly focused on individual differences, by examining the embodiment of mind in the brain. Slightly before Gall, another Austrian physician, Anton Mesmer, introduced in Paris the trance phenomenon that bears his name, mesmerism, which also had a large public audience. When rethought (and called hypnotism), mesmerism suggested that there are hidden or unconscious powers in the human mind. In the late nineteenth century, hypnotism was the direct antecedent of the new science of the unconscious introduced by Freud and the French physician Pierre Janet, among others.

One of the most dramatic of all experiences in human differences, which captured everyone's imagination, was of so-called wild children, children apparently living alone like animals in the countryside. These children posed in concrete form the great political question of the Enlightenment: By what means has man achieved a state of civilization, and is this state natural? Stories of wild children recurred in Europe, even into the twentieth century. Captured in 1724, Peter the wild boy of Hanover was made to tour polite society and even to visit the court of George I of England. In 1801, in what remains the most famous of all experiments on psychological development, Jean Itard, the innovative head of the institute for deaf-mutes in Paris, began the task of bringing civility to the wild boy, Victor, who had lived alone in the woods of the Aveyron region and lacked language, cleanliness, and ordinary sensibilities. It was in these terms, rather than in the twentieth-century language of nature versus nurture, that people faced the challenge of understanding human nature.

MODERN PSYCHOLOGY AND PSYCHIATRY

Psychology and psychiatry thus have very complex roots in many walks of life and not only in academic, philosophical, or medical circles. Two institutional changes in the first half of the nineteenth century had great importance for the consolidation of the fields as distinct social entities. First, the reform of German universities, stimulated by a cultural resurgence under the Napoleonic occupation, created circumstances in which areas of knowledge expanded and flourished as academic disciplines. Other countries imitated the German model or adapted it to local circumstances in the second half of the century. The changes put in place the basis for academic careers, for universities to be accepted as arbiters of knowledge, and for the rapid growth of natural science subjects. The discipline of experimental physiology developed, and it included research on the nervous system and on the senses, systematically studying mind and action in its physical setting. Then, beginning in the 1870s, especially around Wilhelm Wundt in Leipzig and Georg E. Muller in Göttingen, there were new and successful initiatives to make psychology a subject using natural science methods. When taken up elsewhere, especially in the United States, the philosophical dimension was reduced, and the outcome was the modern academic discipline of psychology. German psychological research focused on the composition of consciousness and the rational adult mind. But also in Germany, as elsewhere, research was guided by practical interests in education, commerce, social problems, or the law.

At the same time, especially following the efforts of the physician Wilhelm Griesinger in Berlin, the study of mental disorders entered the university and sought a place as part of scientific medicine rather than as part of asylum management. In gradual ways, varying with local administrative arrangements, this established the academic medical specialty called psychiatry. This step also depended on the second of the institutional changes to be mentioned, the asylum movement of the late eighteenth and early nineteenth century. Across Europe, the asylum became the answer to what was newly perceived as a major social problem and challenge to humanitarianism, the plight of the insane. By the second half of the nineteenth century, the asylums were firmly in the medical orbit and associated with medical organizations that often turned their attention to social problems like alcoholism. The description of mental disorders, the clinical activity that preoccupied late-nineteenth-century psychiatry, was closely tied to moral judgment about the needs of social order. In the decades before World War I, the German psychiatrist Emil Kraepelin, followed by the head of the Zurich institution, Eugen Bleuler, established the basic modern categories of mental illness, the manic-depressive and schizophrenic psychoses.

If institutional changes made possible new academic disciplines of psychology and psychiatry, a widely diffused social and political culture brought attention to the different capacities of individual minds and social groups, like social classes, men, women, nations, and races. Indeed, by the early twentieth century, psychology was well on its way to becoming the lingua franca, the shared language, of human difference. Phrenology had set an early example, but it was largely rejected by scientists by 1850. In the early twentieth century, psychologists began to classify people, and especially children in the classroom, by intelligence, by aptitude, and then, from the 1930s, by personality. The common usage of words like "intelligence" and "personality" is modern: "intelligence" replaced "reason" as it refers to a natural capacity shared in part with animals rather than an abstract phenomenon; and "personality" seemed to be a way to refer to the collective attributes of a person without the old-fashioned moral judgments often implied in a reference to "character."

New work on individual capacities depended on the development and standardization of tests, and the creation of statistics as the means to analyze test results and to relate results to supposed underlying causes of human differences. By this route in particular, psychologists developed an expertise that distinguished psychology as a separate occupation. Statistical analysis was an important British contribution, and in Britain the single most important influence on the academic subject of psychology was Francis Galton, a Victorian obsessed by finding ways to measure human variation. As an academic discipline, however, British psychology developed slowly in the twentieth century, in the interwar years in association with industrial and educational applications; it was only after 1945 that it grew rapidly in size.

In France, Victor Cousin dominated academic philosophy and teacher training for a considerable part of the nineteenth century, and his influence sustained an official view that psychology is the training of the soul in pursuit of the good, the true, and the beautiful. Then, in the 1870s, the concerted efforts of secular and Republican writers like Hippolyte Taine and Théodule Ribot created opportunities for what was called "new psychology," a psychology built on experimental and clinical observation of people. The use of clinical methods, the intensive examination of single, exceptional individuals, gave a special character to French work. Alfred Binet studied hypnotized subjects, his own daughters, and great calculators before undertaking the work on individual children in the classroom that led him to devise the first intelligence tests, published in 1905. The Catholic Church responded to the new psychology, creating an institute that included the field in the University of Louvain or Leuven in Belgium in 1889. Pastors both Catholic and Protestant, as in the Netherlands in the 1920s, turned to psychology in the hope of overcoming the perceived distance of the churches from people's experience of modern life.

Scientific ideas in general, and enthusiasm for psychology in particular, were unevenly spread in Europe. For those committed to modernization, the distribution of psychology mapped the unequal progress made by different countries. Reformers believed that ignorance and resistance to psychology and psychiatry indicated backwardness caused by dogmatic religion, economic and social underdevelopment, and oppressive rule. Progressive intellectuals in Catholic countries like Italy and Spain, or in an autocracy like Russia, therefore often looked to Britain, France, and Germany for advanced ideas and the authority for a rational and humanitarian order. The evolutionary thought of Darwin and the contemporary social thinker, Herbert Spencer, was an important medium of cultural transfer, and both writers clearly supported a psychology that treated human beings as a part of nature. Students from countries on the margins of Europe studied abroad, brought home scientific thought and radical ideas, and—frequently associated with nationalist movements—sought the means to bring their peoples into the modern age. Much of the idealism went in fact into practical tasks in education or in medicine, as in the careers of the people who introduced modern psychology into Romania, Hungary, and elsewhere. Interest in psychology was part of liberal and radical hopes for change in Russia from the late 1850s. By the end of the century, the early efforts of Ivan M. Sechenov to link psychology and the brain were replaced by more recent French and German psychology and psychiatry. The Russian practitioners, however, faced by the unbending reactionary politics of the tsars, nearly all linked the future of their science to the modernization of the country. By the outbreak of World War I, then, Western secular ideas about human nature were widely diffused across Europe, if in some settings restricted to a small professional class.

Psychology and psychiatry took for granted certain norms of mental life and conduct. It was thought that divergences from the norms, implicitly understood to be male, Western, adult, and middle or upper class, constituted natural experiments, and hence great value was placed on studying children in contrast to adults, women in contrast to men, Anglo-Saxon in contrast to Italian, and so on. One such so-called natural experiment, multiple personality, intensively studied in France, appeared dramatically to question belief that human identity is given by a unitary soul. Then, in the years around 1900, Freud developed what he called psychoanalysis, working with the natural experiments provided by neurotic cases. He generalized from these cases, in the light of his own self-analysis, to construct a psychology of the unconscious, which argued that irrational feelings and motivation are normal, not abnormal. Immediately before World War I and in the interwar decades, he gained a large public audience for his views, not least because he provided a framework for thinking about sexuality, then becoming a publicly discussable topic. Further, as he pointed to the power of irrational forces in human life, his outlook matched Europe's experience of war and the rise of Nazism and fascism. But even as Freud gained an audience, psychoanalysis split into factions, and his most influential earlier supporter, the Swiss psychiatrist Carl Gustav Jung, left in 1913 to construct his own analytical psychology, which emphasized the reality of a collective unconscious.

All the combatants in World War I centrally organized production and social life in the interest of national efficiency. Opinion was favorable to those who claimed scientific expertise in human affairs, psychologists among them. Psychologists contributed, for example, to studies of industrial fatigue, of great importance to the manufacture of munitions. In the 1920s psychotechnics, the use of psychological tests and experiments to assess personnel and work situations, was widely taken up. The Austrian railways, for example, employed a special train to test its staff. Research on the psychology of children, to create a basis for welfare and education, rapidly expanded. This research involved many women, and in this way as well as through popular texts and advice manuals, motherhood and psychological expertise became closely linked. Child care brought together psychology, psychoanalysis, and psychiatry, as at the Tavistock Institute in London, which became a major center for training people in psychotherapeutic approaches to social questions like marriage, doctor-patient relations, and delinquency. In the Netherlands and German-speaking countries, psychologists favored character analysis, using handwriting for example, a form of qualitative psychology that was thought to express the unique dignity of each person, in contrast to the quantitative techniques of assessment becoming widespread in the Anglo-American world. In the Soviet Union, by the end of the 1920s the Communist Party was asserting full authority over all areas of intellectual and social life, including the sciences and the professions. During the Stalin years there was suspicion of any practical activity or science not directly serving the communist interest as currently presented by the party. Psychology as a discipline came under suspicion, and in the early 1950s there was a concerted but never fully successful attempt to replace psychology by physiology. In Nazi Germany many psychologists found occupation in personnel testing, and some propagated a form of character analysis sympathetic to racist ends; yet others, many Jewish but also the influential group of Gestalt psychologists, were forced out of work and into emigration.

In the interwar years, psychology became increasingly divided between academic experimental research and the activity (including psychoanalysis) that flourished in practical settings. Many academic psychologists were interested in physiological psychology, the relation of mental events to brain functions, and their research was inaccessible to those not trained in the field. Interest in the brain did link psychology and medicine, especially via the clinical specialty of neurology, the field of brain disorders. Most psychiatrists hoped one day to be able to correlate mental illness and brain disorder, but the early years of the century were filled with pessimism. In the 1930s psychiatrists, almost desperate to make an impact on the seemingly intractable cases in asylums, turned to physical therapies that forcibly intervened in the brain. The effort was international: Manfred Sakel introduced insulin coma in Hungary, Ugo Cerletti used massive electric shock in Italy, followers of Ivan P. Pavlov in the Soviet Union induced deep sleep lasting days, and Egaz Moniz organized the first frontal lobotomy surgery in Portugal. All this was taken up in English-speaking countries before it was substantially displaced in the 1950s by new drug therapies that, for the first time, helped reverse the ever rising number of asylum patients.

Starting in the 1940s, brain research, led by the United States, became a heavily committed and fast-growing area of science, and some scientists claimed it would finally unravel the secrets of the human mind. Skeptics doubted that knowledge would be gained quickly, even when new computing technology suggested powerful models for psychological events and encouraged what is known as cognitive psychology. Some critics were also opposed on religious or ethical grounds to viewing human beings as material machines. Nevertheless, there was a Europe-wide public following for new ideas about the brain and human identity, an interest taken up in science fiction and films.

While psychology developed very unevenly as an academic discipline and as an occupation in Europe, a large profession became established in the United States. Especially after 1945, United States psychology, which claimed to have established objective methods making psychology a rigorous science, was followed by many European countries, especially West Germany, the Netherlands, and those in Scandinavia. At this time the politics of social democracy and the welfare state supported the provision of psychological expertise and intervention in many areas of life and across the population. Whereas early psychoanalysis was available to a small number of fee-paying individuals, post-1945 psychotherapy became part of the life of ordinary people. Psychologically trained personnel worked on a substantial scale in education, personnel management, counseling, and with difficulties in living of all kinds. It seemed possible to represent the goals of life in psychological terms, and the literature of self-development and personal growth became big business, while many churches rethought pastoral care in a psychological idiom.

In Eastern Europe, following the liberation and then occupation of countries by the Red Army, psychology, like every other area of activity, was forced into conformity with the current policies at the center in Moscow. This imposed an approach given legitimacy by reference to Pavlov's name in the 1950s, the evidence of which was still evident much later, though many intellectuals learned to live with a split between overt conformity and covert independence. Nevertheless, in the 1970s Soviet psychology itself began to diversify and expand, often drawing strength from marginalized earlier work, notably by the Marxist psychologist, Lev Vygotsky, who had died in 1934. With the breakdown of the Soviet empire in 1989 and the virtual ending of funding for science in Russia itself, Eastern European psychologists looked to the West for professional standards or for employment, or responded to a new private clientele.

In summary, the conspicuous twentieth-century growth of psychology in North America as well as in Europe means two things: It means, first, the establishment of a service occupation, which is itself divided between academic psychologists, who view psychology as a scientific discipline, and applied psychologists who view psychology as an expertise in the care and management of individual and interpersonal problems. Second, this development means a shift in beliefs and values, so that it is now widely and unthinkingly held that an expressive life in terms of individual psychology is what accords dignity to existence. A European culture, and more generally a Western culture, has emerged in which psychological knowledge is thought to give access to the good life, and critics have variously judged that this conviction is at the expense of political engagement, spiritual concern, civic consciousness, and nonpersonal values generally. More positive observers note the humane values that appear to tie together democracy, systems of social welfare and individual support, and psychological activity, giving people knowledge and power to govern their own lives.

See also other articles in this section.

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