Marks I M
Psychol Med. 1979 Nov;9(4):629-60. doi: 10.1017/s0033291700033961.
Behavioural psychotherapy has long historical roots. Recently it has led to effective treatment for selected neuroses, including phobic, obsessive-compulsive and sexual disorders. Potent therapy has become a tool of experimental psychopathology which advances theory and practice. A pervasive principle is exposure of the patient to those stimuli which evoke his discomfort until this subsides. Level of arousal during exposure does not affect outcome. Theoretical issues are reviewed which decide when exposure will be sensitizing or habituating. Both psychoanalytical and conditioning models of neurosis are out of date, and models derived more directly from clinical experiment are becoming possible. The aetiology of phobias and rituals can be seen as failed extinction rather than enhanced acquisition. Relevant phylogenetic and biological factors are discussed. At the other extreme, well-documented faith-healing indicates huge gaps in our knowledge of psychotherapy.
行为心理治疗有着悠久的历史根源。最近，它已发展出针对某些神经症的有效治疗方法，包括恐惧症、强迫症和性功能障碍。强效治疗已成为实验性精神病理学的一种工具，推动了理论和实践的发展。一个普遍的原则是让患者接触那些引发其不适的刺激，直到这种不适消退。暴露期间的唤醒水平并不影响治疗结果。文中回顾了一些理论问题，这些问题决定了何时暴露会导致敏感化或习惯化。神经症的精神分析模型和条件作用模型都已过时，而更直接源自临床实验的模型正变得可行。恐惧症和仪式行为的病因可被视为消退失败而非习得增强。文中还讨论了相关的系统发育和生物学因素。在另一个极端，有充分记录的信仰治疗表明我们在心理治疗知识方面存在巨大差距。
