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A radical change in the focus of early
experimental psychology took place with the advent of the school of psychology
known as behaviourism. No longer were consciousness and its contents the subject
of psychological study. This revolution was led by J.B.Watson (1913), who
declared that the study of consciousness could never be directly known or
observed by anyone, it was subjective material, and therefore not the proper
subject matter of objective science. Behaviourists, Watson argued, should
concentrate on what could be observed – namely, the events in the external
(stimuli) to which a person responded (behaved). Thus behaviourism tried to
explain behaviour by relating it to the stimuli which produce (cause) it. In
1919, Watson published Psychology from the Standpoint of a Behaviourist,
which today is widely seen as the origin of behavioural psychology.
This behavioural approach was applied to
thinking via the study of animals in problem situations. The early behaviourists
used the physical trial-and-error behaviour as a model for thinking: they
proposed that thinking was a covert process of trial-and-error, whereby
alternative approaches to problem-solving were tried out covertly and rejected
if they did not work. Thorndike (1898) prior to the advent of Watson, had
studied cats in puzzle boxes. The cats tried to escape from the boxes by means
of trial and error, and only marginally improved their ability to do so on
successive experimental sessions
The systematic study of classical
conditioning began in earnest with the work of Ivan Petrovich Pavlov
in Russia. He was especially concerned with the connection between food in the
mouth and the salivary flow. The typical procedure was first to present meat
powder to a hungry dog; eating the meat powder produced copious salivation.
Then, a stimulus light was presented, but no salivation occurred in response to
the light. The stimuli were then paired, with the light preceding the meat
powder by a few seconds. After the light and meat powder had been paired a
number of times, the light alone gradually began to elicit salivation. The
response of salivation, elicited by the previous neutral stimulus (the light),
Pavlov called a conditioned response, or conditioned reflex. The
experimental procedure provides the vocabulary of conditioning. Before
conditioning takes place, there is a stimulus that elicits the reflex
salivation. This stimulus is food in the mouth, and is called the
unconditioned stimulus (US). The response to the unconditioned stimulus is
called the unconditioned response, or reflex (UR). The neutral stimulus,
the light, did not elicit salivation before the pairing of the two stimuli; it
might have elicited what Pavlov termed "an orienting reflex" or the "what is
it?" response, but not salivation. When the neutral stimulus, the light, is
repeatedly paired with the meat powder, the US, it eventually elicits
salivation. The neutral stimulus becomes the conditioned stimulus (CS),
and salivation becomes the conditioned response, or reflex (CR). The CR is
generally not identical in all aspects to the UR. The relationship between the
US, the UR, and the CS and CR are depicted below.
|
Before conditioning
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CS
(Light) |
 |
NO
(Salivation)
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| |
|
|
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US
(Food) |
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UR
(Salivation)
|
|
|
During conditioning
|
CS
(Light) |
|
|
|
 |
|
|
|
US
(Food) |
|
UR
(Salivation)
|
|
|
After conditioning
|
CS
(Light) |
|
CR
(Salivation)
|
| |
|
|
|
For Pavlov, conditioning involved the
development of a "temporary connection" or association between the neural
centers registering the CS and the US. Learning depended on this condition of
linking, hence the term conditioning.
Watson explored how fears could be overcome in
a study he carried out with Mary Cover Jones (1924). The subject was Peter, a
3-year-old who was afraid of small animals. The procedure used to decondition
Peter’s fear has come to be referred to as counterconditioning (Davison,
1968). In the relaxed surroundings of his playroom, Peter was given some
favorite food to eat. The experimenters reasoned that the response of eating,
which they considered to be incompatible with feeling afraid, would suppress the
conditioned fear reaction, and that by presenting a high-intensity, positive
stimulus together with a low-intensity, aversive stimulus, the response of
eating would be more likely to occur than the fear response. While Peter was
eating, a feared stimulus – a rabbit – was brought into the room for a brief
period. On subsequent occasions, the rabbit was placed closer and closer to
Peter, for longer and longer exposures, thereby gradually increasing the
intensity of the feared stimulus, but without disturbing his eating. Eventually,
Peter was able to touch and hold the rabbit without evincing a fear reaction.The
consistent pairing of the rabbit with the food meant that the rabbit and the
pleasurable effects of eating had become associated. This procedure demonstrates
clearly the effectiveness of counterconditioning. In a follow-up of Peter’s
behaviour, Jones reported that Peter had continued to show a genuine fondness
for rabbits and no longer feared small animals.
Deconditioning procedures are now used to
treat a variety of fears in humans. The original, definitive work was done by
Joseph Wolpe (1958, 1973) who used relaxation, a behaviour incompatible with
anxiety, as the basis for deconditioning. Wolpe is a former South-African, who
was awarded a M.D. Degree by the University of the Witwatersrand for his
research on systematic desensitization (see below), which in behaviour
therapy has become one of the best-known techniques for treating anxiety.
Systematic desensitization is an example of reciprocal inhibition which
occurs when an anxiety inhibiting response is produced to an anxiety evoking
stimuli. In other words, the action of one neural pathway is inhibited by the
activity of a stronger (more appropriate) one i.e. the anxiety response is
broken by the re-conditioning of relaxation to the original anxiety-producing
stimulus.
After classical conditioning was established,
B.F.Skinner developed operant conditioning which is the
association between a response and the consequences produced by that response.
The basic assumption of operant conditioning is that behaviour is influenced by
its consequences. Unlike classical conditioning, operant conditioning does not
reflect an association between a specific, antecedent stimulus and a specific
response, but rather refers to the association formed between a response and the
consequence evoked by that response.. For example, a rat pressing a lever in an
experimental apparatus produces the consequence of a food pellet being delivered
into a food tray. In such a situation, the rat will learn the association
between lever pressing and food, and will be more likely to press the lever when
next placed in the apparatus. Similarly, a young child will learn to complete
homework assignments regularly if it has experienced the consequence of praise
and recognition from the teacher on completion of assignments.
E.L. Thorndike
(1911) was one of the first experimental psychologists who observed that
behaviour is altered by the effects it has upon the environment. Having been
greatly influenced by Darwin’s evolutionary theory, he wished to see how animals
learn to adapt to their environment when given a problem-solving task. A
problem-solving task would require the animal to use its natural intelligence,
and would enable psychologists to observe how the animal adjusted to the demands
of the task. Thorndike chose cats as his experimental subjects. The cats were
deprived of food, and then placed inside an experimental apparatus called a
"puzzle-box". Food was then placed outside the box, and the cats’ responses in
attempting to escape from the box in order to reach the food were recorded. The
puzzle-box was a cage with a latched door that could be opened from inside the
cage if the cat pulled a string, or pushed a treadle, or turned a button. When a
cat was first placed inside the box, its behaviour was both random and agitated;
it clawed at the walls, tried to squeeze through the gaps between the slats,
mewed, and struggled to escape from the confined space. Sooner or later in the
course of its struggles, the cat would, by accident rather than design, release
the latch and escape from the cage. Thorndike would immediately feed it and put
it back in the apparatus. The same sort of behaviours would occur, but was
confined to the part of the box that contained the release mechanism. On later
trials, the escape response appeared sooner, and the other behaviours became
less frequent. Gradually, the escape response became more and more precise and
immediate.Thorndike labeled this trial-and-error learning. He reasoned
that those responses which did not lead to a "satisfying" consequence (feeding),
were "stamped-out", whereas the escape response, which did result in a
"satisfying" consequence, was "stamped-in". He proposed that when acts or
responses are followed by a "satisfying" state of affairs, they are more likely
to recur than if they are followed by an "annoying" state of affairs. What
happens to a response, act or behaviour is determined by the effect that it
produces. What the organism learns is governed by the effect produced, according
to what Thorndike called the Law of Effect.
Operant conditioning may explain how a good
deal of behaviour is learned. An operant response is emitted, it is not
automatically elicited by a stimulus as in classical conditioning, but is
brought under the control if the ensuing consequences. The primary law governing
operant responses is known as the Law of Reinforcement, which holds that
behaviours will increase in probability when they produce outcomes that are
reinforcing.There are three important components in the law of reinforcement.
The first is that a response must have some consequence. The second is that the
response must increase in probability, or that the response must occur more
often than it would if it did not produce that consequence. The third is that
the increase in probability occurs because the response has this consequence,
and not for some other reason.
If a response produces a positive consequence,
then it is more likely that it will occur in the future. The response is
reinforced, or strengthened, by the positive consequence, and the probability of
the response occurring in the future, is increased. Any event that occurs as a
result of a response and which strengthens the response is called a positive
reinforcer. If a rat presses a lever in the Skinner-box and food appears,
the rat will learn to press the lever in order to get food. The food is a
positive reinforcer for a hungry rat, and will strengthen the lever-pressing
response. Continued repetition of the response will bring about repetition of
the positive reinforcer, increasing the likelihood that the animal will make the
response. The more frequently the response is reinforced, the more consistently
will it be emitted.Two conditions need to be met for the positive reinforcement
procedure to be effective. The first of these is that the reinforcer is primary.
Some reinforcers, such as food, water, or sexual contact, are related to our
basic biological functioning. Should any of these reinforcers follow a response,
they would have the effect of strengthening that response. When the reinforcer
has no biological significance but, nevertheless, has the potential to control a
response, it is a conditioned or generalized reinforcer.The second
condition concerns the delay of the reinforcer. The sooner the reinforcer occurs
after the response, the more likely it will be that the person, or animal, will
learn what must be done to produce the reinforcer. Thus, if an individual is
required to learn an association between two events, those events must be
presented contiguously, that is, in a close spatial and temporal
relationship.Conditioned reinforcers acquire their reinforcing value or potency
through association with other reinforcers. Stimuli that are necessary for the
survival of the organism are called primary reinforcers. Stimuli which
have no significance for the survival in the biological sense, but are effective
as reinforcers, are called secondary or conditioned reinforcers.
For example, if a light appears together with a food pellet when a rat presses
the lever in a Skinner-box, the light would become a conditioned
reinforcer.Conditioned reinforcers that are associated with more than one
primary reinforcer are referred to as generalized reinforcers. The most
obvious generalized reinforcer is money. Money is associated with a variety of
primary reinforcers, such as food, shelter, warmth, and is usually exchangeable
for these primary reinforcers. Negative reinforcement occurs when some
behaviours allow us to escape or avoid negative consequences. When this happens,
the behaviours are being negatively reinforced in that they are strengthened by
the removal of a negative consequence. For example, a rat is placed in a
Skinner-box and it receives a low-level shock, the aversive stimulus, from the
metal grid floor. The shock can be terminated by a lever-pressing response.
Initially, the rats behave somewhat like Thorndike’s cats in his puzzle-box.
Their behaviour is random, they jump up and down, squeal, run about, urinate and
defecate – all signs of being agitated. During this activity, the animal might
accidentally touch the lever, which acts as a switch and terminates the shock.
As lever-pressing is followed by the removal of the shock, we can say that
pressing the lever is negatively reinforced and that the response will increase
in the future. Thus, like positive reinforcement, negative reinforcement
increases the occurrence of behaviour.Although positive and negative
reinforcement both strengthen behaviour, a distinction is made between them
because in the first instance something (a positive stimulus) is added to
the situation, whereas in the second instance, something (an aversive stimulus)
is removed.Where the behaviour produces a negative consequence, that
consequence would be called punishment. Punishment typically acts to
suppress behaviour, whereas in negative reinforcement, the behaviour is
strengthened because it has resulted in the removal of an aversive stimulus. On
the other hand, if lever-pressing produces a shock, then lever-pressing is
likely to be suppressed.
Different behavioural techniques evolved over
the years which are used to treat many different symptoms which are discussed
below. These techniques include desensitization, flooding, massed
practice, aversion and assertiveness training and are based on the
associative learning processes explained above.
Systematic desensitization
(see above) is a behavioural approach in therapy and relies on Pavlov’s
classical conditioning (reciprocal inhibition; see above) model of learning.
Fears, anxiety and phobias can be successfully treated by this means by first of
all teaching the client how to relax. The therapist either carries out
relaxation exercises during therapy sessions, or gives the client relaxation
instructions and tapes to practice at home. Once the client has mastered
relaxation, the client and therapist work together to identify a hierarchy of
fear-eliciting stimuli or situations (called SUDS: Subjective Unit of
Disturbance Scale), ranging from highly fearful (for example, going for a trip
in a car past the accident spot) to minimally fearful (for example, looking at
pictures of cars in a magazine). Beginning with the least fear-inducing, the
client is exposed to each stimulus in turn, all the while practicing their
relaxation skills. This procedure may take some time, after which the relaxation
response rather than the fear response should be elicited by all the stimuli
included in the hierarchy. The hypno-desensitisation procedure
incorporates all the steps as above after a trance has been induced. During
trance a "cue word" is installed which is paired with the anxieties on the SUDS
(reciprocal inhibition) of the client. The relaxation response which is rapidly
elicited by hypnosis (via the cue word) becomes associated with the anxieties on
the SUDS which are presented as scenes starting from the least fear-inducing
stimuli. Because hypnosis elicits the relaxation response quickly, the whole
therapeutic process is much more rapid. As conscious interference is minimized
with the aid of hypnosis, unconscious learning occur immediately which increases
the effectiveness of the treatment and also increases the speed of learning. (or
rate of conditioning). Although systematic desensitization takes its rationale
from classical conditioning, most behavioural theorist would argue that a full
account of the development of maladaptive fears and phobias requires the use of
ideas from operant, or Skinnerian, as well as classical conditioning. Take for
example someone that has been in a car crash: they would point out that, while
the initial conditioned fear response may have originally acquired through
classical conditioning, in many cases it would have been extinguished in the
natural course of events as the client allowed herself/ himself to re-experience
cars, travel and the outside world. What may happen is that the person actively
avoids these situations, because they bring about feelings of anxiety. As a
result, the person is being reinforced for avoidance behaviour – she is rewarded
or reinforced by feeling more relaxed in the home rather than outside, or
walking rather than going in a car. This "two-factor" model of neurosis views
the anxiety of the client as a conditioned emotional response which acts as an
avoidance drive.The techniques of behavioural self-control and systematic
desensitization are explicitly derived from the behavioural "laws of learning"
of operant and classical conditioning.
In Flooding the situation most dreaded
by the client is presented in intense forms without the benefit of associated
relaxation. The experience of anxiety in the absence of any real aversive
consequences leads to extinction. This is based on an educational process: by
confronting the fear, you know you will survive the experience, which relearns
behaviour in one experience. Theoretically, the anxiety elicited by these
techniques is finally extinguished by the absence of the patient’s usual
reinforcement: escape avoidance. Flooding is used for phobias and fears and
caution must be taken not to re-traumatize the client. Flooding done in vivo can
be physically dangerous and it is also difficult or impossible to create the
correct stimulus. Evidence shows that flooding done in vitro (in imagination) is
more effective, easier and less dangerous. In other words hypnosis creates a
safer environment where the client can be guided easily.
Massed practice
eliminates a habit by continued repetition of the stimulus that triggers the
habit, or repetition of the habit (behaviour) itself. A consequence of the
repetition of a behaviour is a build-up of fatigue. Because the aversive effect
of fatigue and boredom occur simultaneously with the performance of the
practiced behaviour (classical conditioning), they become conditioned to it. In
other words the aim is to weaken the bond between the stimulus and the response.
Massed practice is never used where physical danger or injury (as with bruxism)
is a possibility. This technique works well with learned behaviour and even
emotional learned behaviour, therefore habits (i.e. thumb sucking , chocoholics)
respond favorably as well.
The application of massed practice in vivo
would mean that a chocoholic for instance would be required to eat chocolates
every five minutes. Massed practice in vitro is done through the imagination.
Once massed practice in vitro is paired with hypnosis, it is a lot faster.
Aversion therapy
consists of administering an aversive stimulus to inhibit an unwanted
(emotional) response, thereby diminishing the habit strength. (The aversion is
linked to the prodromal stimulus which initiates the unwanted behaviour and not
the behaviour itself). Aversion is used for habit-breaking i.e. smoking,
nail-biting etc.
Unwanted behaviour
i.e. eating too many sweet cakes |
|
|
|
|
|
|
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Prodromal stimulus
i.e. walking past a cake shop or feeling "empty" in stomach
|
|
Link/ Marry to aversion |
An example of aversion used in vivo is when a
client is asked to smoke one cigarette after another in a small room with other
members of a smoking cessation clinic, until they reach a point of being
physically sick. Thus, the client learns to associate smoking with a new
consequence: sickness rather than relaxation. In vitro it can be achieved
through the client imagining an aversive stimulus, which is then synthesised
with the prodromal stimulus.
The hypnobehavioural protocol would include
taking a full case history and paying particular attention to the stimulus prior
to the behavioural response. The therapist then clearly identify the most
aversive stimulus the patient has experienced, including a detailed account of
their physical responses to that aversive stimuli. Trance is induced and
subconscious communication through finger signaling (IMR: ideo-motor-response)
is established. Through the IMR’s, the therapist can check the progress of the
client and facilitate subconscious learning. After the aversion and the stimulus
prior to the behavioural response have been synthesised a few times, the
therapist can check that the client automatically experiences the aversive
stimulus and response when thinking of the unwanted behaviour stimulus.
The behavioural technique called
assertiveness training started as behavioural training by Wolpe and when
Karl Rogers (1970’s) added the humanistic element to it through including a list
of human rights, he created the basis of the approach now known as
"Assertiveness Training". The basic right of this list is the "right to be
assertive", which means , that people have the right to express their feelings,
needs and wants clearly. To behave assertively doesn’t mean that people get what
they want, but it ensures that you are not left with "unfinished business" and
that relational behaviour is adult and mature. The overall aim is a "win/win"
situation, which should consist of a workable compromise. Karl Rogers defined it
as follows: "To be assertive is to be able to express yourself clearly, directly
and appropriately and to value what you think and feel. To have self-esteem, to
recognise your own strengths and limitations, to appreciate yourself for who you
really are. Assertiveness is about respecting yourself and others. It is about
believing that your opinions, beliefs, thoughts and feelings are as important as
anybody else’s. It is about being in touch with your own needs and wants, but it
is not about getting what you want at any cost".
There are generally three types of behaviour:
passive, aggressive and assertive. Each behavioural style is characterised by a
certain body language, a certain way of verbal communication and creates certain
consequences, which means it makes others feel and react in a specific way.
Whether assertiveness training is used in
therapy or not depends on the condition or problem area of the client and
whether the clients behavioural style is part of the problem. If the client is
passive, has a victim mentally or if their problem is confidence or anxiety
related, assertiveness training may be an important part the overall treatment
plan. If the client deals with the world in an aggressive way they might also
benefit from learning how to behave assertively rather than aggressively.
During therapy the therapist will watch the
clients body language, tone of voice and verbal style of communication and
create awareness in the client about their behaviour (body language,
communication pattern and tone of voice) when relating to other people. Change
is encouraged in body language by helping the client change the way in which
they use their body while communicating and is instructed to practice during the
sessions and between consultations. The client is helped to formulate clear
sentences stating his/her needs, wishes and feelings and to "stick" with that
(broken record technique). To improve the clients tone of voice, they are helped
to develop diaphragmatic breathing to neutralise tension and to develop a fuller
tone of voice. Hypnotherapy deals with passive behaviour in recognising the
underlying anxiety and physical tension and then to employ scripts and other
methods to reduce anxiety. Clients are taught self-hypnosis and positive
suggestions which are helpful for passive and aggressive people. Their
self-esteem is also increased through ego-strengthening. During trance the
client visualises situations and events in which they would like to behave
assertively but behave passively or aggressively (i.e. a job interview,
communicating with different people, social events and so on) and help them to
change body language, voice and verbal communication. Cues are built into the
trance session so that the client will associate these with assertive feelings
and behaviours.
From the above it can be noted that hypnosis
plays an important role within behavioural psychology. An increasing amount of
people want answers to life, how they can reach their goals and bring their
dreams into reality. A countless sum of money is spent annually – seeking
professional help just in overcoming undesirable habits alone. It follows
naturally then that hypnotherapy which is short-term, safe and practical would
be an effective solution.
Some behavioural techniques can be dangerous
when recreated (i.e. Flooding) in vivo and hypnosis here facilitates the process
in a safe manner through using the imagination of the client. Imagery can also
be experienced in a more vivid fashion where it will obviously influence the
result of the therapy in a very beneficial way indeed. Some situations which are
difficult to re-create in vivo can easily be simulated during trance via
imagination. This has also proved to be cost-effective.
Classical conditioning, operant conditioning
and reinforcement which most behavioural techniques are based upon relies
entirely on the learning process which starts as a conscious process and
thereafter becomes unconscious. Through the use of hypnosis and because the
conscious mind is inhibited, unconscious learning occurs immediately and
therefor the entire learning process is speeded up. As all the behavioural
techniques are based upon this concept of learning, it can be said that hypnosis
enhances behavioural therapy greatly and increases the effectiveness of the
treatment.
Andre Duvenage
MBSCH, D. Hyp., ITEC (Phys.)
Clinical Hypnotherapist,
Hypnoanalyst and Psychotherapist
Author/ Copyright: Andre Duvenage trained with the London
College of Clinical Hypnosis and runs a successful private practice in central
London. He works scientifically and utilizes Cognitive Behavioural Therapy (CBT)
within hypnosis. He is a member of the British Society of Clinical Hypnosis.
Andre may be contacted by telephone at:
020 8507 3767 or 084 5612 0366
or via his website at:
www.londonhypnotherapist.com
Copyright Andre Duvenage 2008 - all rights reserved
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