Is behavior therapy or insight-oriented therapy more effective?

Dr. Kinarthy: The problem is: “How does someone realize that their behavior is “maladaptive” except by self-consciousness? But that is precisely what the behaviorists deny is possible. Behaviorism is committed–as a “first principle,” as an ultimate assumption, as a fundamental premise–that self-consciousness is impossible; that all behavior is a response to external stimuli, to stimulus-response mechanisms. Reflexive thinking doesn’t even enter into it for classical behaviorism.Also, it’s not so much a matter of getting excited about “talking” and l “listening” but of hearing and empathizing. Of getting “within” the “soul” and distress of the other. That’s where it all has to start. To help by first understanding what the other wants help with.Notice 2 Comments above:Gabrielle Chorney: “Insight is needed to understand and adjust behavior.” First self-conscious insight: then the effort to alter behavior!

Again, Gullian Solomon: “…it seems that the that the important thing is that the insight comes from the patient” and not the contractual goals that the therapist devises in his/her “treatment plan” for the patient. That’s precisely the problem. As a profession, we turn the “patient” into a passive subject to be worked on by thinking we know best what is good for them.

By Ben Mijuskovic

Dear Ben Mijuskovic. Let me respond to your email through my blog in a public way in the form of making comments. Agreement between professionals about this issue can help or hinder progress not only in therapy but is human relations as a whole. You may or may not accept my comments as true, but to me that form of response is best when an issue is intractable:

1. Have you heard of the fallacy called “begging the question”? Forcing a dichotomy between behavior and insight is logical but not ethical or scientific. I should stop responding right here but I will continue for the sake of helping your knowledge get rid of bias. A more ethical, truthful and scientific question would be: Are behavior therapy and insight therapy in conflict about effectiveness? The answer is NO!

2. Behavior is not maladaptive because you or DSM 5 say so. You don’t get to play God as a therapist. Behavior is maladaptive when a person behaves in such a way that he can’t hold a job or carry on an honest relationship. Classical behaviorism is like classical economics, it’s a dead horse (end) that died last century. You can advance in the profession by studying behavioral psychology for the 21st century.

3. The rest of your comments are much ado about nothing, a discussion that is more useful for therapists than for patients. Now, that I have convinced you fellows of nothing, have a good day. I hope that I didn’t  offend you, but you think in the box too much. Go out into the fresh air and take your patients with you.



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