In vivo desensitization of a phobic shop steward.

Techniques used in behaviour therapy effectively counteract the symptoms presented by the patient. The question arises as to the precise nature of such intervention, and whether this form of treatment is in fact a superficial one which deals only with symptom removal, or whether this is really a much more fundamental form of therapy, in which the patient alters as a whole. The case reported here is of interest in that, during a course of in vivo desensitization, in which the therapist accompanied the patient on journeys through London, it was shown that, as the symptoms were alleviated, there were concomitant changes in his whole personality structure. He no longer needed to be a militant shop steward and developed an amicable relationship with his employers, and yet he was still able to negotiate a pay rise for the men. This suggests that the treatment had an effect on his hostility level, so that he could deal effectively with his superiors without the need to fight them. This has important theoretical and ethnical implications.