Downloaded by [New York University] at 02:06 15 August 2016 O

Downloaded by [New York University] at 02:06 15 August 2016 O. H. MOWRER’S THEORY OF INTEGRITY THERAPY REVISITED In the mid-20th century, O. H. Mowrer was a celebrated academic psycholo- gist, owing largely to his experiments with animals and humans that led to breakthrough theories on how we learn. His numerous publications in this arena propelled him to the post of President of the American Psychological Association in 1954. His own battles with depression led him to develop a new theory of psychotherapy, which he called Integrity Therapy. The premise of this modality is that the client’s deception with people they care about is the source of conscience pangs, but the client resists or represses the prompting of the conscience, and this causes his or her psychological symptoms. Treat- ment, therefore, consists of urging the clients to acknowledge their hidden behaviors to themselves and to signifi cant others that they might both gain restored community with intimates and the fruits of personal integrity and inner peace (to come clean about their deceptions and rewarding the confession with approval.) This book explores the conceptual underpinnings of Integrity Therapy and Mowrer’s unique treatment approach, detailing his methods for setting conditions for therapy, assessing clinical data, rules of engagement for transference and countertransference, and handling client resistance. Case examples and transcripts are included to demonstrate key points of this technique. Mental health professionals interested in Mowrer’s ideas or the history of psychotherapy will fi nd this book to be a valuable and interesting resource. V. Edwin Bixenstine , Ph.D., ABEPP, is Emeritus Professor of Psychology, Downloaded by [New York University] at 02:06 15 August 2016 Kent State University, Ohio. He obtained his doctorate under the mentoring of Dr. O. H. Mowrer at the University of Illinois in 1953. After working as a clinician at a neuropsychiatric hospital and later at an outpatient clinic, he accepted an appointment as clinical instructor at Kent State. In due course, he inaugurated a therapeutic community, called Community House, based on the concept that those receiving help were also purveyors of help. Downloaded by [New York University] at 02:06 15 August 2016 O. H. MOWRER’S THEORY OF INTEGRITY THERAPY REVISITED V. Edwin Bixenstine Downloaded by [New York University] at 02:06 15 August 2016 First published 2014 by Routledge 711 Third Avenue, New York, NY 10017 and by Routledge 27 Church Road, Hove, East Sussex BN3 2FA Routledge is an imprint of the Taylor & Francis Group, an informa business © 2014 Taylor and Francis The right of V. Edwin Bixenstine to be identifi ed as author of this work has been asserted by him in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988. All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. Trademark notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identifi cation and explanation without intent to infringe. Library of Congress Cataloging-in-Publication Data Bixenstine, V. Edwin. O.H. Mowrer’s theory of integrity therapy revisited / by V. Edwin Bixenstine. pages cm Includes bibliographical references and index. 1. Mowrer, Orval Hobart, 1907–1982. 2. Psychoanalysts— United States—Biography. 3. Psychotherapist and patient. 4. Psychotherapy—Methodology. 5. Confession— Psychology. I. Title. II. Title: Mowrer’s theory of integrity therapy revisited. RC480.5.B573 2014 616.89′14—dc23 2013043918 ISBN: 978-0-415-72155-4 (hbk) ISBN: 978-1-315-86308-5 (ebk) Typeset in Galliard by Apex CoVantage, LLC Downloaded by [New York University] at 02:06 15 August 2016 CONTENTS Acknowledgments xi Introduction 1 Who Was O. H. Mowrer and What Were His Theories? 1 Mowrer’s Learning Theories 1 Mowrer’s Shift to Focusing on Psychotherapy 2 Why Do It? 4 Reason One 4 Reason Two 7 Reason Three 7 Reason Four 9 Reason Five 10 Conclusion 11 PART I The Therapeutic Process 15 1 Preview of Concept: A Point of Departure 17 Conceiving the Normal 18 Conceiving Psychopathology 19 Pathology as Addiction 20 Downloaded by [New York University] at 02:06 15 August 2016 Implications for Psychotherapy 21 2 The Introduction Stage: Establishing Contact 23 Choosing Your Perspective 23 Pain and Its Relief 25 Conclusion 28 v CONTENTS 3 The Introduction Stage: Establishing Conditions 31 The First Hour 31 Establishing Conditions: What to Avoid 31 Establishing Conditions: What to Embrace 33 The Typical Opening 34 Less Typical Cases: The “Helpless Person” 36 Other Atypical First Hours 40 Ending the First Hour 43 The Second Hour 46 Opening the Second Hour 46 Reinforcing the Conditions 46 Other Considerations 48 More on Taking Notes 48 How to Take Notes 50 The Use of Recordings 51 Conclusion 52 4 Engagement: The Clinical Data 55 The Clinical Data 56 Subjective Responses as Raw Clinical Data 56 Learning to Rely on Your Clinical Data 56 Clinical Data and Empiricism 57 First Steps in Processing the Clinical Data 58 The Perceptual Orientation of the Therapist 58 The First Message Detected: Acknowledging Pain 60 The First Message Detected: Primal Ambivalence 60 Resistance 62 Conclusion 63 5 Engagement: Some Useful Rules 65 Transference and Countertransference Revised 65 Transference and Ambivalence 65 Downloaded by [New York University] at 02:06 15 August 2016 Unavoidable Countertransference 66 Processing Countertransference as Clinical Data 67 Rule 1: Divergent Attention 67 Rule 2: Acknowledge Feelings and Tendencies 67 Rule 3: Is It Me? 70 Rule 4: Refrain from Acting Out Your Feelings and Tendencies 72 vi CONTENTS Don’t Rules in Working with Countertransference 73 Don’t Rule 1: Don’t Act Out Being AFRAID 74 Don’t Rule 2: Don’t Act Out Being ANGRY 77 Don’t Rule 3: Don’t Act Out Being AMOROUS 79 Don’t Rule 4: Don’t Act Out Being AMUSED 80 Don’t Rule 5: Don’t Act On APATHY 82 Don’t Rule 6: Don’t AGONIZE 83 Don’t Rule 7: Don’t ASK Questions 87 Don’t Rule 8: Don’t ANSWER Questions 89 Conclusion 90 6 From Insight to Action 91 Insight as a Map 91 A Less Than Perfect Fit 91 Insight and Effort 92 The Truth in Insight 92 The Test of Action: A Case Illustration 92 Whose Insight and When? 94 Conclusion 96 7 Client Actions 99 Client Disclosure 99 Disclosure as the First Action Taken 99 The Insistent Secret: A Case Study 100 Resistance to Disclosure 104 Disclosure Will Harm Others: The Primary Theme 104 The Intellectual Resistance: A Secondary Theme 111 It’s None of Their Business: A Secondary Theme 113 Conclusion 116 Endnote 117 8 Additional Client Actions 120 Compensation 120 Downloaded by [New York University] at 02:06 15 August 2016 The Subjectivity in Compensation 121 Enacting New Roles 126 Role-Play 126 Role-Play and Assertion 130 A Case of “Assertion Defi ciency” 132 vii CONTENTS Other Client Actions 136 Drawing on Micro-Behavioral and Cognitive Techniques 136 Case Examples Where Classical Conditioning May Be Applied 137 Joining a Group 138 Terminating Therapy 139 Conclusion 140 PART II The Nature of the Problem 143 9 Linking Psychotherapy to Pathology 145 The Goal of Psychotherapy 145 Goals Express Concept 145 The Means to Achieve the Goal of Psychotherapy 146 Recapturing Guilt 146 Faith and Hope 147 Restoring Community 149 A Graphic Rendering 151 Conclusion 155 10 The Nature of Normality 158 As Absence of Pathology 158 Are Normality and Pathology Independent? 158 A Limited Independence 159 An Otherworld Perspective 160 A Report to a Distant Planet 160 Human Interdependence 160 The Joys of the Moment 161 The Engineering of Integrative Behavior 162 Integrative Versus Adjustive Behavior 162 The Power of the Sign 163 A Matter of Passion 164 Downloaded by [New York University] at 02:06 15 August 2016 The Human as the Worrying Animal 165 The Normality of Worry 165 The Mystery of Worry 165 Worry: Omnipresent and Complex 167 Worry and Humor 168 The Benevolent Circle of Integration 169 A Continuing Mystery 169 Parent Mediation of Future Outcomes 170 viii CONTENTS “Priming the Pump” of Integrative Behavior 170 The Signifi cance of One’s Personal History 173 The Intimate Other 174 The “Improbable Flight” of Integrative Behavior 174 A Final Contributor: Intimate Community 176 A Special Kind of Conformity 178 Conclusion 179 11 The Nature of Pathology 183 On the Absence of or Departure from Normality 183 Integrative Behavior and Survival 183 Integrative and Adjustive Behavior 184 The Role of Guilt 185 The Law of Effects Over Time 186 Distinguishing Psychological From Biomedical Problems 186 Introducing the Dimension of Psychopathology 187 Psychopathology Defi ned 187 Pathological Deception 188 The Widespread Contempt for Guilt 189 The Dynamic Versus the Manifest in Psychopathology 190 A Classifi cation System 191 Nature of the Independence of Normality and Pathology 191 Commonly Used Labels 192 Characteristics Distinguishing Normality and Pathology 194 Ordering Quadrants According to Psychological Health 194 The Primitive Person 195 Psychopathology as Negative Addiction 197 Addiction: An Expanded Concept 197 Explaining Negative Addiction 198 The Precondition to the Development of Pathology 199 Failed Efforts at Self “Cure” 201 The Barrier of Despair 203 Conclusion 204 Downloaded by [New York University] at 02:06 15 August 2016 Postscript 207 Appendix 210 Bibliography 244 Index 249 ix This page intentionally left blank Downloaded by [New York University] at 02:06 15 August 2016 ACKNOWLEDGMENTS It is my good fortune to have a wife forever interested in my endeavors, but also herself a voracious reader, an English teacher, with an unerring apprecia- tion for the spelling, placement, and choice of words.

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