Psychopathology - The Behavioural Approach to explaining and treating phobias Flashcards
What are phobias?
Phobias are a type of anxiety disorder - anxiety is an emotion all people experience and is a natural response to potentially dangerous stimuli, but phobias are characterised by uncontrollable, extreme, irrational and enduring fears and involve anxiety levels that are out of proportion to any actual risk, producing conscious avoidance of the feared object or situation.
- Phobias are a group of mental disorders within the category of anxiety disorders. Phobias are irrational fears of an object or situation. The anxiety interferes with normal living.
Three sub-types of phobia:
- Agoraphobia - fear of open spaces or being trapped in a public place where escape is difficult
- Social phobias - anxiety related to social situations, such as talking to a group of people
- Specific phobias - fears about specific objects or situations, such as spiders, heights or the dark
Emotional characteristics of phobias
What an individual feels in response to the phobia such as internal fear or anxiety -
- Anxiety - anxiety is an unpleasant heightened state of arousal which prevents the sufferer from relaxing and make it very difficult to experience any positive emotion, and this feeling can be long-term; fear is the immediate and extremely unpleasant response we experience when we encounter or think about phobic situations
- Emotional responses are unreasonable - the emotional responses we experience in relation to phobic stimuli go beyond what is reasonable (i.e it is disproportionate to the danger posed by the phobic stimulus)
Behavioural characteristics of phobias
The actions or reactions of a person in response to external and internal stimulus
- Panic - a person with a phobia may panic in response to the presence of a phobic stimulus which may involve a range of behaviours, including crying, screaming or running away, and children may react slightly differently such as by freezing, clinging or having a tantrum
- Avoidance - one obvious behavioural characteristic in which a person who is faced with a feared object or situation has the immediate response to avoid it in order to reduce the chances of such anxiety reoccurring; this can make it hard to go about daily life e.g. a person who fears public toilets may limit their time outside their home so they can last without a toilet which can interfere with education, work and social life
- Endurance - instead of avoiding, endurance may occur, when a sufferer remains in the presence of the phobic stimulus but continues to experience high levels of anxiety and this may be unavoidable in some situations, such as having an extreme fear of flying
Cognitive characteristics of phobias
The thinking and attention directed towards the phobia and the irrational beliefs about a phobia
- Selective attention to the source of the phobia - if a person sees a phobic stimulus it is hard to look away as keeping attention to something that may cause danger is positive or giving the best chance of reacting quickly to a threat, but is not useful when the fear is irrational
- Irrational beliefs - they may hold irrational beliefs in relation to the stimuli e.g. social phobias involve beliefs such as ‘I must always sound intelligent’ and these kinds of beliefs increase the pressure on the sufferer to perform well in social situations
- Cognitive distortions - the phobic person’s perceptions of the phobic stimulus maybe distorted, so someone with a phobia of snakes may see them as alien and aggressive looking
The Behavioural Approach to Explaining Phobias
- The behavioural approach emphasises the role of learning in the acquisition of behaviour, focusing on behaviour we can see, so it is geared towards explaining the behavioural characteristics of phobias, rather than the emotional and cognitive characteristics
- Mowrer (1947) proposed the two-process model to explain phobias, and this argues that phobias are acquired (learned in the first place) by classical conditioning and then maintained (continue) by operant conditioning
The Two-Process Model
1) Classical conditioning - acquisition and onset of phobia
- Phobia is acquired through the association of something we initially have no fear of with something that already triggers a fear response - example:
Before conditioning -
- Dark (neutral stimulus) -> No response
- Being mugged (unconditioned stimulus) -> Fear response (unconditioned response)
During conditioning -
- Dark (NS) + being mugged (UCS) -> Fear response (UCR)
After conditioning -
- Dark (conditioned stimulus) -> Fear response (conditioned response) becomes a phobia of the dark
2) Operant conditioning - maintenance of phobia
- This step explains how people continue to feel fearful and avoid feared objects, and Mowrer argued that this can be explained through operant conditioning
- Mowrer suggested that whenever we avoid a phobic stimulus, we successfully escape the fear and anxiety that we would have suffered if we had remained there
- This reduction in fear reinforces the avoidant behaviour via negative reinforcement and so the phobia is maintained as avoidance is more likely to happen again in the future
- For example, if a person has a phobia of the dark because they were mugged at night-time then the person might sleep with lights on; this is negatively reinforcing as it reduces the fear response associated with being in the dark
- This reinforces the behaviour, as it increases the chances of the person sleeping with the lights on again because anxiety is not experienced
- Phobias therefore become very resistant to extinction (dying out) because of the sufferer constantly making reinforcing avoidance responses
Explaining phobias using the behavioural approach - Watson & Rayner (1920)
Aim - the provide empirical evidence that human emotional responses could be learned through classical conditioning
Procedure - a laboratory experiment was conducted with one participant, an 11-month-old boy who lived in the hospital where his mother was a nurse. Albert was presented with various stimuli, including a white rat, a rabbit and some cotton wool, and his responses were filmed and he showed no fear reaction to any stimuli.
- A fear reaction was then induced into Albert by striking a steel bar with a hammer behind his head; this startled Albert and made him cry and he was then given a white rat to play with of which he was not scared. As he reached to touch the rat, the bar and hammer were struck to frighten him, and this procedure was repeated three times and variations of these conditioning techniques continued for 3 months
Findings - subsequently, when shown the rat, Albert would cry, roll over and crawl away, and he had developed a fear towards the white rat, which he also displayed with less intensity to other white furry objects, like a white fur coat and Santa Claus beard (generalisation)
Conclusions - conditioned emotional responses, including love, fear and phobias, are acquired as a direct result of environmental experiences which can transfer and persist, possibly indefinitely, unless removed by counter-conditioning
Explaining phobias using the behavioural approach - Di Gallo (1996)
- Di Gallo reported that around 20% of people experiencing traumatic car accidents developed a phobia of travelling cars, especially of travelling at speed and this can be explained by classical conditioning as the car becomes associated with the crash
- They then tended to make avoidance responses involving staying at home rather than making car journeys to see friends, which can be explained by operant conditioning in terms of negative reinforcement and this made the phobia resistant to extinction
Evaluation of the behavioural approach to phobias - Strengths
1) There is research evidence to support that some phobias develop and are maintained by classical and operant conditioning (Watson & Rayner, Di Gallo)
- There is some external validity for the model and approach as an explanation of phobias
2) The two-process model has good explanatory power and it explained how phobias could be maintained over time and this has important implications for therapies because it explains why patients need to be exposed to the feared stimulus, once a patient is prevented from practising their avoidance behaviour, that behaviour ceases to be reinforced and so it declines
- Good external validity and good real-world applications; it allows a treatment plan to be formed for patients and allows understanding of how conditioned fears can be unconditioned
Evaluation of the behavioural approach to phobias - Weaknesses
1) Sometimes people develop a phobia and are not aware of having had a related bad experience
- It is therefore not fully generalisable to all phobia developments
2) Not all avoidance behaviour associated with phobias appears to be the result of anxiety reduction - in more complex phobias such as agoraphobia, there is evidence to suggest that at least some avoidance behaviour appears to be motivated by the positive feelings of safety. Therefore, in choosing not to leave the house, it is less about avoiding the phobic stimulus and more sticking where it is safe. This explains why some agoraphobics are able to leave the house when with a trusted person with relatively little anxiety, but not alone
- This means that the explanation is not fully generalisable to explaining all types of phobias and is overly determinist - it contradicts the operant conditioning stage by suggesting phobia maintenance is not always from negative reinforcement or focused on anxiety reduction
Evaluation of the behavioural approach to phobias - Weaknesses cont.
3) Behavioural explanations are geared towards explaining behaviour rather than cognitions and this is why the two-process model explains maintenance of phobias in terms of avoidance, but phobias also have cognitive and emotional elements
- It is not encompassing of all the characteristics of phobias and therefore does not provide a full picture of how phobias manifest - it therefore has poor internal validity as it does not explain the other components of a phobia
4) Evolutionary factors probably have an important role to play in phobias, but the two-process model does not mention this and we easily acquire phobias of stimuli that would have been a source of danger in evolutionary past, such as spiders, snakes and the dark. It is adaptive to acquire such fears as then we would have avoided these stimuli and so survived, passing down the preparedness to learn to fear such stimuli to our offspring.
- Seligman calls this biological preparedness - the innate predisposition to acquire certain fears, which explains why it is quite rare to develop phobias of cars and guns which are much more dangerous in modern society, but did not exist in our evolutionary past so we are not biologically prepared to learn fear responses towards them
- Therefore it fails to explain how some phobias develop from innate characteristics rather than learned associations, and so is not applicable to the development of all types of phobia
Treating phobias - the behavioural approach; Flooding
- Classical conditioning is based on the principles of association; flooding uses the idea to get people to associate their phobia with relaxation
- Flooding is a behaviourist therapy, the patient is first taught relaxation techniques such as focusing on breathing, taking slow, deep breaths, visualising a peaceful scene or progressive muscles relaxation
- The patient is then immediately exposed to an extreme form of the threatening situation and the patient is unable to make their usual avoidance responses as they are not given the right to withdraw (although they have given informed consent)
- To begin with, the person feels extremely anxious, but the fear response (and release of adrenaline underlying this) has a time limit
- As adrenaline levels naturally decrease, a new stimulus-response link can be learned between the feared stimulus and relaxation, and so patient overcomes their phobia - therefore, the patient has learned to associate the phobic stimulus with a new response (relaxation)
- This is counter-conditioning and this able to occur because of reciprocal inhibition; a patient cannot feel afraid and relaxed at the same time, meaning that one emotion (relaxation) prevents the other (anxiety)
Treating phobias - flooding cont.
- Flooding is not unethical as patients give fully informed consent about the procedure
- However, it is a traumatic experience and if patients exercise a right to withdraw during the procedure, they can make their phobia worse, and this is because they have reinforced that the phobic stimulus is associated with anxiety and have not learned the new stimulus-response (phobic stimulus-relaxation) from the therapy
- This is not the case with systematic desensitisation, as patients are not exposed to the most feared situation initially
- This means that if they withdraw, they won’t get any better, but they won’t get worse either - patients are normally given the choice of flooding or systematic desensitisation
- This is a form of behavioural therapy used to treat phobias and other anxiety disorders. A client is immediately exposed to (or imagines) an extreme form of the threatening situation until the anxiety reaction is extinguished.
- Counterconditioning = learning a new response. In flooding, counterconditioning occurs as a new response (relaxation instead of anxiety) to the phobic stimulus is learned.
- Reciprocal inhibition = the idea that you cannot feel afraid and relaxed at the same time, meaning that one emotion prevents the other.
Treating phobias - the behavioural approach; Systematic desensitisation
- Works for the same reasons as flooding because of counter-conditioning and reciprocal inhibition
- It is very similar to flooding, except that it is designed to gradually expose the patient to the phobic stimulus using an anxiety hierarchy
- Because the exposure is more gradual, it is a more ethical procedure and also does not have the same risk of worsening the phobia as flooding does
1) The therapist and patient together construct an anxiety hierarchy (a list of situations related to phobic stimulus that provoke anxiety arranged in order from least to most frightening) - in the exam you have to create one relevant to the scenario
2) The patient is taught how to relax, such as breathing exercises, progressive muscle relaxation, being mindful of the ‘here and now’, focusing on a particular object. visualising peaceful scenes or meditation
3) The patient is exposed to the phobic stimulus whilst in a relaxed state, starting at the bottom of the hierarchy; they then practise their relaxation techniques until they can stay relaxed in the presence of the stimulus. They then move onto the next step of the hierarchy and this is then repeated at each step
4) The patient eventually masters the feared situation that caused them to seek help in the first place i.e. they can stay relaxed in situations high on the anxiety hierarchy
Key words in the behavioural approach and phobias
- Flooding - a form of behavioural therapy used to treat phobias and other anxiety disorders; a client is exposed to the an extreme form of a threatening situation under relaxed conditions until the anxiety reaction is extinguished
- Systematic desensitisation - based on classical conditioning; a therapy used to treat phobias and problems involving anxiety; a client is gradually exposed to the threatening situation under relaxed conditions until the anxiety is reduced and eventually extinguished
- Anxiety hierarchy - a series of graduated anxiety-arousing stimuli centering on a specific source of anxiety in a specific individual
- Counterconditioning - being taught a new association that is a true opposite of the original association, thus removing the original association
- Reciprocal inhibition - the view that two incompatible emotions (such as being anxious and relaxed) cannot be experienced simultaneously
- Symptom substitution - in behavioural therapy, if the symptoms are removed the cause still remains, and the symptoms will simply resurface, possibly in another form
