Story of Psychology - Morton Hunt [382]
Such systematic desensitization, according to Wolpe, proved to be the method of choice for about 70 percent of his patients; for the other 30 percent he worked out other techniques. During the early 1950s, he began making his work known through journal articles, and in 1958 presented a full-scale treatment of it in the book Psychotherapy by Reciprocal Inhibition.
By then, a handful of other therapists had followed suit and begun practicing desensitization and developing other forms of behavior therapy. The most influential were Arnold Lazarus, another South African, who had come to the United States and was the first person to use the term “behavior therapy,”52 and H. J. Eysenck in England. For a while, behavior therapy of neurotic conditions remained a novelty and rarity. Few clinicians practiced it, because it was diametrically opposed to the dominant dynamic tradition, and, in any case, there was no place in the United States to get training in it. But in 1966, Wolpe, by then at Temple University School of Medicine in Philadelphia, launched a program of research and training in behavior therapy. The same year, a nonprofit clinic and training center called the Behavior Therapy Institute opened in Sausalito, California; a new book, Behavior Therapy Techniques, by Wolpe and Lazarus (by then his colleague at Temple), appeared; and the following year Wolpe and behavior therapy were introduced to the nation’s intelligentsia by an article in the New York Times Magazine. 53
From that point on, research on behavior therapy and publication of articles about it increased rapidly; by the 1970s it had become a leading method of therapy and has remained so, though it has never supplanted dynamic therapy, as Joseph Wolpe felt it should. Some psychotherapists practice it exclusively; many more use it in combination with cognitive therapy (which we will look at shortly and which they call cognitive behavioral therapy); and a number of others, including some whose primary allegiance is to dynamic therapy, use behavior therapy now and then for the treatment of specific phobias such as fear of driving, flying, cats, or crowded places, which often can be cured without concomitant dynamic treatment.
A particularly interesting use of the desensitization technique is in treating sexual dysfunctions, especially impotence and female lack of orgasm. In the late 1960s, William Masters and Virginia Johnson, both sex researchers but neither one a psychologist, developed what has ever since been one of the key treatments of such difficulties when they result from anxiety, not from an organic condition. The method pioneered by Masters and Johnson involved instruction in, and the practice of, step-by-step desensitization—the procedures were carried out by the couple at home over a period of days or weeks—starting with the partners touching each other’s bodies, gradually coming to fondle each other’s genitals (intercourse is barred, to prevent performance anxiety), eventually inserting the penis in the vagina but without coital movement, and finally, when that condition is anxiety-free, proceeding to full coition. Unlike treatment of the simpler phobias, however, sex therapy generally required discussion of and education in the couple’s relationship.54
The Masters and Johnson form of sex therapy was rapidly adopted and used by a wide variety of therapists. The results, however, were often less than hoped for, and over a number of years sex therapists modified the basic desensitization therapy into more of a cognitive-behavioral process, often including bibliotherapy. In one form or another, it continued to be one of the techniques used by some psychotherapists, especially those who specialize in treating sexual dysfunctions.55
Desensitization remains the most frequently used technique of behavior therapy, but for certain conditions different techniques developed by Wolpe and others work better. They are:
Aversive