A brief history of psychotherapy and physical disability

In this brief history, the authors have attempted to highlight salient aspects of psychotherapy with physically disabled individuals across a span ranging from the prepsychoanalytic to the contemporary. Particular attention is given to the prepsychoanalytic work of Charcot and Janet on neurological diseases and trauma, respectively. Psychoanalytic concepts are reviewed as they relate to physical disability and they are compared with contemporary themes involving trauma and loss. The paper has a distinctly psychoanalytic bias about the psychology of congenital and acquired physical differences. Important to the psychotherapist is the fact that these individuals who happen to have physical disabilities bring to the clinical situation the same kinds of problems, defenses, and adaptations as do so-called "ordinary people." There are some important differences in focus between those whose physical differences are congenital and those who acquire physical disability later in life. However, for the most part, the principles and practice of psychotherapy with the physically disabled are no different from those for any other human being.