Two distinctive features of American society, however, contributed to new developments—its pragmatism and its gregariousness. The pragmatic outlook is action-oriented, therefore sympathetic to attempts to modify feelings and behavior by direct assault rather than through the leisurely, roundabout way of free association, leading to the still mushrooming growth of so-called behavior therapies. Like psychoanalysts, proponents of these methods claim them to be scientific, often with some justification. Behavioral phenomena can be counted and measured, so goals and outcomes of behavior therapy can be stated with far more specificity and objectivity than those of psychoanalysis. But it must be remembered that, despite the name, many behavior therapies rely heavily on the patient’s imagery and fantasies, which cannot be measured directly, and their theoretical underpinning seldom is as rigorous as it appears. I concur with those behavior therapists who maintain that the central contribution of behavior therapy is methodological (2). All forms force the therapist to make specific predictions and modify his own behavior in accordance with the outcome. This encourages flexibility of approach, permits the formulation of questions that are amenable to precise research, and makes possible experimentation with a single case, leading to real gains in knowledge of the limitations of behavior therapies as well as the sources and nature of their therapeutic effects.