Clinical Psychology and Bulimia Nervosa: History and Practice

Introduction: The Scope of Clinical Psychology

The beginnings of clinical psychology date back to the year 1492, and the field has changed from the mere treatment of mental illness into an entire discipline of research and experimentation. This evolution has helped individuals affected by mental disorders — including eating disorders such as bulimia nervosa and anorexia nervosa, which are prevalent among adolescent and young adult women worldwide — overcome harmful habits and lead more productive lives. Some of the most important names in the history of clinical psychology, who can be regarded as the founding fathers of the field, are Lightner Witmer and Wilhelm Wundt. Their theories and methods paved the way for the clinical psychologists of today, who are now trained to encompass a broader range of healthcare concerns for the individuals who come to them for treatment. The future of clinical psychology may see it come under the wider umbrella of general healthcare, moving beyond its earlier narrow focus on mental disorders alone.

History and Definitions of Clinical Psychology

The actual beginnings of clinical psychology can be attributed to Luis Vives, who lived from 1492 to 1540. He can be called the precursor of modern psychology, but the official founding date of clinical psychology is generally considered to be 1879, when Wilhelm Wundt established his experimental laboratory at the University of Leipzig.

Current Definition of Clinical Psychology

Today, clinical psychology can be defined as the application of psychology to mental illnesses, abnormal behavior, or behavioral problems in the human mind. It is also defined as the branch of psychology that focuses on the treatment of mental disorders of any kind, as well as abnormal thinking and abnormal behavior. The actual term "clinical psychology" was introduced by the American psychologist Lightner Witmer in a paper published in 1907.

There has been widespread criticism of the contemporary definition of clinical psychology, with critics arguing that the definition is too broad and all-encompassing, incorporating many non-pathological behaviors and conditions within its scope. As a result, several alternative definitions have been proposed. One well-known alternative was put forward by Wakefield in 1992, who termed mental disorder as "harmful dysfunction." Bergner, in 1997, endorsed a definition proposed earlier by Ossorio in 1985, which stated that psychopathology is best defined as a "significant restriction" on an individual's abilities and faculties, whereby the person cannot engage in deliberate actions; that is, they are not in control of their behavior and therefore cannot participate effectively in the prevalent social practices of their time. (Stricker, Widiger, & Weiner, 2002)

In other words, clinical psychology can be understood as a broad field of research within psychology that applies psychological principles to the assessment, prevention, amelioration, and rehabilitation of individuals experiencing psychological distress or trauma of any kind, with the ultimate aim of enhancing both mental and physical well-being.

Original Definition of Clinical Psychology

The original definition of clinical psychology did not necessarily include all these elements. The field developed in ways that its founder, Lightner Witmer, may not have anticipated when he opened the very first psychology clinic in 1896 and founded the first scholarly academic journal related to psychology, named The Psychological Clinic, which was responsible for training some of the world's first generation of clinical psychologists. One of the first cases treated, as is widely known today, was that of Charles Gilman, a school-going child with certain spelling difficulties. (Routh, 1996)

After treating visual difficulties in this case, Witmer became convinced that psychology could meaningfully help such individuals. His primary emphasis was on the academic treatment of children who were "retarded" in their normal mental development — using "retarded" in the sense of delayed, for whatever reason. This emphasis on children's academic problems contributed to the development of school psychology and was a major stepping stone in the early definition of clinical psychology. (Routh, 1996)

Beginnings of Clinical Psychology

The beginnings of clinical psychology are again attributed to Lightner Witmer. It was in his first publication in The Psychological Clinic, in an article entitled "Clinical Psychology," that Witmer explained the clinical method he had been using in treating his subjects — or "cases," as he called them. This method involved performing small experiments on subjects so that the attending psychologist could better understand the basic nature of the patient's difficulties. Over time, Witmer also began to conduct educational experiments, in which he advocated a strategy of "teaching to weaknesses." Although both Witmer's clinic and his journal no longer exist, the conception of clinical psychology that he developed must be attributed to this pioneering figure. (Lightner Witmer and the Beginning of Clinical Psychology)