Wolpe J
Department of Psychology, Pepperdine University, Graduate School of Education and Psychology, Culver City, CA 90310.
J Behav Ther Exp Psychiatry. 1993 Jun;24(2):141-7. doi: 10.1016/0005-7916(93)90042-u.
During the 1980s the behavior therapy movement was infiltrated by cognitivists, people who believe that all maladaptive fears are based on wrong beliefs and all can be overcome by cognitive correction. This article asserts and defends the following propositions: (1) There are numerous maladaptive fears demonstrably immune to cognitive correction but removable by deconditioning. (2) These conditioning based fears constitute the majority, but there are also some based on mistaken beliefs. (3) Proponents of the cognitivist viewpoint have overrated the outcomes of cognitive therapy, because they have not realized the fact that conditioned anxiety is often inadvertently weakened by simultaneous competing emotions (nonspecific therapeutic effects). (4) This overrating led to the fiction that cognitive-behavior therapy is behavior therapy's best resource to overcome non-psychotic depression, a fiction that was exposed by cognitive-behavior therapy's inferior performance in the National Institute of Mental Health's Collaborative Research Project. (5) There is data to suggest that use of the full resources of behavior therapy would have produced notably superior results. The commentary concludes with comments on the other contributions to the symposium, From Behavior Theory to Behavior Therapy.
在20世纪80年代,行为疗法运动受到认知主义者的渗透,认知主义者认为所有适应不良的恐惧都基于错误信念,并且都可以通过认知矫正来克服。本文主张并捍卫以下命题:(1)存在许多适应不良的恐惧,这些恐惧显然不受认知矫正的影响,但可以通过去条件作用消除。(2)这些基于条件作用的恐惧占大多数,但也有一些基于错误信念。(3)认知主义观点的支持者高估了认知疗法的效果,因为他们没有意识到这样一个事实,即条件性焦虑常常会因同时存在的竞争性情绪(非特异性治疗效果)而无意中减弱。(4)这种高估导致了一种错误观念,即认知行为疗法是行为疗法克服非精神病性抑郁症的最佳方法,而这种错误观念在国立精神卫生研究所的合作研究项目中,因认知行为疗法的较差表现而被揭露。(5)有数据表明,充分利用行为疗法的全部资源会产生明显更好的效果。评论最后对专题研讨会《从行为理论到行为疗法》的其他贡献发表了看法。