Most of the currently available methods for the psychological treatment of behavioral disturbances (including sexual disturbances) are one of two models, the psychoanalytic or the behavioral. The psychoanalytic methods range from the orthodox free-association and dream interpretation to the newer methods such as primal scream and bioenergetics. All have in common the “freeing” of unconscious forces and feelings and the consequent change in the behavioral disturbance. The behavioral model provides a completely opposite approach. It either denies, ignores, or minimizes unconscious forces and attempts to change the disturbed behavior directly. To understand fully the behavioral approach to the treatment of sexual disorders, the difference between these two models must be examined.
One clarification of the difference between the two models is provided by Wachtel’s consideration of the unconscious processes. He argues that these processes may be viewed as either independent variables or as dependent variables.
When these unconscious processes are considered as independent variables, it is assumed that they are tendencies within the person, locked in the past and unresponsive to current events in the person’s life. They exert a pressure unchanging in quality or intensity. Behavior is the dependent variable in that these unconscious forces influence feelings, perceptions, and actions. Changing the independent variables, the unconscious processes, thus is the only way to change the dependent variables, the behaviors. Insight, conflict resolution, working-through, abreaction, and other methods stemming from the Freudian paradigm are the only means of altering the behavioral disturbance, in a meaningful way.
But when considered as a dependent variable, it is the reverse: the person’s action and life-style influence the unconscious processes. Although the unconscious processes originally may have caused the person to act in certain ways, to form a given life-style, it is these actions and their consequences that now perpetuate and maintain these very same unconscious forces. By deliberately changing specific behaviors (now considered the independent variable), not only may various symptoms be made to disappear, but also the (dependent) intrapsychic forces maintained by these behaviors may be changed. Following this line of reasoning, changing behaviors does lead to “deeper” change even in the Freudian sense of these words. The technology of behavior therapy is the most effective means for achieving these behavioral changes.
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