!!   spellx done
127  Sickness of the Mind
     The Washington Post  Saturday, December 8, 1968

     Recent work on the experimental psychology of laboratory animals
has focused renewed attention on the mutual relationship of bodily 
states and emotional disturbances as a central factor in mental
health. The medical profession and the interested public has, by now,
become reasonably perceptive about psychosomatic disease: the extent
to which emotional unbalance can distort bodily functions and -
eventually produce such gross pathology as a bleeding ulcer.

     We are now at the point of rediscovering some common-sense truths
about the self-perception of disturbance in body functions and its 
impact on emotional stability.  Muscular tensions, high heart rate and
blood pressure, clammy perspiration, intestinal cramp or flabbiness
and sleeplessness are examples of such disturbances with which are all
familiar, and we know we do not experience them without immediate
threat to mood.  The same symptoms are also the most typical 
consequences of emotional upset, and it is easy to see how a vicious 
cycle can be started, like the man who stays up nights worrying about  
his insomnia and about the impact of his lack of sleep on his daily 
life.

     These demons are reinforced by the psychological fact that 
information received during emotional stress is hard to evaluate 
correctly, tends to be fixed more readily in memory and becomes a 
a further cue for generating more tension.

     Behavioral therapy is a new school of psychotherapy. According to
its acknowledged leader, Professor Joseph Wolpe of Temple University
Medical School in Philadelphia, "neuroses are persistent learned 
unadaptive habits. These habits are acquired under conditions of anxiety
arousal...the anxiety can be reversed only through applying the 
learning process so as to involve this primitive level."

     Dr. Wolpe therefore treats his patients by desensitizing them to
cues that elicit their anxiety.  He believes that primitive anxiety is
incompatible with muscular relaxation, voiced assertion of grievances
and gratification of drives like sex and hunger, and he therefore uses
all of these techniques to make his patients more receptive to learning
to cope with small, ever-increasing doses of anxiety-provoking 
thoughts and situations. He rather pointedly sidesteps the elaborate
controversies of freudian psychoanalysis and the other warring camps
of psychodynamic theories.

     Behavioral therapy has been attracting growing attention - and
criticism - from psychiatrists, especially for its claim for objective
statistical evidence of its effectiveness.

     Happily, psychiatrists are far less deeply divided in the ways
they actually deal with their patients than in the theories they sup-
port. An article in the American Journal of Psychiatry by Dr. Barry M.
Brown, recently a resident in psychiatry at Temple, characterizes Dr.
Wolpe and his techniques in some detail and in the most praiseworthy
terms - above all for his warmth and respect for and insight into his
patient's problem. This is as embarrassing as it is irrefutable, for
it becomes impossible to judge the efficacy of behavioral therapy as a
system apart from the therapeutic personality of the psychiatrist.  On
the other side of the fence, the psychoanalyst's couch is an excellent
place to relax.

     It is obviously impossible to do controlled double-blind 
experiments on methods of psychotherapy, and we may always have to stay 
in the position of exploiting the expectations of both doctor and 
patient as part of healing.

     We may not be able to go much further in evaluating different
systems than by critical common sense, and by incorporating what
little we can glean from hard science that relates to human depth
psychology.
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