Broadly speaking, we can say that assertiveness is the ability to say “no” to requests or favors that we do not wish to perform. This term was coined by J. Wolpe in 1958, although A. Salter had already used the concept in his therapy of the conditioned reflex .

Salter’s conditioned reflex therapy is a model of assertive therapy, which seeks to promote the patient’s open expression, reducing inhibition and promoting action. The therapy focuses primarily on enhancing the patient’s emotional expression. Let’s see what it consists of.

Preconcepts: Assertiveness

Assertiveness is a social skill that allows us to defend our own rights, interests and ideas in a clear and honest way , without hurting or harming others.

One of the first authors to talk about assertive training was A. Salter. In 1949 he published a book entitled Therapy of the Conditioned Reflex , which spoke about the negative effects of emotional conditioning and the fact of not being assertive. In this book he presented a model with different procedures for dealing with assertiveness problems.

For A. Salter, assertiveness referred to a person’s ability to express his emotions (excitatory personality). The lack of assertiveness referred to the inhibition or difficulty in expressing emotions (inhibitory personality).

However, although Salter was one of the first to speak of assertiveness, it was only J. Wolpe who coined the term, basing the concept on Salter’s works. Wolpe first used the term in his book Psychotherapy by Reciprocal Inhibition, in 1958.

Salter’s Reflex Conditioning Therapy: Characteristics

In order to develop Salter’s conditioned reflex therapy, he used Pavlov’s contributions about conditioned reflexes and the knowledge of the fundamental processes of higher nerve activity, i.e. the processes of excitation and inhibition, as mentioned above.

Thus, Salter relates mental disorders to inhibitory processes (inhibitory personality), and mental health to excitatory processes (excitatory personality).

The role of the therapist in Salter’s therapy is to promote the patient’s overcoming of his inhibitions . The aim is to enable the patient to freely express his/her own feelings. Many times patients have suffered excessive inhibitory conditioning that has caused them some suffering in previous stages of their lives. This occurred because such inhibition exceeded the person’s social requirements.

On the other hand, Salter’s conditioned reflex therapy focuses on two fundamental ideas:

1. The instruction offered to patients

This will be aimed at making patients act more and think less . Salter (quoted in Balarezo, 2003) points out in his work that “The healthy one works without thinking and the sick one thinks without acting”.

2. Use of the 6 basic techniques in psychotherapy

These 6 techniques are as follows:

2.1. Externalisation of feelings

The patient is expected to express his or her feelings and thoughts freely, without inhibition.

2.2. Facial expression of feelings

The patient is trained to learn to identify and recognize their facial expressions and the relationship they have with emotions and their expression .

2.3. Contradiction and attack when disagreeing with the exposures of others

The idea is to train the patient to express his or her disagreement with the opinions or views of others. This can be done verbally and/or behaviorally.

Use of the word “I” deliberately in the greatest number of cases

The aim is for the patient to use pronouns and words which allude to himself (e.g. I, me, mine…), and to do so more often than he does at present.

2.5. Acceptance and recognition of praise

The aim is for the patient to be able to recognise the praise and accept it, and not to use an attitude of false modesty when being praised .

2.6. Encouraging the capacity for improvisation

The patient will be trained to improvise his behaviors and not plan them excessively, which may arise spontaneously when the situation requires it.

Other techniques used by Salter

In Salter’s Conditioned Reflex Therapy, special emphasis is placed on the patient’s focus on the here and now, i.e. on his own present behaviour, feelings and thoughts .

The therapeutic tasks employed by Salter focused on confronting problematic situations in reality (live). It could be considered in a way a background to exposure techniques. He also used relaxation techniques and pleasant images as tools to face anxiety and reduce it, as well as to promote appropriate or desired behaviors. These techniques could constitute the precedents of systematic desensitization.

Bibliographic references:

  • Salter, A. (1949): Conditioned Reflex Therapy, New York.
  • Zaldívar, D. (1994). La terapia assertiva: una estrategia para su empleo. Revista Cubana de Psicología, 11(1), 53-64.
  • Balarezo, Lucio. (2003). Psychotherapy. Quito: Centro de Publicaciones de la Pontificia Universidad Católica del Ecuador, 150 – 154.