Lazarus has Risen: Multimodality in the Modern Age

Despite the popularity of specialty trends in psychotherapy, it behooves us to remember Arnold Lazarus for introducing Multimodal Therapy (aka technical eclecticism). It was Lazarus, the South African psychologist, who coined the term behavior therapy in the late 1950s (under the guidance of Dr. Joseph Wolpe) and observed the effects of implementing interdisciplinary approaches in private practice.

Through his assessment technique known as BASIC I.D., Lazarus provided insight into the cognitive processing of interpersonal dynamics and subsequently reinforced the work of Aaron Beck and Albert Ellis to broaden the field of cognitive behavior psychology. Nonetheless, even though the behavioral movement revolutionized a shift away from strict Freudian orientation, one can’t help but notice the unintended “slip” or intentional homage to Freud via Lazarus’s play on words. The basic idea behind BASIC I.D. is to comprehensively assess the client’s behavior, affect, sensation, imagery, cognition, interpersonal interactions, and biology. An unfortunate tendency among many behavior therapists is to abandon the psychoanalytic model, including the methodology of free association, for fear of being seen as professionally antiquated. However, an acknowledgement of dynamic systems is exactly the reason why we must make psychoanalysis an unshakable bulwark while discovering creative ways of incorporating it with modern behavioral modalities. While recognizing the empirical efficacy and stealth of cognitive behavior therapy (not to mention popularity), it’s also helpful to see how the psyche and sexual identity create a baseline for understanding the biological self in relation to social behavior. For example, an effective combination of psychoanalysis and cognitive behavioral approaches can be witnessed during EMDR therapy.

As specialization becomes an increasingly lucrative phenomenon in health care, the therapist must remain somewhat defiant to this trend and open to experimenting with a variety of theoretical models. Technical eclecticism allows the therapist to creatively engage the client in ways particular to salient issues while considering the personality of the individual. Consequently, the therapeutic alliance is more easily consecrated when the therapist allows for adaptation to various treatment protocols based on the client’s needs. Furthermore, the therapist may alternate between several modalities during a given session—depending on the direction the client feels comfortable with and where progress is ascertained. Whether it’s Gestalt, cognitive behavior therapy, psychoanalysis, rational-emotive therapy, client-centered therapy or a combination of the aforementioned, the Lazarus legacy provides a conceptual framework for the therapist to act as a lucid and flexible surveyor when interpreting a multitude of perceptual and behavioral responses.