Joseph Wolpe

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Joseph Wolpe
Born20 April 1915  OOjs UI icon edit-ltr-progressive.svg
Johannesburg   OOjs UI icon edit-ltr-progressive.svg
Died4 December 1997  OOjs UI icon edit-ltr-progressive.svg (aged 82)
Los Angeles   OOjs UI icon edit-ltr-progressive.svg
Education Doctor of Medicine   OOjs UI icon edit-ltr-progressive.svg
Alma mater
Occupation
Academic career
Institutions

Joseph Wolpe (20 April 1915 in Johannesburg, South Africa – 4 December 1997 in Los Angeles) was a South African psychiatrist and one of the most influential figures in behavior therapy.

Contents

Wolpe grew up in South Africa, attending Parktown Boys' High School and obtaining his MD from the University of the Witwatersrand.

In 1956 Wolpe was awarded a Ford Fellowship and spent a year at Stanford University in the Center for Behavioral Sciences, subsequently returning to South Africa but permanently moving to the United States in 1960 when he accepted a position at the University of Virginia.

In 1965 Wolpe accepted a position at Temple University. [1] [2]

One of the most influential experiences in Wolpe's life was when he enlisted in the South African army as a medical officer. Wolpe was entrusted to treat soldiers who were diagnosed with what was then called "war neurosis" but today is known as post traumatic stress disorder. The mainstream treatment of the time for soldiers was based on psychoanalytic theory, and involved exploring the trauma while taking a hypnotic agent - so-called narcotherapy. It was believed that having the soldiers talk about their repressed experiences openly would effectively cure their neurosis. However, this was not the case. [3] It was this lack of successful treatment outcomes that forced Wolpe, once a dedicated follower of Freud, to question psychoanalytic therapy and search for more effective treatment options. [4] Wolpe is most well known for his reciprocal inhibition techniques, [5] particularly systematic desensitization, which revolutionized behavioral therapy. A Review of General Psychology survey, published in 2002, ranked Wolpe as the 53rd most cited psychologist of the 20th century, [6] an impressive accomplishment accentuated by the fact that Wolpe was a psychiatrist.

Reciprocal inhibition

In Wolpe's search for a more effective way in treating anxiety he developed different reciprocal inhibition techniques, utilizing assertiveness training. Reciprocal inhibition can be defined as anxiety being inhibited by a feeling or response that is not compatible with the feeling of anxiety. Wolpe first started using eating as a response to inhibited anxiety in the laboratory cats. He would offer them food while presenting a conditioned fear stimulus. [7] After his experiments in the laboratory he applied reciprocal inhibition to his clients in the form of assertiveness training. The idea behind assertiveness training was that you could not be angry or aggressive while simultaneously assertive at same time. [8] Importantly, Wolpe believed that these techniques would lessen the anxiety producing association. Assertiveness training proved especially useful for clients who had anxiety about social situations. However, assertiveness training did have a potential flaw in the sense that it could not be applied to other kinds of phobias. Wolpe’s use of reciprocal inhibition led to his discovery of systematic desensitization. He believed that facing your fears did not always result in overcoming them but rather lead to frustration. According to Wolpe, the key to overcoming fears was "by degrees". [9]

Systematic desensitization

Systematic desensitization is what Wolpe is most famous for. [10] Systematic desensitization is when the client is exposed to the anxiety-producing stimulus at a low level, and once no anxiety is present a stronger version of the anxiety-producing stimulus is given. This continues until the individual client no longer feels any anxiety towards the stimulus. There are three main steps in using systematic desensitization, following development of a proper case formulation [11] or what Wolpe originally called, "behavior analysis". The first step is to teach the client relaxation techniques. [12]

Wolpe received the idea of relaxation from Edmund Jacobson, modifying his muscle relaxation techniques to take less time. Wolpe’s rationale was that one cannot be both relaxed and anxious at the same time. [13] The second step is for the client and the therapist to create a hierarchy of anxieties. The therapist normally has the client make a list of all the things that produce anxiety in all its different forms. Then together, with the therapist, the client makes a hierarchy, starting with what produces the lowest level of anxiety to what produces the most anxiety. Next is to have the client be fully relaxed while imaging the anxiety producing stimulus. Depending on what their reaction is, whether they feel no anxiety or a great amount of anxiety, the stimulus will then be changed to a stronger or weaker one. [14] Systematic desensitization, though successful, has flaws as well. The patient may give misleading hierarchies, have trouble relaxing, or not be able to adequately imagine the scenarios. Despite this possible flaw, it seems to be most successful. [15]

Achievements

Wolpe's effect on behavioral therapy is long-lasting and extensive. He received many awards for his work in behavioral science. [16] His awards included the American Psychological Associations Distinguished Scientific Award, the Psi Chi Distinguished Member Award, and the Lifetime Achievement Award from the Association for the Advancement of Behavior Therapy, where he was the second president. [2] In addition to these awards, Wolpe’s alma mater, University of Witwatersrand, awarded him an honorary doctor of science degree in 1986. Furthermore, Wolpe was a prolific writer, some of his most famous books include, The Practice of Behavior Therapy and Psychotherapy by Reciprocal Inhibition. Joseph Wolpe’s dedication to psychology is clear in his involvement in the psychology community, a month before his death he was attending conferences and giving lectures at Pepperdine University even though he was retired. Moreover, his theories have lasted well beyond his death.

Wolpe developed the Subjective Units of Disturbance Scale (SUDS) for assessing the level of subjective discomfort or psychological pain. He also created the Subjective Anxiety Scale (SAS) and the Fear Survey Plan that are used in behavior research and therapy. [2]

Wolpe died in 1997 of mesothelioma. [17]

Bibliography

Related Research Articles

Hypnotherapy is a type of alternative medicine in which hypnosis is used to create a state of focused attention and increased suggestibility during which positive suggestions and guided imagery are used to help individuals deal with a variety of concerns and issues.

Phobia Anxiety disorder defined by a persistent and excessive fear of an object or situation

A phobia is a type of anxiety disorder defined by a persistent and excessive fear of an object or situation. Phobias typically result in a rapid onset of fear and are present for more than six months. Those affected will go to great lengths to avoid the situation or object, to a degree greater than the actual danger posed. If the object or situation cannot be avoided, they experience significant distress. Other symptoms can include fainting, which may occur in blood or injury phobia, and panic attacks, which are often found in agoraphobia. Around 75% of those with phobias have multiple phobias.

Psychotherapy is the use of psychological methods, particularly when based on regular personal interaction with adults, to help a person change behavior and overcome problems in desired ways. Psychotherapy aims to improve an individual's well-being and mental health, to resolve or mitigate troublesome behaviors, beliefs, compulsions, thoughts, or emotions, and to improve relationships and social skills. There are also numerous types of psychotherapy designed for children and adolescents, such as play therapy. Certain psychotherapies are considered evidence-based for treating some diagnosed mental disorders. Others have been criticized as pseudoscience.

Acrophobia Extreme or irrational fear of heights

Acrophobia is an extreme or irrational fear or phobia of heights, especially when one is not particularly high up. It belongs to a category of specific phobias, called space and motion discomfort, that share both similar causes and options for treatment.

Assertiveness is the quality of being self-assured and confident without being aggressive. In the field of psychology and psychotherapy, it is a skill that can be learned and a mode of communication. Dorland's Medical Dictionary defines assertiveness as:

Behaviour therapy or behavioural psychotherapy is a broad term referring to clinical psychotherapy that uses techniques derived from behaviourism and/or cognitive psychology. It looks at specific, learned behaviours and how the environment, or other people's mental states, influences those behaviours, and consists of techniques based on learning theory, such as respondent or operant conditioning. Behaviourists who practice these techniques are either behaviour analysts or cognitive-behavioural therapists. They tend to look for treatment outcomes that are objectively measurable. Behaviour therapy does not involve one specific method but it has a wide range of techniques that can be used to treat a person's psychological problems.

Andrew Salter was the founder of conditioned reflex therapy, an early form of behaviour therapy which emphasized assertive and expressive behaviour as the way to combat the inhibitory personality traits which Salter believed were the underlying cause of most neuroses. In the 1940s, Salter introduced to American psychotherapy a Pavlovian model of hypnotherapy and self-hypnosis training.

Systematic desensitization, also known as graduated exposure therapy, is a type of behavior therapy developed by South African psychiatrist, Joseph Wolpe. It is used in the field of clinical psychology to help many people effectively overcome phobias and other anxiety disorders that are based on classical conditioning, and shares the same elements of both cognitive-behavioral therapy and applied behavior analysis. When used by the behavior analysts, it is based on radical behaviorism, as it incorporates counterconditioning principles, such as meditation and breathing. From the cognitive psychology perspective, however, cognitions and feelings trigger motor actions.

Somatic experiencing is a form of alternative therapy aimed at relieving the symptoms of post-traumatic stress disorder (PTSD) and other mental and physical trauma-related health problems by focusing on the client's perceived body sensations. It was developed by trauma therapist Peter A. Levine.

Flooding, sometimes referred to as in vivo exposure therapy, is a form of behavior therapy and desensitization—or exposure therapy—based on the principles of respondent conditioning. As a psychotherapeutic technique, it is used to treat phobia and anxiety disorders including post-traumatic stress disorder. It works by exposing the patient to their painful memories, with the goal of reintegrating their repressed emotions with their current awareness. Flooding was invented by psychologist Thomas Stampfl in 1967. It is still used in behavior therapy today.

A Subjective Units of Distress Scale is a scale of 0 to 10 for measuring the subjective intensity of disturbance or distress currently experienced by an individual. The individual self assesses where they are on the scale. The SUDS may be used as a benchmark for a professional or observer to evaluate the progress of treatment. In desensitization-based therapies, such as those listed below, the patients' regular self assessments enable them to guide the clinician repeatedly as part of the therapeutic dialog.

Francine Shapiro was an American psychologist and educator who originated and developed eye movement desensitization and reprocessing (EMDR), a form of psychotherapy for resolving the symptoms of traumatic and other disturbing life experiences.

Cynophobia is the fear of dogs and canines in general. Cynophobia is classified as a specific phobia, under the subtype "animal phobias". According to Dr. Timothy O. Rentz of the Laboratory for the Study of Anxiety Disorders at the University of Texas, animal phobias are among the most common of the specific phobias and 36% of patients who seek treatment report being afraid of dogs or cats. Although snakes and spiders are more common animal phobias, cynophobia is especially debilitating because of the high prevalence of dogs and the general ignorance of dog owners to the phobia. The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) reports that only 12% to 30% of those suffering from a specific phobia will seek treatment.

Exposure hierarchy

In exposure therapy, an exposure hierarchy is developed to help clients confront their feared objects and situations in a manner that is systematic and controlled for the purpose of systematic desensitization. Exposure hierarchies are included in the treatment of a wide range of anxiety disorders.

In psychology, desensitization is a treatment or process that diminishes emotional responsiveness to a negative, aversive or positive stimulus after repeated exposure to it. Desensitization also occurs when an emotional response is repeatedly evoked in situations in which the action tendency that is associated with the emotion proves irrelevant or unnecessary. The process of desensitization was developed by psychologist Mary Cover Jones, and is primarily used to assist individuals in unlearning phobias and anxieties. Joseph Wolpe (1958) developed a method of a hierarchal list of anxiety evoking stimuli in order of intensity, which allows individuals to undergo adaption. Although medication is available for individuals suffering from anxiety, fear or phobias, empirical evidence supports desensitization with high rates of cure, particularly in clients suffering from depression or schizophrenia.

Exposure therapy is a technique in behavior therapy to treat anxiety disorders. Exposure therapy involves exposing the target patient to the anxiety source or its context without the intention to cause any danger. Doing so is thought to help them overcome their anxiety or distress. Procedurally, it is similar to the fear extinction paradigm developed studying laboratory rodents. Numerous studies have demonstrated its effectiveness in the treatment of disorders such as generalized anxiety disorder, social anxiety disorder, obsessive-compulsive disorder, PTSD, and specific phobias.

Arnold Allan Lazarus was a South African-born clinical psychologist and researcher who specialized in cognitive therapy and is best known for developing multimodal therapy (MMT). A 1955 graduate of South Africa's CHIPS University of the Witwatersrand, Lazarus' accomplishments include authoring the first text on cognitive behavioral therapy (CBT) called Behaviour Therapy and Beyond and 17 other books, over 300 clinical articles, and presidencies of psychological associations; he received numerous awards including the Distinguished Psychologist Award of the Division of Psychotherapy from the American Psychological Association, the Distinguished Service Award from the American Board of Professional Psychology, and three lifetime achievement awards. Lazarus was a leader in the self-help movement beginning in the 1970s writing books on positive mental imagery and avoiding negative thoughts. He spent time teaching at various universities in the United States including Rutgers University, Stanford University, Temple University Medical School, and Yale University, and was executive director of The Lazarus Institute, a mental health services facility focusing on CBT.

A driving phobia is a pathological fear of driving. It is also referred to as amaxophobia or vehophobia. Amaxophobia is an intense, persistent fear of participating in car traffic that interferes with the patient’s lifestyle and quality of life, including aspects such as inability to participate in the workforce due to the pathological and self-defeating avoidance of driving. The fear of driving may be triggered by specific driving situations, such as expressway driving or dense traffic. Driving anxiety can range from a mild cautious concern to an irrational phobia.

David H. Barlow

David H. Barlow is an American psychologist and Professor Emeritus of Psychology and Psychiatry at Boston University. He is board certified by the American Board of Professional Psychology (ABPP). Barlow is known for his research and publications on the etiology, nature, and treatment of anxiety disorders. The models and treatment methods that he developed for anxiety and related disorders are widely used in clinical training and practice. Barlow is one of the most frequently cited psychologists in the world.

References

  1. Stanley Rachman (April 2000), "Obituaries: Joseph Wolpe (1915–1997)", American Psychologist, 55 (4): 441–442, doi:10.1037/0003-066x.55.4.431
  2. 1 2 3 Pace, Eric (8 December 1997), "Dr. Joseph Wolpe, 82, Dies; Pioneer in Behavior Therapy", The New York Times
  3. Joseph Wolpe and David Wolpe, Our Useless Fears, (Boston: Houghton Mifflin Company, 1981), 3–4.
  4. Wolpe and Wolpe, Our Useless Fears, 4.
  5. Wolpe, Joseph (1 August 1954). "Reciprocal inhibition as the main basis of psychotherapeutic effects". Archives of Neurology and Psychiatry. 72 (2): 205–226. doi:10.1001/archneurpsyc.1954.02330020073007. PMID   13180056.
  6. Haggbloom, Steven J.; Warnick, Renee; Warnick, Jason E.; Jones, Vinessa K.; Yarbrough, Gary L.; Russell, Tenea M.; Borecky, Chris M.; McGahhey, Reagan; Powell, John L., III; Beavers, Jamie; Monte, Emmanuelle (2002). "The 100 most eminent psychologists of the 20th century". Review of General Psychology. 6 (2): 139–52. CiteSeerX   10.1.1.586.1913 . doi:10.1037/1089-2680.6.2.139. S2CID   145668721.
  7. Joseph Wolpe, Psychotherapy by Reciprocal Inhibition, (California: Stanford University Press, 1958), 53-62.
  8. Wolpe, Reciprocal Inhibition, 72–75.
  9. Wolpe, Reciprocal Inhibition, 71.
  10. Joseph Wolpe and Arnold Lazarus, Behavior Therapy Techniques, (Oxford: Pergamon Press Ltd., 1996), 55-56.
  11. Joseph Wolpe and Ira Turkat, Behavioral formulation of clinical cases in I.D. Turkat (Ed.) Behavioral Case Formulation, (New York: Plenum/Springer, 1985).
  12. Joseph Wolpe, The Practice of Behavioral Therapy, (New York: Pergamon Press, Ltd., 1969), 100-122.
  13. Wolpe, The Practice of Behavioral Therapy, 95
  14. Wolpe, The Practice of Behavioral Therapy, 100-122
  15. Wolpe, The Practice of Behavioral Therapy, 138-149.
  16. Rachman, "Joseph Wolpe", 441-442
  17. Pace, Eric (8 December 1997). "Dr. Joseph Wolpe, 82, Dies; Pioneer in Behavior Therapy". The New York Times.