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The history of the use of psychological knowledge in medicine

Medical psychology examines the psychological aspects of the doctor’s activities and patient behavior. It studies the mental manifestations of diseases, the role of the psyche in their occurrence, course, treatment, and also in promoting human health.

The value of psychology for medicine was realized long ago. As early as the 18th century, the great reformer of psychiatric care in France, Pinel, in his Treatise on Mental Illness, wrote that a psychiatric hospital should be managed by a doctor, administrator and psychologist. Moreover, he considered the most desirable unification of medical and psychological competence in one person (Lebedinsky, Myasishchev, 1966, p. 20). Since the XVTII century, the experience of the successful application of psychological knowledge in medicine has been known.

In the XIX century, the interest of scientists to the psyche of both a normal person and the somatic and mentally ill continuously increases. Neurological and psychiatric practices needed the help of psychology to analyze complex disorders of the human psyche. In 1834, the famous neurologist Friedreich published "A Systematic Index of Medical and Forensic Psychology Literature." The section on medical psychology contained 3,469 titles of works, covering the problems of psychology, psychopathology, psychiatry and psychotherapy in various plans. In the middle of the century, "Medical Psychology" Lotze appears, and in the 1870s, D.H. Tuke publishes a book called Psychological Medicine. But these books, according to MS. Lebedinsky and V.N. Myasishchev, were mostly essays on psychiatry of the time (Lebedinsky, Myasishchev, 1966, p.22).

Medical psychology as a branch of applied psychology emerged as an independent science only in the 20th century. A number of monographs appeared covering the subject of medical psychology (see: Lebedinsky, Myasishchev, 1966, p.22). Of great interest were the works of P. Janet on neuroses and medical psychology, the work of Prins on the problem of the subconscious. P. Janet owned the book "Medical Psychology", in which he summarized his extensive clinical and psychotherapeutic experience. P. Jeanne and other authors described special conditions that were called a split consciousness, a dual personality or depersonalization. One of the first generalizing work in medical psychology was also the book by the Swiss psychiatrist G. Shterring "Psychopathology as applied to psychology".

An important contribution to the development of medical psychology was made by 3. Freud, E. Krechmer, V. M. Bekhterev, S.S. Korsakov, G.I. Rossolimo. Doctors became the first practical psychologists in medicine. As neuropathologists or psychiatrists began to work 3. Freud, E. Krechmer, G. Rorschach, VM Bekhterev, P.B. Gannushkin and many other medical psychologists.

The practical work of psychologists in medicine was associated primarily with the development and application of methods of psychodiagnostics (for medical and psychological expertise), as well as methods of psychotherapy. The main methods of medical and psychological study of the patient were clinical conversation and experimental psychological research of the mentally ill.

The main methods of psychotherapy were suggestive, psychological, psychoanalytic (Krechmer, 1998). Suggestive methods consisted in the use of suggestion in the waking state or hypnosis. Psychological methods meant everything related to education, exercise and occupational therapy (ibid., P.419).

At the beginning of the 20th century, a new direction of psychotherapy was created by Freud - psychoanalysis. This method arose from the experience of treating hysterical conditions and dealt primarily with the neurosis clinic, the psychological analysis of neurotic manifestations, and their psychotherapy. Among the students and followers of Freud were prominent psychotherapists and medical psychologists. Subsequently, some of them partially disagreed with him and created their own directions in psychotherapy and psychology. The most famous of them were A. Adler and CG Jung.

In the 1920s, a number of important publications appeared on the medical psychology of Kronfeld, Schilder, Schwartz, Kretschmer. The outstanding German psychiatrist, Ernst Kretschmer, owned one of the first textbooks on medical psychology, first published in 1922, reprinted several times in Germany, Russia, and other countries (Kretschmer, 1998). This textbook has served a good service to psychiatrists and psychologists and became for many years a model of systematization of medical and psychological knowledge in the unity of theory and practice.
Proceeding from the interests of practitioners, he thoroughly developed a section on psychological methods of research (medical-psychological examination) and described the main methods of psychotherapy.

In the development of medical psychology, the emergence of laboratories of experimental psychology at clinical neuropsychiatric institutions was of great importance. Since 1890, under the guidance of P. Janet, the laboratory has worked in the largest psychiatric clinic in France in Salpetriere. In Russia, the first experimental psychological laboratories in psychiatric clinics were opened in 1885 in Kazan by V.M. Bekhterev, in 1886 in Moscow S.S. Korsakov. Then came the VF laboratories Chizha in Yuriev, I.A. Sikorsky in Kiev and others (Zeigarnik, 1999, p.9).

Russian psychiatrist and psychologist Vladimir Bekhterev, who was educated at the St. Petersburg Medico-Surgical Academy, made a huge contribution to the development of medical psychology in Russia. Practical work in psychiatry, the study of the mental life of a person were the main focus of his work. At the same time, his organizational contribution to the development of clinical psychology in Russia is huge. In 1907, Bekhterev established the Psychoneurological Institute in St. Petersburg, on the basis of which a whole network of scientific, clinical and research institutes was created, including the first Pedagogical Institute in Russia. This allowed us to link the theoretical and practical research, which was particularly necessary at that moment. The work of these institutions was continued after the revolution. In the 1920s, laboratories of individual and genetic reflexology were created, headed by VN Bekhterev's students. Myasishchev and N.M. Shche-lovanov.

The second center in which medical psychology developed was the psychiatric clinic of S.S. Korsakov in Moscow. Since 1886, the second psychological laboratory in Russia, which was headed by A.A. Tokarsky (Zeigarnik, 1999, p. 13).

Intensive experimental psychological studies were conducted at the Leningrad Institute of Brain named after. V.M. Bekhtereva under the direction of V.N. Myasishchev. Following the tradition of V.M. Bekhtereva, V.N. Myasishchev sought a combination of psychiatry and psychology and the introduction of objective methods of research of patients in a psychiatric clinic (ibid., P. 15).

Much practical psychological work was carried out by Soviet psychologists in medical institutions during and after World War II. They participated in the restoration of impaired mental functions in wounded soldiers with brain injuries.

Works by A.R. Luria on the problems of localization of higher mental functions, their abnormalities in local brain damage, the development of a system of neuropsychological diagnostic methods allowed the creation of a new branch of scientific and practical psychology - neuropsychology.

In the second half of the 20th century, the sphere of practical application of psychological knowledge in medicine expanded. Practical psychology has become isolated organizationally. In many countries, practical psychology institutes were opened and their own psychological services were created. They began to work professional practical psychologists, who received an education in the departments of practical psychology in higher educational institutions or in special short-term courses. Unfortunately, the post-revolutionary political history of Russia has had an adverse effect on the development of such an important practical direction in Russian medical psychology as psychotherapy. The influence of the communist ideology, the long isolation of Russian psychotherapy from its leading directions in other countries, the tendency to biologization of medicine caused a gap in the level of development of domestic and western psychotherapy. In the mid-1960s - early 70s, this gap began to narrow due to the introduction of medical psychology specialization in educational institutions and the beginning of active inter-institutional cooperation with Polish, Czech and German psychotherapists. In the creation of domestic psychotherapy, an important role was played by scientists of the St. Petersburg Research Psychoneurological Institute. V.M. Bekhtereva and historically related groups of the St. Petersburg University and the St. Petersburg Medical Academy of Postgraduate Education, as well as the Moscow and Kharkiv institutes of advanced medical education (see Karvasarsky, 1998, p.7).
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The history of the use of psychological knowledge in medicine

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