Behaviour Therapy, Extinction and Relapse in Neurosis

Abstract

Behaviour therapy is defined as the application of the principles of modern learning theory to the treatment of neurotic disorders (Eysenck, 1960a, 1963). It defines neurotic “symptoms” as unadaptive conditioned autonomic responses, or the skeletal and muscular activities instrumental in moderating these conditioned autonomic responses. Treatment consists essentially in the extinction of autonomic, skeletal and muscular responses of this type. This extinction may be produced in a great variety of ways, but experience has shown that the most useful and important is probably the method of counterconditioning or “reciprocal inhibition” (Wolpe, 1958). This method takes two forms, according to the nature of the symptom. (1) When the symptom is of a dysthymic character (anxieties, phobias, depression, obsessive-compulsive reactions, etc.) it is assumed that the disorder consists of conditioned sympathetic reactions, and the treatment consists of reconditioning the stimulus (or stimuli) to produce parasympathetic reactions which, being antagonistic to the sympathetic ones, will weaken and finally extinguish them. These disorders we will here call “disorders of the first kind”. (2) When the symptom is of a socially disapproved type in which the conditioned stimulus evokes parasympathetic responses (alcoholism, fetishism, homosexuality), or where there is an entire absence of an appropriate conditioned response (enuresis, psychopathic behaviour), treatment (aversion therapy) consists of the pairing of the stimulus in question with strong aversive stimuli producing sympathetic reactions. These disorders we will call “disorders of the second kind”. (In putting the distinction between these two types of treatment in this very abbreviated form, we have used the terms “sympathetic” and “parasympathetic” in a rather inexact shorthand notation to refer to hedonically positive and negative experiences respectively; the reader familiar with the complexities of autonomic reactions will no doubt be able to translate these blanket statements into more precise language appropriate to each individual case. We have retained this use of the terms here because it aids in the general description given, and indicates the physiological basis assumed to exist for the hedonic reactions.)