Andrew Salter, who for almost six decades conducted a successful private practice in Manhattan, New York, died from cancer on October 7, 1996, at the age of 82. Born in Waterbury, Connecticut, on May 9, 1914, Salter graduated from New York University in 1937 with a BS in psychology. With only a bachelors degree and his independent psychology practice, he went on to achieve a significant founding role in behavior therapy. Immersing himself after graduation in the intellectual riches of the New York Public Library and impressed by Clark Hull’s little known work in hypnosis and conditioning, Salter published a seminal paper on autohypnosis in 1941 and a book on the topic in 1944, reporting successful applications to some of the problems (e.g., insomnia, smoking, overeating) he was treating in his newly established practice.
Using his clinical experiences in a heuristic fashion, Salter went on to publish two other books that form the basis of behavior therapy today, Conditioned Reflex Therapy (1949) and The Case Against Psychoanalysis (1952). These works occupy an honored place for those with an appreciation of history in clinical psychology, psychiatry, and especially behavior therapy. At the time these works were published, it was not fashionable indeed, it was downright risky- to critique psychoanalysis or to propose that clinical interventions could be based on experimental data. Dollard and Miller’s classic Personality and Psychotherapy (1950) was published a year later than Andy’s first book and was much different in purpose and ultimate effect; whereas Dollard and Miller attempted to explain existing psychoanalytic procedures in terms of well-established principles of learning, Salter used learning principles as a guide to devising new therapeutic methods.
Salter thus courageously and successfully challenged the establishment and articulated a vision and a set of techniques that have become so widely accepted and applied that he is often not formally cited. This is especially true when contemporary writers in psychotherapy refer to “assertion training,” “expressiveness training,” “getting in touch with one’s feelings ,” and related phrases that have to do with the expression of both positive and negative emotion under circumstances that meet one’s needs without infringing on the rights and sensibilities of others.
The central thesis in Salter’s conditioned reflex therapy book, couched in Pavlovian terms, is that the direct expression of both positive and negative emotion leads to improvement in a wide variety of psychological disorders via a disinhibition of excessive cortical inhibition. While the theorizing was open to question, the techniques he derived from the theory were effective for a wide variety of disorders. (This kind of “disconnect”- between theory and technique- is not uncommon in scientific applications.) Throughout his application of the techniques, Salter’s emphasis was on changing overt behavior rather than on changing associated thoughts and feelings.
Changes in the latter would follow behavioral change, he argued. And this approach was in sharp contrast to the prevailing doctrines of the “insight” based therapies. Less generally known than Salter’s “assertion training” is this avowed behaviorist’s innovations in the use of imagery, specifically paired with positive affect, to reduce unwarranted anxiety. But it was this idea that helped to lay the foundation for Joseph Wolpe’s pioneering work in systematic desensitization. (The degree to which an appeal to imagery is within the realm of behavioristic techniques has been argued for years, but Salter was always in good conceptual company with the likes of Clark Hull, Kenneth Spence, O.H. Mowrer, and Neal Miller.)
Though humanistic in his values and in his clinical approach to patients, Salter remained a philosophical materialist in his theoretical conceptions of behavior and its therapeutic modification. In Conditioned Reflex Therapy, he wrote: … we attain [behavior change] by what may be termed verbal chemistry. Words, spoken by the therapist, travel along appropriate nerve tracts in the person under treatment, and produce chemical modifications in his nervous system. These changes are associated with behavior changes, which in turn precipitate more biochemical modifications and more behavior changes. (Salter, 1949, p. 316)
To place this in historical context, most readers will recall that D.O. Hebb published his own speculative but prescient Organization of Behavior in the same year. Like other trail-blazing and creative thinkers, Salter’s ongoing influence extends beyond behavior therapy and psychology generally. In the field of psychotherapy, he emphasized the importance of “I-talk” years before Fritz Perls pointed to its significance in Gestalt therapy. Assertion training has permeated our culture, especially in the feminist movement, a fact which made Salter very proud. Ironically, being an innovator does not guarantee that one’s contribution will receive due visibility. So, just as references to “psychoanalysis” seldom cite Sigmund Freud, a similar scarcity of citations to Salter occurs in the literatures on “assertion training” and the origins of behavior therapy.
In 1964, he published with Joseph Wolpe and Leo Reyna the proceedings of the first conference on behavior therapy, The Conditioning Therapies. Along with Eysenck’s edited volume, Behaviour Therapy and the Neuroses, this collection of provocative papers was instrumental in bringing to a larger audience the clinical achievements and, most importantly, both the perspective and the potential of a scientific approach to clinical intervention based on experimental studies of learning. This was followed two years later by his key role in the founding of the Association for Advancement of Behavior Therapy (AABT). He did not publish after the mid-1960s, busying himself instead with a practice that included many well-known people in the arts and the professions and with presentations that always enlivened the proceedings of scholarly meetings.
But there was more to this man than his creative writings. Though fiercely and consistently committed to a scientific analysis of complex human behavior, Salter felt that students entering the helping professions should be, as he put it in a recent interview for the AABT Archives Project, “complete human beings.” He believed they should read widely outside of psychology and should have varied life experience, something long emphasized in non behavioral approaches to therapy but only recently in behavior therapy. To a question about recent efforts to integrate competing approaches to clinical intervention (e.g., psychoanalysis and behavior therapy), Salter replied that “Everybody knows something.”
He seemed thus to have succeeded in blending a coherent theoretical commitment with a tolerance of and openness to ideas that lay outside the boundaries of his own paradigm-not an easy task for scientifically minded professionals. Also unusual about Salter was the wide variety of people who read and praised his writing. Who among us can say that our writing style is “captivating,” as Thomas Mann said about Salter’s prose? Who among us has written things that commanded the attention and approbation of people such as Vladimir Nabokov, H.G. Wells, and Aldous Huxley? And who, as a college student and writer of poetry, won an interview with the likes of Robert Frost? Finally, who among us has had a character in a book- and then a widely celebrated movie modeled after us, as was the case with Salter in Richard Condon’s The Manchurian Candidate?
Those of us who knew Salter personally appreciated his sheer brilliance, his wit, his warmth, decency and consideration for others, his supportiveness, his keen intuitive grasp of human nature, his infectious zest for life, his love of art and literature, and his devotion to family and friends. His effect on people, especially his patients, can be summed up by an anecdote about a new patient he began seeing a few months ago. As recounted by one of his sons, she came to a session one day extremely unhappy. As his wife described her as she left his office, “You should have seen her the last session. She came out of the office looking like she had just had her hair done.”
Active till a few months before his death, Andrew Salter leaves behind his wife Rhoda, sons William and Robert, a sister, and three grandchildren. He will be sorely missed.
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