Hostname: page-component-586b7cd67f-l7hp2 Total loading time: 0 Render date: 2024-11-22T08:47:28.450Z Has data issue: false hasContentIssue false
  • English
  • Français

Behaviour Therapy in the Treatment of Psychoneurosis

Published online by Cambridge University Press:  29 January 2018

Susan Shafar  and
J. R. Jaffe
Susan Shafar
Affiliation:
Crumpsall Hospital, Manchester, 8
J. R. Jaffe
Affiliation:
Medical Hypnotist, Department of Psychiatry, Crumpsall Hospital, Manchester, 8
Get access Rights & Permissions [Opens in a new window]

Extract

According to Wolpe (1964b) “conditioning therapists as a rule undertake treatment of all cases of neurosis“. However, some limitations in the application of conditioning therapies must be recognized, and the nature of their difference from psychotherapy requires definition. Considering the problem of unconditioned anxiety, which Wolpe (1964a) defines as occurring with an ongoing conflict situation when there are simultaneous impulses to opposing actions, we observe that Wolpe does not claim that conditioning therapies are applicable here. But behaviour therapists do not believe that anxiety generated by conflict plays a part in the causation of neurosis, and wholly discount the significance of repression. In general, mature personalities tend to resolve their conflicts, motivated by the driving force of anxiety, but in neurotically ill individuals, often unable to face problems arising out of personal shortcomings, these conflicts are not always in full awareness, though they may not be very deeply “repressed”. Quite rightly, behaviour therapists point out that in their case material, where conditioned neurotic reactions constitute the main symptoms, the patient may recover, though the forgotten incidents remain forgotten, as for instance in functional amnesia. Accordingly they conclude that resolution of repression is not a prerequisite for recovery. But, as even many psychoanalysts concede, the detail of the forgotten memory, the repressed incident, is of less importance than are the associated affects and attitudes, and it is these which often cannot be squarely faced by the neurotic patient. Unconditioned anxiety aroused by conflict comes indeed within the orbit of psychoneurosis. Wolpe (1964b) alludes to this as follows: “You may find a person who is in a chronic conflict situation … which arouses emotional tension, perhaps all the time; … treatment of neurotic anxiety reactions may be much impeded by emotional disturbance due to the life circumstances. But the behaviour therapist can often instigate action leading to the resolution of difficult situations.” How Wolpe (1964a) accomplishes this is described when he deals by behaviouristic analysis with reactions in which “crucial stimulus antecedents are obscure”. Claiming that it is possible to establish the stimulus antecedents of reactions in every variety of neurosis, he states that the patient may simply be unaware of certain of his reactions, because of “conditioned inhibition of awareness of particular responses”. He quotes a case of unacknowledged rebellion of a patient against domination by her husband, in whom the complete exposure of this set of attitudes within her led to the possibility of their expression and to therapeutic change. Although Wolpe (1958) denies that this type of phenomenon constitutes repression, he appears to imply a very similar event when he discusses “conditioned inhibition of awareness”. It seems pedantic to insist that these are conceptually quite different and to claim that behaviour therapists are unique and original in trying to uncover underlying attitudes and affects.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 111 , Issue 481 , December 1965 , pp. 1199 - 1203
Copyright
Copyright © Royal College of Psychiatrists, 1965 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Cooper, J. E. (1963). “A study of behaviour therapy in 30 psychiatric patients”. Lancet, i, 411.Google Scholar
Costello, C. G. (1963). “Behavior therapy: criticisms and confusions”. Behav. Res. Ther., 1, 159.Google Scholar
Meyer, V., and Gelder, M. G. (1963). “Behaviour therapy and phobic disorders.” Brit. J. Psychiat., 109, 19–28.CrossRefGoogle ScholarPubMed
Murray, E. J. (1962). Paper read at American Psychiatric Association Annual Convention, St. Louis, Missouri.Google Scholar
Reyna, L. J. (1964). In discussion, The Conditioning Therapies: The Challenge in Psychotherapy, pp. 172 and 173 (ed. J. Wolpe, A. Salter, L. J. Reyna). New York: Holt, Rinehart and Winston.Google Scholar
Thigpen, C. H. (1964). In discussion, The Conditioning Therapies: The Challenge in Psychotherapy, p. 109 (ed. J. Wolpe, A. Salter, L. J. Reyna). New York: Holt, Rinehart and Winston.Google Scholar
Wolpe, J. (1958). Psychotherapy by Reciprocal Inhibition. Stanford: Stanford University Press.Google Scholar
Wolpe, J. (1960). “Reciprocal inhibition as the main basis of psychotherapeutic effects,” in Behaviour Therapy and the Neuroses (ed. H. J. Eysenck). London: Pergamon Press.Google Scholar
Wolpe, J. (1961). “The systematic desensitisation treatment of neuroses.” J. nerv. ment. Dis., 132, 189–203.Google Scholar
Wolpe, J. (1964a). “Behaviour therapy in complex neurotic states.” Brit. J. Psychiat., 110, 28–34.Google Scholar
Wolpe, J. (1964b). In discussion, The conditioning Therapies: The Challenge in Psychotherapy, pp. 15, 20, 108 (ed. J. Wolpe, A. Salter, L. J. Reyna). New York: Holt, Rinehart and Winston.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.