Stampfl's Therapist-Directed Implosive (Flooding) Therapy

Description of the Strategy

In the late 1950s, Thomas G. Stampfl developed a new, comprehensive behavioral-treatment approach designed to be used in the treatment of a wide variety of adult clinical psychological symptoms. He based his new approach on the use of established principles of learning developed from laboratory research. The technique he adopted was both unique and controversial. It was unique in that Stampfl was the first therapist to systematically recommend that symptom reduction could be achieved by exposing patients to those fear cues their symptoms were designed to avoid. The goal of his technique was to intentionally elicit within the patient a high level of emotional responding in order to establish the necessary conditions for the unlearning of emotions to these stimuli. At the time, the use of a direct-exposure principle was highly controversial, in large part because of the dominance within the field of psychoanalytic theory, which argued that such a procedure would exacerbate the patient's problem by creating more fear or even producing a psychotic break. This therapists' fear persisted within the psychotherapy community despite the absence of any empirical data to support this concern. Resistance to Stampfl's approach was also generated by clinicians who understandably felt uncomfortable about increasing the fear level of patients who were already overwhelmed by fear.

Nevertheless, Stampfl proceeded in the development of his new approach, which he labeled “implosive therapy” (IT). He borrowed the term implosion from physics in order to reflect the inwardly release of affectively stored energy within the brain. Today, some therapists prefer the more behavioral-sounding term of flooding to describe a fear cue exposure technique. Although unpublished papers outlining his approach were widely distributed, Stampfl refused to publish his approach for 10 years, until research was conducted to ensure the technique was safe and nonharmful and was applicable to the treatment of a variety of clinical nosologies. IT is characterized as a stimulus-response, dynamic cognitive-behavioral therapy approach.

Implosive theory represents a comprehensive theory of psychopathology, which incorporates a revised version of O. H. Mowrer's two-factor theory of avoidance learning. Maladaptive behavior is conceptualized as a learned behavior resulting from the exposure to past, specific aversive-conditioning experience of considerable intensity. Mowrer adopted Freud's contention that maladaptive behavior represented in the form of clinical symptoms consists of avoidance behavior designed to remove or reduce the presence of previously conditioned aversive cues. Mowrer argued, following extensive research, that avoidance learning or symptom development involves the learning of two response classes. The first response class, which is based on the established laws of classical conditioning, addresses the issue of how fears or anxieties are learned. According to theory, fear and other emotional conditioning results from the contiguity of pairing a nonemotional stimulus in space and time with one inherently primary aversive event producing pain, fear, frustration, or severe states of deprivation. Following sufficient repetition of the “neutral,” previously nonemotional stimulus with the biological pain stimulus, the nonemotional stimulus is able to elicit the emotional response of fear in the absence of the biological stimulus. It has been shown that the conditioning events of humans are multiple, involving complex [Page 565]sets of stimuli both internal and external, which are believed to be encoded in long-term memory.

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