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A point-counterpoint clinical dialogue between a behavioral and a psychoanalytic practitioner underscores fundamental differences as well as shared points of emphasis. In discussing a case treated by Lazarus, Messer selected "choice points" where he would have intervened differently, while also noting significant commonalities. Lazarus's rejoinders and Messer's rebuttals help to clarify areas of divergence and convergence by focusing on practical rather than philosophical and theoretical issues.
Alongside the separate development of psychoanalytic therapy and behavior therapy have come efforts to juxtapose one with the other for the purpose of comparing, contrasting, or integrating these therapies. Such attempts have been carried out at quite different levels of analysis including the philosophical (Messer, 1986a; Schacht, 1984), the methodological (Franks, 1984), the metatheoretical (Messer & Winokur, 1980, 1984), the conceptual (Goldfried, 1980; Wachtel,
We express our gratitude to Allen Fay and Seth Warren for their incisive comments on an earlier draft of this article. A more extended version of this article was presented and commented on from a family systems perspective by Ellen Wachtel at the Third Annual Conference of the Society for the Exploration of Psychotherapy Integration, Evanston, Illinois, May 1987. Reprints may be ordered from Arnold A. Lazarus or Stanley B. Messer, GSAPP, Rutgers University, P.O. Box 819, Piscataway, NJ 08855-0819.
1984), and the clinical or technical (Rhoads, 1984; Wachtel, 1977). What the literature lacks, however, is clinical dialogue between behavioral and psychoanalytic practitioners focusing on specific therapeutic interventions. Such a dialogue can help ground the current debate regarding integration and eclecticism in clinical realities and practice in a way that philosophical and theoretical conceptualizations frequently cannot. A case discussion has the potential to reveal fundamental differences in practice between these therapies as well as to point to shared emphases and opportunities for integration. In the case presented below, Ms. Davis was treated by Dr. Lazarus, an eclectic, behaviorally based therapist, at two different stages: first "behaviorally" for circumscribed problems (symptoms), and at a later date, "multimodally" (Lazarus, 1981, 1985) for a much more pervasive range of dysfunctions. In reading through the case of Ms. Davis, Messer, a psychodynamically oriented theoretician and clinician, was to select "choice points" where he would have intervened differently, stating his rationale for eschewing certain strategies, while explaining what he would have done instead. Commonality of approach was also to be noted. We trust that this format will help to clarify areas of convergence and divergence between current versions of behaviorally based and psychoanalytically oriented therapies. The Treatment of Ms. Davis Stage 1 When Ms. Davis first consulted Lazarus, she was 32 years of age, a slim, attractive, and stylishly groomed woman who appeared somewhat tense and deferential. Recently married for the second
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