Behaviorism see psychological disorders as the
result of maladaptive learning, as people are born tabula rasa (a blank slate).
They do not assume that sets of symptoms reflect single underlying causes.
Behaviorism assumes that all behavior is learnt from
the environment and symptoms are acquired through classical conditioning and
operant conditioning.
Classical conditioning involves learning by
association and is usually the cause of most phobias. Operant conditioning
involves learning by reinforcement (e.g. rewards) and punishment, and can
explain abnormal behavior should as eating disorders.
Consequently, if a behavior is learnt, it can also
be unlearned.
Therapies
Behavioral therapies are based on the theory of
classical conditioning. The premise is
that all behavior is learned; faulty learning (i.e. conditioning) is the cause
of abnormal behavior. Therefore the individual has to learn the correct or
acceptable behavior.
An important feature of behavioral therapy is its
focus on current problems and behavior, and on attempts to remove behavior the
patient finds troublesome. This contrasts greatly with psychodynamic therapy
(re: Freud), where the focus is much more on trying to uncover unresolved
conflicts from childhood (i.e. the cause of abnormal behavior). Examples of behavior therapy include:
o Systematic
Desensitization
o Aversion
Therapy
o Flooding
The theory of classical conditioning suggests a
response is learned and repeated through immediate association. behavioral therapies based on classical
conditioning aim to break the association between stimulus and undesired
response (e.g. phobia, additional etc.).
Aversion Therapy
Aversion therapy is used when there are stimulus
situations and associated behavior patterns that are attractive to the client,
but which the therapist and the client both regard as undesirable. For example,
alcoholics enjoy going to pubs and consuming large amounts of alcohol
Aversion therapy involves associating such stimuli
and behavior with a very unpleasant unconditioned stimulus, such as an electric
shock.
The client thus learns to associate the undesirable
behavior with the electric shock, and a link is formed between the undesirable
behavior and the reflex response to an electric shock.
In the case of alcoholism, what is often done is to
require the client to take a sip of alcohol while under the effect of a
nausea-inducing drug. Sipping the drink
is followed almost at once by vomiting. In future the smell of alcohol produces
a memory of vomiting and should stop the patient wanting a drink.
More controversially, aversion therapy has been used
to "cure" homosexuals by electrocuting them if they become aroused to
specific stimuli.
Critical Evaluation
Apart from ethical considerations, there are two
other issues relating to the use of aversion therapy.
First, it is not very clear how the shocks or drugs
have their effects. It may be that they
make the previously attractive stimulus (e.g. sight/smell/taste of alcohol)
aversive, or it may be that they inhibit (i.e. reduce) the behavior of
drinking.
Second, there are doubts about the long-term
effectiveness of aversion therapy. It
can have dramatic effects in the therapist’s office. However, it is often much less effective in
the outside world, where no nausea-inducing drug has been taken and it is
obvious that no shocks will be given.
Also, relapse rates are very high – the success of
the therapy depends of whether the patient can avoid the stimulus they have
been conditioned against.
Flooding
Flooding (also known as implosion therapy) works by
exposing the patient directly to their worst fears. (S)he is thrown in at the
deep end. For example a claustrophobic will be locked in a closet for 4 hours
or an individual with a fear of flying will be sent up in a light aircraft.
What flooding aims to do is expose the sufferer to
the phobic object or situation for an extended period of time in a safe and
controlled environment. Unlike systematic desensitisation which might use in
vitro or virtual exposure, flooding generally involves vivo exposure.
Fear is a time limited response. At first the person
is in a state of extreme anxiety, perhaps even panic, but eventually exhaustion
sets in and the anxiety level begins to go down. Of course normally the person
would do everything they can to avoid such a situation. Now they have no choice
but confront their fears and when the panic subsides and they find they have
come to no harm. The fear (which to a large degree was anticipatory) is
extinguished.
Prolonged intense exposure eventually creates a new
association between the feared object and something positive (e.g. a sense of
calm and lack of anxiety). It also prevents reinforcement of phobia through
escape or avoidance behaviours.
Critical Evaluation
Flooding is rarely used and if you are not careful
it can be dangerous. It is not an appropriate treatment for every phobia. It
should be used with caution as some people can actually increase their fear
after therapy, and it is not possible to predict when this will occur. Wolpe
(1969) reported the case of a client whose anxiety intensified to such as
degree that flooding therapy resulted in her being hospitalized.
Also, some people will not be able to tolerate the
high levels of anxiety induced by the therapy, and are therefore at risk of
exiting the therapy before they are calm and relaxed. This is a problem, as
existing treatment before completion is likely to strengthen rather than weaken
the phobia.
However one application is with people who have a
fear of water (they are forced to swim out of their depth). It is also
sometimes used with agoraphobia. In general flooding produces results as
effective (sometimes even more so) as systematic desensitisation. The success
of the method confirms the hypothesis that phobias are so persistent because
the object is avoided in real life and is therefore not extinguished by the
discovery that it is harmless.
For example, Wolpe (1960) forced an adolescent girl
with a fear of cars into the back of a car and drove her around continuously
for four hours: her fear reached hysterical heights but then receded and, by
the end of the journey, had completely disappeared.
References
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