Multimodal Therapy: BASIC I.D.

Arnold LazarusOpens in new window developed the multimodal BASIC I.D. model in 1970 as a cognitive behavioral therapyOpens in new window.

BASIC I.D. is an acronym of several dimensions (or modes) of a person’s interactions with and perceptions of the world:

  • B (behavior)
  • A (affect)
  • S (sensory)
  • I (imagery)
  • C (cognition)
  • I (interpersonal), and
  • D (diet/drugs/biology).

The multimodal model can be used by a psychotherapist or counselor to work with clients on issues such as anxietyOpens in new window, depressionOpens in new window, other mood problems, or various psychological disorders. It can also be used as a self-analysis tool as part of a stress reduction program to gain insight into one’s style of thinking and interacting with the world.

Multimodal therapy has been used in private practice, in conjunction with art therapy, and in working with children in school settings. The multimodal process asks the questions about each letter of the BASIC I.D. acronym given in Table X-1.

Table X-1 Multimodal Therapy: BASIC I.D.
B: behaviorWhat self-defeating actions or maladaptive behaviors are getting in the way of my personal fulfillment or happiness? What should I do differently?
A: affectWhat seems to generate negative affects (emotional reactions), including anger, anxiety, or depression? To what degrees are these emotions experienced (e.g., rage or irritation, uneasiness vs. panic)? Do certain thoughts, images, or interpersonal conflicts generate these negative emotions? How do I respond (behave) when I feel a certain way?
S: sensory What sensation do I feel in my body (e.g., pain, muscle tension, butterflies in the stomach)? What thoughts, feelings, and behaviors accompany these sensations?
I: imagery What kinds of images do I tend to experience (e.g., images of failure or success)? How do these images connect with thoughts, feelings, and behaviors? What is my “self-image”?
C: cognitionWhat are my main cognitions (i.e., thoughts, including values, beliefs, attitudes, and opinions)? Are they rational or irrational? Do my thoughts include “I should,” “I ought to,” or “I must”?
I: interpersonalWhat are my significant interpersonal relationships like? What do I expect from and provide to others? Which relationships are satisfactory and which cause problems?
D: diet/drugsRegarding biological health (including diet and drugs), how is my overall health? How do I manage my health, including exercise and nutrition, sleep, and use of drugs and alcohol?
Source: Yvette Malamud Ozer, based on Lazarus (1984) and Lazarus and Abramovitz (2004).

Let’s say that Henry wants to reduce the level of stress in his life. Henry describes a typical situation that recently caused him stress.

Last night I had three or four beers in a sports bar while watching the big game with my friends. I got home kind of late, and I didn’t sleep well, so I didn’t hear the alarm go off this morning. When I woke up, I was kind of hung over and I was afraid I’d be late for work, I could just see my boss chewing me out; so I was rushing, and then this guy cut me off on the freeway. Boy was I pissed! I gunned the engine and laid on the horn. I was passing him at 95 miles per hour when I saw the flashing lights in my rearview mirror. I felt my heart pounding as I pulled the car over and thought about what I’d say to the cop, and to my boss. I was really afraid I’d get fired this time.

We can describe various aspects of Henry’s situation using the BASIC I.D. model as follows:

  • B (behavior): Stay out late drinking; sleep through alarm; drive recklessly
  • A (affect): Anger; worry, anxiety
  • S (sensory): Hung over; heart pounding
  • I (imagery): I see my boss chewing me out; I imagine what I’ll say to the cop, to my boss
  • C (cognition): I’ll be late; I’ll get fired
  • I. (interpersonal): I like to spend time with my friends watching sports; I’m upset that I got a speeding ticket; I’m afraid my boss is going to chew me out or fire me; I hate it when other drivers cut me off!
  • D. (diet/drugs/biology): Drinking so much alcohol and getting to bed late may have affected how well I slept, and I didn’t get enough sleep, so I woke up grouchy and hung over

After breaking the stressful situation into its BASIC I.D. components, Henry can gain additional insight about the relationships between his different modalities by determining his firing order, or the sequence in which he responds to stress (Lazarus refers to this as trackingOpens in new window).

In Henry’s example, D. (diet/drugs/biology) is the biggest factor that sets the stage for all the other elements. If Henry consumes too much alcohol and has too little sleep, then S (sensory) kicks in—in the form of a hangover—closely followed by A (affect, e.g., fear), I (imagery, e.g., seeing the boss chewing him out), and C (cognition, “I’ll be late,” “I’ll get fired”).

If Henry does not intervene at this point, then self-defeating behaviors (B) follow on the heels of negative feelings, with resultant interpersonal (I.) consequences. So Henry’s firing order in this example is DSAIC.

Lazarus pointed out in his decades-long discussions of multimodal approaches to therapy that we experience the world on many different levels, and we react and cope using many different modalities.

Using the BASIC I.D. approach can help someone determine the role that outside stressors and ways of viewing and interacting with the world have on her ability to cope with life. Identifying her firing order can help someone figure out which therapeutic or stress management techniques to focus on most and where she has the most challenges.

Someone whose negative feelings, thoughts, or behaviors are often prompted by physical stress may benefit from yogaOpens in new window, meditationOpens in new window, biofeedbackOpens in new window, aerobic exercise, or other body-oriented approaches. If diet or drugs appear early in someone’s firing order, he mght benefit more from a nutritional approach, smoking cessation, or switching from regular coffee to decaf.

Someone whose negative thoughts always precede negative feelings or behaviors may benefit more from a cognitive therapy approach.

See also:
  1. Lazarus, A.A. (1984). Multimodal therapy. In L. Grinspoon (Ed.), Psychiatry update: The American Psychiatric Association annual review (Vol. 3, pp. 67 – 76). Washington, DC: American Psychiatric Press.
  2. Lazarus, A.A., & Abramovitz, A. (2004). A multimodal behavioral approach to performance anxiety. Journal of Clinical Psychology, 60, 831 – 840.
  3. Palmer, S. (2009). A multimodal approach to stress management and counsellnig. Retrieved from Centre for Stress Management: