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Behavioural Concepts and Treatments of Neuroses

Published online by Cambridge University Press:  16 June 2009

Isaac Marks
Isaac Marks
Affiliation:
Institute of Psychiatry, University of London
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Extract

Behavioural psychotherapy has many roots, and experimental psychology is but one of many “idols of origin” which is in any case largely ignored by behavioural practitioners. The conditioning model of neurosis has shortcomings, and cognitive explanations alone are not satisfactory. It may be necessary to think in terms of failed extinction of phobias and rituals rather than of enhanced acquisition. Aetiological theories need not be related to effective treatment, nor are they necessary for clinicians to carry out successful behavioural treatment. For therapists, paradigms are more useful when derived from clinical experiments rather than from the laboratory. A critical task concerning treatments to reduce anxiety is to investigate those parameters which decide when exposure will be habituating and when it will be sensitizing. To this end, analogue research is less relevant than clinical experiments whose results can be used directly by clinicians. Ten theoretical problems with exposure are noted.

The demand for behavioural psychotherapy exceeds the supply of therapists. Paraprofessionals and self-help methods can help to bridge the gap, while preventive measures may prevent the development of some pathology. Most clinical psychologists and psychiatrists are overqualified merely to deliver behavioural services; there is no evidence that such qualifications add to effectiveness, though they are invaluable for research and teaching.

Information

Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 9 , Issue 2 , April 1981 , pp. 137 - 154
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 1981

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References

Akiyama, M. (1968). Effects of extinction techniques on avoidance response Bulletin of the Faculty of Education, Hiroshima University 17, 173.Google Scholar
Arnold, L. E. et al. (1977). Prevention by specific perceptual remediation for vulnerable first-graders. Archives of General Psychiatry 35, 1279–1294.CrossRefGoogle Scholar
Barraclough, G. (1966). History and the Common Man. Presidential Address to the Historical Association of Great Britain, London.Google Scholar
Baum, M. (1969). Extinction of an avoidance response following response prevention: some parametric investigations. Canadian Journal of Psychology 23, 1.CrossRefGoogle Scholar
Boulougouris, J. C. (1976). Variables affecting the behaviour of obsessive compulsive patients treated by flooding. Paper to EABT Spetsae, Greece, Sept. 1976. in Studies in Phobic and Obsessive-Compulsive Disorders Boulougouris, J. C. and Rabavilas, A. (Eds), Oxford: Pergamon, pp. 73–84.Google Scholar
Bregman, E. O. (1934). An attempt to modify the emotional attitudes of infants by the conditional response technique. Journal of Genetical Psychology 45, 169–198.Google Scholar
Chabot, B. (1979). The right to care for each other and its silent erosion. Tidschrift voor Psychotherapie 5, 199–216.Google Scholar
Chambers, L. W. and West, A. E. (1978). The St. John's randomized trial of the family practice nurse: Health Outcomes of Patients. International Journal of Epidemiology 7, 153–161.CrossRefGoogle Scholar
Climent, C. E. et al. (1978). Development of an alternative, efficient, low-cost mental health delivery system in Cali, Colombia. Part 1: The auxiliary nurse. Social Psychiatry 13, 29–35.CrossRefGoogle Scholar
Cochrane, R. and Sobol, M. P. (1976). Myth and methodology in behaviour therapy research. In Theoretical and Experimental Bases of the Behavior Therapies, Feldman, M. P. and Broadhurst, A. (Eds), New York: John Wiley and Sons.Google Scholar
SirDigby, Kenelm (1644). In Three Hundred Years of British Psychiatry R. Hunter and J. MacAlpine 1963, London: Oxford University Press, p. 125.Google Scholar
Emmelkamp, P. M. G. (1979). The behavioural study of clinical phobias. in Progress in Behaviour Modification, Volume VIII, Hersen, M., Eisler, R. M. and Miller, P. M. (Eds), New York: Academic Press.Google Scholar
Foa, E. B. and Steketee, G. S. (1979). In Progress in Behaviour Modification, Hersen, M., Eisler, R. M. and Miller, P. M. (Eds), New York: Academic Press.Google Scholar
Foa, E. B. and Goldstein, A. (1979). Continuous exposure and complete response prevention treatment of obsessive-compulsive neurosis. Behavioural Therapy (In Press).Google Scholar
Freud, S. (1919). Turnings in the ways of psychoanalytic therapy. ln Collected Papers, Volume 2. London: Hogarth Press and Institute of Psychoanalysis.Google Scholar
Freyman, J. G. (1975). Medicine's great schism: Prevention v. cure. An historical interpretation. Medical Care 13, 525–536.CrossRefGoogle Scholar
Griest, J. et al. (1980). Avoidance versus confrontation of fear. Behavioural Therapy, 11, 1–40.CrossRefGoogle Scholar
Hartmann, D. B., Baker, T. B. and Wade, T. C. (1978). The professional reading practices of behaviour therapists. The Behavior Therapist, AABT Newsletter 5, 13.Google Scholar
Janet, P. (1925). Psychological Healing, Volume II. New York: MacMillan.Google Scholar
Jannoun, O. et al. (1979). Paper to EABT, Paris.Google Scholar
Jaspers, K. (1923) Allgemeine Psychopathologie. Manchester: Reprinted by Manchester University Press, 1962.CrossRefGoogle Scholar
Kass, D. J. and Stauss, F. F. (1975). Sex Therapy at Home. New York: Simon & Schuster.Google Scholar
Kazdin, A. E. (1978). History of Behavior Modification: Experimental Foundation of Contemporary Research. Baltimore: University Press.Google Scholar
Lang, P. (1977). Imagery in Therapy. Behaviour Therapy, in press.CrossRefGoogle Scholar
Leonhard, K. (1959). Individual therapie und prophylaxe der hysterischen, anankastichen und sensohypochendrischen neurosen. Fischer, Jena. Cited by G. Roper, Behaviour Research and Therapy 13, 1975.Google Scholar
Lewis, C. E. et al. (1969). Activities, events and outcomes in ambulatory patient care. New England Journal of Medicine 280, 645–649.CrossRefGoogle ScholarPubMed
Liberman, B. L. and True, J. E. (1979). Evaluation of the comparative effectiveness of professionals, mental health associates, and other professionals in therapeutic interventions with psychiatric outpatients. In press.Google Scholar
Lieberman, M. A. and Gardner, J. R. (1976). Institutional alternatives to psychotherapy. Archives of General Psychiatry 33, 157–162.CrossRefGoogle ScholarPubMed
Locke, J. (1700). An essay concerning human understanding. In The Philosophical Works of John Locke. St. John, J. A., (Ed.), 1913.Google Scholar
Mahler, H. (1975). Health—a demystification of medical technology. Lancet ii, 829–833.Google Scholar
Marks, I. M. (1969). Fears and Phobias. London: Heinemann Medical and Academic Press.Google Scholar
Marks, I. M. (1975). Behavioral treatments of phobic and obsessive–compulsive disorders: a critical appraisal. In Progress in Behavior Modification Volume 1, Hersen, R. et al. (Eds) New York: Academic Press.Google Scholar
Marks, I. M. (1977). Exposure treatments. Behaviour Modification 2nd Edit.Agras, S. (Ed), New York: Little, Brown and Co.Google Scholar
Marks, I. M. (1980). Living with Fear. New York: McGraw-Hill.Google Scholar
Marks, I. M., Bird, J. and Lindley, P. (1978). Behavioural nurse-therapists 1978—developments and implications. Behavioural Psychotherapy 6, 25–36.CrossRefGoogle Scholar
Marks, I. M., Rachman, S. and Hodgson, R. (1975). Treatment of chronic obsessive–compulsive neurosis by in vivo exposure. British Journal of Psychiatry 127, 349–364.CrossRefGoogle ScholarPubMed
Marks, I. M. et al. (1980). Clomipramine and exposure for obsessive–compulsive rituals I & II British Journal of Psychiatry 136, 1–25.CrossRefGoogle Scholar
Maxmen, J. S. (1976). The Post physician Era: Medicine in the 21 st Century. New York: John Wiley and Sons.Google Scholar
McDonald, R., Sartory, G., Grey, S., Cobb, J., Stern, R. and Marks, I. M. (1979). The effects of self-exposure instructions on agoraphobic outpatients. Behavior Research and Therapy 17, 83–85.CrossRefGoogle Scholar
McGregor, M. (1976). Impact of health care legislation on the medical school. Chapter 8. In International Aspects of the Provision of Medical Care, Kent, P. W. (Ed.) London: Oriel Press, pp. 68–78.Google Scholar
Raphael, B. (1977). Prevention intervention with the recently bereaved. Archives of General Psychiatry 34, 1450–1454.CrossRefGoogle ScholarPubMed
Rimm, D. C. et al. (1977). An explanatory investigation of the origin and maintenance of phobias. Behaviour Research and Therapy 15, 231–238.CrossRefGoogle Scholar
Sackett, D. L. and Spitzer, W. O. (1974). The Burlington randomized trial of the nurse practitioner. Annals of Internal Medicine 80, 137–142.CrossRefGoogle ScholarPubMed
Seligman, M. (1971). Phobias and preparedness. Behavior Therapy 2, 307–320.CrossRefGoogle Scholar
Seligman, M. and Hager, J. (1972). Biological Boundaries of Learning, Appleton-Century Crofts.Google Scholar
Spitzer, W. O., Roberts, R. S. and Delmore, T. (1976). Nurse practitioners in primary care. VI: Assessment of their deployment with the litigation and Financial Index. Canadian Medical Association Journal 114, 1103–1108.Google Scholar
Stunkard, A. J. and Brownell, K. D. (1980): Workside treatment for obesity. American Journal of Psychiatry, in press.Google Scholar
Thoren, P. et al. (1980). Clomipramine treatment of obsessive-compulsive disorder I: a controlled clinical trial. Archives of General Psychiatry, in press.CrossRefGoogle Scholar
Thorndike, E. L. (1898). Ph.D. dissertation cited by Seligman and Hager (1972).Google Scholar
Thorndike, E. L. (1935). The Psychology of Wants, Interests and Attitudes, London: Appleton–Century, pp. 195–196.Google Scholar
Timmons, E. O. (1963). Implications of awareness-applied areas. Unpublished symposium paper In (Southeastern Psychol. Assocn.). Miami, Florida, 1963, In Experimental Psychopathology: Recent Research and Theory. H. D. Kimmel (1971) (Ed), New York: Academic Press, p. 7.Google Scholar
Usa, G. and Usa, I. (1958). A case of a nun who suffered from visionary obsessions of snakes treated by Morita therapy. Psychologica 1, 226.CrossRefGoogle Scholar
Watson, J. B. and Rayner, R. (1920). Conditioned emotional reactions. Journal of Experimental Psychology 3, 1–14.CrossRefGoogle Scholar
Watson, J. P. and Marks, I. M. (1971). Relevant vs. irrelevant flooding in the treatment of phobias. Behavior Therapy 2, 275.CrossRefGoogle Scholar
W.H.O.: Report cited by Fichter, M. M. and Wittchen, H. V. (1979). Clinical psychology and psychotherapy: a survey of the present state of professionalization in 23 countries. Awaiting publication.Google Scholar
Wolpe, J. (1958). Psychotherapy by Reciprocal Inhibition. Stanford: Stanford University Press.Google Scholar
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