CHANGING THE FACE OF PSYCHOTHERAPY AND COMMON SENSE: JOSEPH WOLPE, 20 APRIL 1915 – 4 DECEMBER 1997

Abstract

In 1958, Dr Joseph Wolpe published a book (Psychotherapy by reciprocal inhibition) in which he not only claimed that it was possible to treat the symptoms of anxiety by helping patients to confront their fears, but also systematically to evaluate such effects. These suggestions were greeted with scorn by the psychoanalytic establishment, which maintained that symptomatic treatment that did not deal with the “cause’ of neuroses would inevitably result in “symptom substitution”. The prevailing view was that problems such as phobias were defences against deep seated conflicts, and that the removal of such symptoms would at best be ineffective, and at worst be harmful by destabilizing the patient's psyche. The notion that the effectiveness of psychotherapy could be scientifically evaluated in controlled studies was also rejected by analysts as irrelevant to their work. Forty years later the work instigated by this quiet, gentle and determined man has resulted in cognitive-behavioural therapy substantially replacing psychoanalysis as the psychological treatment of choice. Furthermore, Wolpe's view has passed into “common sense”, which now maintains that anxieties are best reduced by confronting them. His emphasis on controlled evaluation of the efficacy of the treatment he advocated anticipated current interest in “evidence based” approaches to mental health by more than three decades.