Joseph Wolpe 20th April 1915 to 4th December 1997
Joseph Wolpe was born in South Africa and studied at the University of
Witwatersrand in Johannesburg where he obtained his MD. During the Second
World War he worked in a military psychiatric hospital - his role as a
medical officer in the South African Army.
After the war he worked at the University of Witwatersrand and began to
devise 'systematic desensitisation' as a form of behavior therapy. Various
therapeutic procedures, including psychoanalysis, seek to influence the mind
on the understanding that having done so then any unwanted behavior will fade.
Behavior therapy seeks to do the opposite - to change a person's behavior
directly with the result that any related mental anguish will be eased.
Both approaches are valid because mental activity and behavior are dependent
on each other - and neither one can be identified as the controlling entity.
Although it is widely assumed that actions can only result from choice of
mind, this is not so. For example, if a very shy person can be persuaded
to 'act' confidently then that person will almost invariably report that
they also feel more confident while they are performing this task, and
repeated 'acting' results in a reinforcement of the confidence gained.
Desensitisation was originally criticised as a therapeutic process for only
being useful in cases which are 'monosymptomatic' ie:- only have a single
symptom whereas with more complex problems it was alleged that 'the deep
cause ' of neuroses were left untouched by desensitisation. However there
is no real proof that any such ' deep cause ' exists. Joseph Wolpe was
particularly blunt in one of his replies to such criticism stating that "...
because the psychoanalysts have misapprehended the requirements of scientific
evidence they have adduced no acceptable support for their theory, beguiling
themselves with surmises, analogies and extrapolations". He was also well
qualified to comment since he was a psychoanalyst himself until
dissatisfaction with the limitations of his own art encouraged him to
re-assess the needs of his patients resulting in the birth of behavioral
therapies in the early 1950s. There are still unnecessary insults hurled
from one camp to the other - one Doctor of psychoanalysis writing in 2002
incorrectly describes Joseph Wolpe as 'a behavioral psychologist... who was
actually studying cats more than dealing with clients'. Studying cats was
certainly involved in the thought processes that spawned the concept of
behavior therapy in Wolpe's mind - but by definition, behavioral psychology
did not exist at this time - it was only when Wolpe applied his feline
observations to the human condition that behaviorism began to be evolved.
It is clear though, that such description wishes us to see Wolpe as a rural
incompetent which is so very far from the truth and is unhelpful to the
progress of all psycho-science. My own opinion is based purely on
practical concerns - why bother with things that remain unproven when
there are procedures ( Including those that use behavior therapy ) which
are clearly defined and work well.
Both phobias and more complex neuroses develop as a result of the learning
process going astray so desensitisation aims to enable people to 're-learn'.
On finding that we have been wrongly informed about ordinary facts and
figures, re-learning is easy - if, for some reason we have been taught that
two plus two equals five, then on discovering that that is incorrect we
simply replace the incorrect data with the right answer - this occurs in
our 'higher' memory which is very much under our control.
If the false learning is associated with instincts it is linked with our
primitive ( hypothalamic) brain functions it is not so easily changed since
it forms part of our fundamental structure, usually as a process related to
development. To try to clarify this - we all have the instinct to avoid
anything that would cause us physical injury - that is all part of the
instinct to survive - it is a necessary result of our genetic structure,
however we have to learn what things and situations could possibly cause
physical injury. Because this information is vital to our survival, we
take it very seriously, so we naturally allow such learning
to take control.
Where someone has 'learnt' that a balloon represents potential danger
and this learning is linked to instinctive processes, then that person
takes every precaution to avoid balloons - in exactly the same way that
people in general avoid other such learnt dangers such as putting ones
hand into flames. Even if such a person can realize on a technical level
that balloons do not represent a life threatening hazard, the association
of balloons with instinct means that it is a harder thing to re-learn,
and therefore such re-learning needs a process which is different and
more comprehensive than simply replacing false data with true knowledge,
and desensitisation is one such process which can achieve this. In fact
where balloons are seen instinctively as a danger but there is a reasoned
understanding that they are not a threat, this internal conflict may add
to any anxiety that is felt.
The self therapy that I have suggested on this site is somewhat different
to the therapy you would receive from a behavior therapist - essentially
because the therapist is not present, but an explanation of the normal
process could be helpful.
The first step in the process is to produce a 'hierarchy' which is a list of
situations which cause you anxiety with the most disturbing at the top of the
list and numbered '1' with the next most disturbing at number 2 and so on
until all the situations that appear to require therapy have been listed.
For convenience the list can be limited to ten suitable items. Behavior
therapy is interested in what is known as 'stimulus - response' and to
define both accurately in the hierarchy - in the case of balloon popping
phobia a stimulus would be being close to a balloon and the response would
be fear or anxiety - and behavior therapy simply seeks to change the
response to a greater calmness by learning this new response.
It is, at this stage, useful to look at the nature of the problem that
is effectively defined by the hierarchy. Where there is a range of problems
which are all related it is normally defined as a 'simple neurosis' - so
single phobias fall into this category. Where there several categories
represented in the list of problems it is usually referred to as a 'complex
neurosis'. There may be links between problems that appear to be unrelated
which the therapist will try to uncover by general enquiry so that any past
events that may have initiated more than one problem area can be brought
into the open so that they can be discussed and understood by the client.
During therapy the client is encouraged into a very relaxed state which
is by definition incompatible with fear, and is asked to imagine a
situation which is related to a mild form of the least disturbing
problem on the hierarchy. This is continued until the situation itself
can be imagined in its entirety and so confidence in meeting this situation
in real life is established. It is unusual, but not unknown, for the
patient to be taken into the real situation by the therapist where there
appears to be incomplete success using the imagination technique.
Once the least disturbing situation on the list is overcome then therapy
is concentrated on the next anxiety causing situation and so on until
all the items on the list have been dealt with satisfactorally. If the
list contains many items then therapy can take quite a time - Joseph Wolpe's
own figures for a period of his own work which he monitored shows that for
simple neuroses the average number of therapeutic sessions required was
15, whereas where complex neuroses were found the number of sessions
required was 55. Every form of therapy enjoys some success and occasional
failures - behavior therapy having one of the best track records with an
achievable success rate close to 90% whereas the average success rate
for all therapeutic processes is only 50%.
I am certain that Joseph Wolpe was right to criticise psychoanalysts
for their reliance on unproven, and often unprovable, theories, but
that is not to say that underlying causes do not exist, just that they
are unlikely to be defined in any accurate way using psychoanalytical
terminology. Everyday language should be sufficient to describe everyday
events but that in itself is no guarantee that we understand the all the
implications of particular happenings in our lives - indeed we may not
remember some of the things that cause us problems because we can easily
repress or blot out any memories which are uncomfortable or unsavoury,
and it may take a discussion with a highly trained therapist to
rediscover lost memories and to understand their significance.
Another therapy that was developed by Joseph Wolpe is called assertiveness
training. The therapy helps people to stand their ground and is designed to
build self confidence, so with this general approach it can help with a
wide variety of problems. It is important to understand that the aim is
simply to provide a person with the tools to support their individuality -
to make sure that no-one is able to take advantage of someone they may
think of as weaker, it is not about learning to impose on or control other
people - but to be able to resist the efforts of others who wish to do that
to us.
Assertiveness training can take place in groups so it is useful to people
who wish their problems to remain a secret while gaining confidence in the
group situation. Assertiveness trainers will not always inquire about
your reasons for attending the group and the question can be sidestepped
anyway - or you can say 'I would rather not be specific' if asked.
The group normally uses role play in order to allow people to get used to
situations which can be upsetting, such as arguments or the prospect of
complaining about faulty goods or poor workmanship. Also there are usually
exercises which seek to encourage the group to rely on each other. In
one such exercise, a member of the group stands in the middle of a circle
formed by the rest of the group. The person in the middle is encouraged
to 'let go' by closing their eyes and allowing themselves to become
unbalanced - the circle of people around are there to catch the falling
person and gently push that person upright again, the result is that the
person in the middle is gently pushed backwards and forwards and left and
right. This is allowed to take place for up to a minute, and each person
in the group takes turns in the middle.
This teaches each member of the group that they can rely on each other,
with the wider implication that there are circumstances where they can
trust other people as well.
Following his research at the University of Witwatersrand Joseph Wolpe
moved to the USA where he taught at the University of Virginia. In 1965
he became a professor of psychiatry at Temple University Medical School in
Philadelphia where he stayed until his retirement in 1988. That same year
he moved to California where he was soon back in action lecturing at
Pepperdine University and was doing so until a month before his death
in his 84th year.
The thoughts and inventions of one person are often merged into other
therapies to some extent and also can act as a catalyst which enable
others to think of new ways to approach therapy and help people with
their lives. There are very few people who have had the dedication or
the capacity to make the enormous contribution to the practice of the
psychological sciences that has been made by Joseph Wolpe.
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