Symptoms, Insight, and Behavior Techniques in Psychoanalytic Psychotherapy*

Behavior therapy literature reports significant success in the reduction of psychopathology without the application of insight therapy.4,5,6,7,13,18,19,23,24 Many reports flatly state that the search for intrapsychic causes of tics, phobias, sexual disabilities, obsessions, etc. is a waste of time since such symptomatology is based on learning, or habit formation, and does not arise from internal causes or conflicts; nor is it necessary to analyze the client's verbalized mental content in order to cure a neurosis. Moreover, the behavior therapist discounts the function of other psychodynamic issues, such as transference motivation, despite the behaviorist's close attention to the relationship between therapist and client. However, even Lehner,14 in quoting Dunlap's original work4,5 in negative practice technique, emphasized ideation, affect, and motivation as being crucial components of Dunlap's relationships which were devoted to reducing thumbsucking, stuttering, homosexuality, and typing errors. Later behavior practitioners7,24 also underscore the patient's “expectations of help,” and that general “benefits accrue … when people establish close rapport.”

Motivation, both affectual and ideational, and the desire for close rapport, would seem to be located internally, however they might have originated. To belabor the point, the behavior therapist's recognition of the client's “desire” for something called “help or close rapport” implies awareness of the existence of the client's