Spontaneous remission and latent learning

Abstract

IN A recent paper Eysenck (1962) stressed the theoretical importance of the phenomenon of spontaneous remission. He pointed out that “any general theory of neurotic behaviour must attempt to account for the main phenomena in this field”. The fact that approximately two-thirds of all the sufferers from neurotic complaints can be expected to recover without any formal treatment can not be ignored by any serious theory. The purpose of the present paper is to suggest an extension of the theoretical accounts provided by Wolpe (1958) and Eysenck (1960; 1962) in their discussion of spontaneous remission. Various estimates of the frequency of spontaneous remissions have been offered. Landis (1938) suggested a baseline of over 66 per cent, Denker (1946) found that 45 per cent recovered after one year and an additional 27 per cent after 2 years. On the basis of these and other estimates, Eysenck concluded that a spontaneous remission rate of 72 per cent seemed to be a useful baseline at the present stage of our knowledge. Levitt (1957) conducted a similar survey on the effects of psychotherapy with children and was able to extract a baseline recovery rate of 72.5 per cent. In arriving at an evaluation of therapeutic improvement it is important to remember Landis’ proviso that the outcome of therapy in a group of patients must be examined in terms of some stated interval of time. Eysenck has gone so far as to propose that improvement should be regarded as a function of time and suggests a rough formula for describing the process of change which is involved. There is no doubt that in a high percentage of neurotic illnesses a marked degree of improvement occurs over a period of time. (Shepherd and Gruenberg, 1957, regard two years as the average duration of neuroses.) Clearly it is not the simple movement of a clock which effects cures; as Eysenck (1960) says, “it can only be ‘events’ happening in time which can exert a causal influence”. The nature of these events is the focus of our interest. Two prominent attempts to explain the events which produce spontaneous remissions are those of Wolpe (1958) and Eysenck. Wolpe has attempted to incorporate the phenomenon of spontaneous remission within his general theory of psychotherapy based on reciprocal inhibition. He argues that “if habits of neurotic response can be overcome through inhibiting neurotic responses by simultaneous antagonistic responses, it might be expected that sometimes in the ordinary course of life there will be emotional arousals that inhibit neurotic anxiety responses”. He then proceeds to illustrate this suggestion with various examples of fortuitous incidents which have the effects of “dampening” and finally overcoming neurotic responses. The investigation of children’s fears reported by Jersild and Holmes (1935) provides interesting details of various trial-and-error procedures developed by parents in helping their children to overcome fears of various types. Many of these techniques (such as progressive contacts with the feared situation) can be accounted for in terms of Wolpe’s reciprocal inhibition theory. Wolpe’s explanation also enables one to make predictions about the effectiveness