Psychoanalytic Therapy and Behavior Therapy: Is Integration Possible?

380 Pages·1984·12.856 MB·English

by  Hal Arkowitz (auth.), Hal Arkowitz, Stanley B. Messer (eds.)

Psychoanalytic Therapy
and Behavior Therapy
Is Integration Possible?
Psychoanalytic Therapy
and Behavior Therapy
Is Integration Possible?
EDITED BY
HAL ARKOWITZ
University of Arizona
Tucson, Arizona
AND
STANLEY B. MESSER
Rutgers University
New Brunswick, New Jersey
PLENUM PRESS • NEW YORK AND LONDON
Library of Congress Cataloging in Publication Data
Main entry under title:
Psychoanalytic therapy and behavior therapy.
Includes bibliographical references and index.
1. Psychotherapy-Addresses, essays, lectures. 2. Psychoanalysis-Address
es, essays, lectures. 3. Behavior therapy-Addresses, essays, lectures. I.
Arkowitz, Hal, 1941- . II. Messer, Stanley B. [DNLM: 1. Behavior
Therapy. 2. Psychoanalytic Therapy. WM 460.6 P9743]
RC480.5.P73 1984 616.89'14 84-9898
ISBN-13: 978-1-4612-9694-2 e-ISBN-13: 978-1-4613-2733-2
DOl: 10.1007/978-1-4613-2733-2
©1984 Plenum Press, New York
A Division of Plenum Publishing Corporation
233 Spring Street, New York, N.Y. 10013
Softcover reprint of the hardcover 1s t edition 1984
All rights reserved
No part of this book may be reproduced, stored in a retrieval system, or
transmitted in any form or by any means, electronic, mechanical,
photocopying, microfilming, recording, or otherwise, without written
permission from the Publisher
Lovingly dedicated to our parents:
Ruth Arkowitz
William Arkowitz (in memoriam)
Sylvia Messer
Nathan Messer
Contributors
Hal Arkowitz, Ph.D., Department of Psychology, University of Arizona, Tucson,
Arizona
Cyril M. Franks, Ph.D., Graduate School of Applied and Professional Psychology,
Rutgers University, Busch Campus, Piscataway, New Jersey
Merton M. Gill, M.D., Department of Psychiatry, University of Illinois, Chicago,
Illinois
Alan E. Kazdin, Ph.D., Western Psychiatric Institute and Clinic, University of Pitts
burgh School of Medicine, Pittsburgh, Pennsylvania
Michael J. Mahoney, PhD., Department of Psychology, Pennsylvania State Uni
versity, University Park, Pennsylvania
Eric Mendelsohn, PhD., The New York Hospital-Cornell Medical Center, West
chester Division, White Plains, New York
Stanley B. Messer, Ph.D., Graduate School of Applied and Professional Psychology,
Rutgers University, Busch Campus, Piscataway, New Jersey
John M. Rhoads, MD., Department of Psychiatry, Duke University Medical Center,
Durham, North Carolina
Leon Salzman, M.D., School of Medicine, Georgetown University, Washington, D.c.
vii
viii CONTRIBUTORS
Thomas E. Schacht, Psy.D., Center for Psychotherapy Research and Department of
Psychology, Vanderbilt University, Nashville, Tennessee
Lloyd H. Silverman, Ph.D., New York Veterans Administration Regional Office,
New York, New York and Department of Psychology, New York University, New
York, New York
Paul L. Wachtel, Ph.D., Department of Psychology, City College of the City University
of New York, New York, New York
Meir Winokur, Psy.D., Student Counseling Service, Hebrew University, Jerusalem,
Israel
Preface
This book has a question mark in its title because it aims to invite inquiry.
The possibility of integrating psychoanalytic and behavior therapies has
been controversial since it was first proposed about 50 years ago, and this
has elicited a wide range of reactions from both psychologists and psy
chiatrists. It was with the hope of fostering constructive interchange that
this book was conceived. We wanted to spark further thinking about the
question in the title in a way that could lead either to conceptual and
clinical progress toward an integrated approach or to a clearer sense of the
obstacles involved. In either case, we hoped that it would present a healthy
challenge to current forms of psychoanalytic and behavior therapies.
The present volume was stimulated by the appearance in 1977 of Paul
Wachtel's book Psychoanalysis and Behavior Therapy: Toward an Integration. Al
though many reviewers did not necessarily agree with Wachtel's proposals
for integration, they (and we) were highly laudatory of his attempt. After
reading the book, Hal Arkowitz organized a symposium on integration
that took place in Chicago at the November 1978 meeting of the Association
for the Advancement of Behavior Therapy. The symposium included Cyril
Franks, Merton Gill, Hans Strupp, Paul Wachtel, and Michael Merbaum
as moderator. Arkowitz subsequently proposed to edit a book on integra
tion and invited Messer to be coeditor. In this way, there was a joining
of forces between one behaviorally oriented editor leaning toward inte
gration (Arkowitz) and one psychoanalytically oriented editor leaning away
from it (Messer).
The effort and involvement by the two editors of this book have been
truly equal, and the order of editorship was determined alphabetically.
Together, we selected contributors from the fields of psychiatry and clinical
psychology who held different points of view about the possibility of
integrating psychoanalytic and behavior therapies. We asked each to ad
dress the main question of whether integrating these two approaches was
ix
x PREFACE
possible or practical and to spell out his position in some detail. The result
was a range of thoughtful contributions that emphasized either theoretical,
philosophical, empirical, or clinical issues.
To encourage an interchange of ideas further, we sent each contributor
one of the chapters on which to comment. Chapter authors were given
the opportunity to write a rejoinder to the commentary if they wished to
do so. Some chose to respond, whereas others felt that a rejoinder was not
necessary. The book begins with a chapter that gives a historical perspective
on integration, and this is followed by a series of separately authored
chapters, commentaries, and rejoinders. Each chapter is accompanied by a
brief autobiographical statement giving the background of the author's
interest in the question of integration. We hope that this provides a more
personal touch and a context for their contributions. The book concludes
with an overview of the central emergent themes, including the models
of integration that are proposed and the controversies they raise.
We would like to thank a number of people who helped facilitate the
task of preparing this book for publication. We especially appreciate the
devoted help of our secretaries who were asked to prepare material that
needed to be completed "no later than yesterday." At the University of
Arizona, we wish to thank Rufulyn Andrew, Susan Diffenderfer, Nancy
Hobbs, Alice Traut-Cavell, and Cathy Wylie, and, at Rutgers University,
Karen Peterson and Sylvia Sorgo
Finally, we want to make special mention of our families. Hal Arkowitz
would like to thank his daughters, Laura and Jennifer, for their enjoyable
company and games of Centipede during breaks from working on the
book. Stanley Messer would like to thank his wife, Donna, for her loving
support and insightful comments on his work, and his daughters, Elana,
Leora, and Tova, for their willingness to "play ball" with their sometimes
distracted father.
HAL ARKOWITZ
STANLEY B. MESSER
Contents
1. Historical Perspective on the Integration of Psychoanalytic
Therapy and Behavioral Therapy................. . . . . . . . . . . . . . . . . . 1
Hal Arkowitz
2. On Theory, Practice, and the Nature of Integration ......... " . . . 31
Paul L. Wachtel
Psychoanalytic Therapy versus Psychodynamic Therapy:
Commentary on Paul L. Wachtel.................................. 53
Stanley B. Messer and Meir Winokur
A Rejoinder to Stanley B. Messer and Meir Winokur........... 59
Paul L. Wachtel
3. Ways of Knowing and Visions of Reality in Psychoanalytic
Therapy and Behavior Therapy.................................... 63
Stanley B. Messer and Meir Winokur
Tragedy, Irony, and Human Assistance: Commentary on Stanley
B. Messer and Meir Winokur. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 101
Paul L. Wachtel
4. The Varieties of Integrative Experience........................... 107
Thomas E. Schacht
xi