Changing behaviour for the better

Press, 1 April 1989, Page 23

Changing behaviour for the better

Life Without Fear. By Joseph Wolpe and David Wolpe. New Harbinger/ Benton Ross, 1988, 131 pp. $24.95 (paperback). (Reviewed by Ralf Unger)

Behaviour therapy is that form of psychological treatment which can be applied appropriately to pathological conditions that have come about through learning and uses procedures to unlearn and bring about new learning. Its present-day exponents have been developing the field for about 50 years and it has been attacked variously as simply using commonsense, or being ineffective against “deeper” causes of conditions of neurosis.

Dr Wolpe is one of the clearest exponents of the approach who, now in his 70s, still sets out his belief that it is only by experienced analysis and systematic desensitisation of anxieties that people can be improved and continue on fulfilling themselves to their full potential. The co-author, his son, is an actor and writer who the father found functioned as a good sounding board to ask questions and simplify jargon for the nonprofessional. All of us carry a number of useless fears and when they materially interfere in our endeavours this calls for intervention. Behaviour therapy deals not only with clear-cut phobias — such as a fear of thunderstorms — but it is the function of the therapist to tease out the fear underlying symptoms of complex disorders such as a migraine, constipation, or poor sexual performance. Once a set of responses has been set up during life to be consistently triggered by the same circumstances it is a habit, which continues even when it no longer serves any recognisable purpose. In order for a “fear habit” to be weakened a competing pleasant response must occur together with it, either naturally or imposed in an experimental situation such as treatment. This should be experienced during development in a normal way when a parent, in the example Wolpe gives, picks up and cuddles her frightened child during a

thunderstorm and croons to it, “listen to the thunder, bringing lovely rain.” Wolpe describes his dawning awareness of a therapeutic approach when reading of animals who had their fear combated by introducing feeding associated with increasing amounts of the fearful stimulus. This led to his approach of progressive or systematic desensitisation which, he claims, is the most commonly used form of behaviour therapy, and exposing patients both in imagination and reality to increasingly frightening situations while teaching them simultaneous relaxation. In following up his own work Wolpe makes the bold statement that “alone among the systems of psychotherapy, behaviour therapy yields a percentage of recoveries significantly above the baseline of standard improvement.” 80 per cent to 90 per cent of patients are either apparently cured or much improved after an average of 25-30 sessions in. his follow-up of his own

cases. There is no question but that behaviour therapy has entered the armoury of virtually every therapist no matter what his or her original orientation — be it psychoanalytic, or Gestalt, or Primal Cry, or Rebirthing, or any of the latest ones that may have come out since the beginning of this year in California. Wolpe will go down in psychology history as one the clearer exponents of the methods and the philosophy of behaviourism with a minimum of jargon and a useful delineation of the limits of the approach. One always gets the impression in his writing, however, that he underestimates his and his disciples’ personal influence within the relationship with a patient or a group, and while waxing scientific, the empathic and caring individual that he is still comes to the fore as he explains his fully-matured ideas and case histories to his son.