Behavioural approach explaining and treating phobias Flashcards
Phobias
A phobia can be defined as an ‘extreme and irrational fear of a specific stimulus that produces a conscious avoidance of the source of the fear’.
We all experience anxiety and fear in particular situations but this does not necessarily amount to a phobia. Experiencing fear in some situations can be useful as it protects us from danger; however, for individuals with a phobia this fear response is irrational and maladaptive.
The behavioural approach to explaining phobias: the two-process model
The behavioural approach suggests that phobias, like all behaviours, are learned. An individual learns to fear certain objects or situations through the interactions and experiences they encounter.
The Two-Process Model explains how a phobia begins in the first place and then how the phobia continues.
Step 1: Firstly, a phobia develops through the process of classical conditioning. Classical conditioning is learning through association. This involves an individual associating two stimuli with one another when they occur at the same time. The association that forms means that the individual’s response to one of those stimuli transfers to the other.
For example, if an individual chokes when they are swimming they might associate choking with water (two stimuli). Their response to choking (e.g. fear and panic) might transfer to water. In the future they will respond to water with fear – a phobia has formed.
Step 2: Secondly, the phobia is maintained through the process of operant
conditioning. Operant conditioning is learning through consequences. The likelihood of a behaviour being repeated depends on the consequences that follow that behaviour. If a behaviour is followed by a reward (something pleasant) the behaviour is likely to be repeated.
For example, an individual with a phobia of water avoids being in or around water and this is followed by a reduction in their fear and anxiety (something pleasant). Therefore they are likely to continue avoiding water. This is called negative reinforcement.
Evaluation of the behavioural approach to explaining phobias, strength
A strength of this approach is that there is evidence from studies that support the idea that learning can be responsible for the development of phobias. For example, Little Albert learned to fear white rats through the process of classical conditioning. This is a strength because we can be more confident that the behavioural approach offers an accurate explanation for how and why phobias develop.
Watson and Rayner demonstrated how phobias develop by frightening Little Albert with a very loud noise each time he played with a white rat. (He was very fond of the rat in the beginning!) The fear that he felt from the loud noise became associated with the white rat and Albert developed a phobia of white rats and indeed anything white and furry. The phobia is the conditioned (or learned) response.
Evaluation of the behavioural approach to explaining phobias, practical applications
a major strength of this approach to explaining phobias is that it has important practical applications as it has led to the development of successful behavioural therapies. Both systematic desensitisation and flooding are based on the principles of classical conditioning and research has shown that they are effective at treating phobias. This is a strength because the behavioural approach offers a solution to a problem and helps people in the real-world. This has had a strong positive impact upon the economy by allowing people to stay in work while they are undergoing treatment and minimising the amount of sickness payment required within society.
Evaluation of the behavioural approach to explaining phobias, weaknesses
A weakness of this approach to explaining phobias is that not all evidence supports the claims made by the Behaviourist approach. Not all phobias appear following a bad experience. For example, someone could develop a phobia of snakes without having ever been near a snake let alone having been frightened by one. i.e. Munjack (1984) found that only 50% of people with driving phobia had frightening experience in a car . This is a weakness because these instances cannot be explained by conditioning; the behavioural approach cannot explain all phobias.
Another weakness of the behavioural approach is that it is heavily focused on the nurture side of the nature nurture debate . The approach only considers learning experiences as the cause of phobias and ignores the impact that biological factors have. There is evidence that genes and neurotransmitters play a role in the development of phobias. Furthermore, learning theory cannot explain why many people have the same phobias e.g. snakes, spiders, heights. It is believed that an alternative cause is evolution. We are biologically prepared to fear things that could be a danger, for survival purposes. This is a weakness because the learning approach is unbalanced; it is more likely that both experiences and biology combine together to bring about a phobia.
The behavioural approach to treating phobias: Systematic desensitisation
Systematic desensitisation (SD) involves gradual exposure to the individuals’ feared object or situation and is based on counterconditioning. This therapy is based on the notion of reciprocal inhibition. This is the notion that we cannot experience two incompatible emotional states at the same time i.e. we cannot be frightened and relaxed at the same time.
The therapy has three main stages:
1. First, relaxation techniques are taught to and practised by the individual so that they can successfully get themselves into a state of calm and relaxation. These techniques might include progressive relaxation, whereby various muscle groups in the body are first tightened and then relaxed. During the alternating clenching and relaxing, the client should be focusing on the contrast between the initial tension and the subsequent feelings of relaxation and softening that develop once the tightened muscles are released. After discovering how muscles feel when they are deeply relaxed, repeated practice enables a person to recreate the relaxed sensation intentionally in a variety of situations.
- Secondly, the individual creates their hierarchy of fear. This is a list of situations or scenarios involving their feared stimulus which is then ranked from least to most frightening
- Finally, the first two stages are put together. The individual uses their relaxation techniques whilst being gradually exposed to (in vivo) or imagining (in vitro) each scenario on their hierarchy of fear. It is not possible to feel frightened at the same time as feeling relaxed. This is known as reciprocal inhibition. Therefore, the individual learns a new association between their feared stimulus and feeling relaxed. This is called counterconditioning because the new response (relaxation) is counter to the original response (fear and anxiety).
Evaluation of systematic desensitisation, effectiveness
One strength of the therapy is that there is evidence to suggest that it is
effective at alleviating a range of phobic symptons. McGrath (1990) found that 75% of people were successfully treated by SD. Also, Gilroy (2003) compared 42 spider phobic patients treated with three, 45 minute sessions of SD with a control group treated with relaxation alone. Both 3 months and 33 months after treatment the SD group showed less fearful responses than the relaxation group. This shows that for simple phobias SD can be a relatively quick and long lasting therapy. This is a strength because it shows that SD is an effective treatment for phobias; it has been shown to work and supports the economy.
A weakness of the therapy is that not all aspects of the process seem to be equally effective. Imagining examples of the feared stimulus (in vitro) is less effective than confronting actual examples of the feared stimulus (in vivo). The extent to which any individual has a vivid imagination sufficient to represent their fear is questionable and better results have been attained when using in vivo techniques. This
is a weakness because the therapy may not be effective for all individuals undertaking SD.
Evaluation of systematic desensitisation, appropriateness
Another weakness is that the therapy is not always an appropriate method of treatment. For example, for someone who has a phobia of zombies it would not be possible to confront actual examples of this feared stimulus. Therefore, the only option would be to use the less effective in vitro therapy. It has also been suggested that some phobias have an underlying evolutionary cause (inherited adaptive fears) and have not been learned. In these cases, counterconditioning would not be appropriate. This is a weakness because the therapy will not be successful for all individuals with a phobia.
SD may not be appropriate as it does not attempt to treat the underlying causes of a phobia. In doing so SD ignores any deeper
underlying psychological or emotional issues that may be involved in the phobia. For example, Wolpe (1973) reported the
case of a woman with a phobia of insects who did not respond well to SD. It turned out that her husband was nicknamed after an
insect and Wolpe recommended that she see a marriage counsellor which successfully treated her phobia. This suggests that SD may not be appropriate to deal with the underlying issues that may be causing a phobia.
Evaluation of systematic desensitisation, ethical
SD may be considered to be a more ethical way of treating phobias than flooding (see below). This is because the client is thought to have some control over the process, in drawing up the hierarchy and stopping a stage when the feeling of fear become overwhelming. This is a strength because it may limit the drop out rate of therapy and be more desirable to people seeking help.
flooding
Flooding is similar to SD in that it is based on the principles of counterconditioning and reciprocal inhibition. However, this therapy involves full and immediate exposure to the individual’s feared stimulus rather than the gradual exposure used in SD.
An individual with a phobia would have one long session (usually 2-3 hours) where they are exposed to their phobia at its worst while at the same time using relaxation techniques. Eventually their anxiety levels come down (we cannot maintain a state of heightened anxiety forever!) and a new association is learned between their phobic stimulus and relaxation.
Like SD, this can take place in vivo or in vitro. Flooding can be used with virtual reality where the patient wears a head mounted display which simulates the phobic object or situation.
Evaluation of flooding, strength
One strength of the therapy is that research has found that it is effective for some individuals. Choy et al. (2007) found that for those who are able to see the therapy through to the end and complete the full session, flooding is more effective than SD. Furthermore, Kaplin (2011) found 65% of patients with a specific phobia given a single session of flooding showed no symptoms 4 years later . This is a strength because the therapy is also quicker than SD and could therefore be a good option for many sufferers of phobias (especially those with little time).
Evaluation of flooding, weakness
A weakness is that the therapy is not always an appropriate method of treatment. This is because flooding deliberately creates high levels of anxiety so is a traumatic experience for phobic patients. This raises ethical issues concerning acceptable levels of suffering by patients and means they may drop out of treatment. For many, the prospect of being flooded is far too traumatic to consider. For those who opt for this therapy many will withdraw during the treatment and
won’t benefit from it in the same way. This is a weakness because the therapy will not be successful for all individuals with a phobia and may be inaccessible for some.
General evaluation of behavioural treatments (SD and flooding), strength
One strength of both therapies is that they are relatively fast and require less effort on the part of the individual. For example, cognitive behaviour therapy (CBT) requires a lot of motivation and insight from the individual whereas the behavioural therapies do not require thought or understanding. This is a strength because the therapy may be appropriate for people who lack insight into their thought processes and emotions, such as young children.
The fact that there are research studies suggesting that the techniques are effective has a positive effect upon the economy. By providing therapy for those with mental health difficulties, there is less time taken off work with sickness, less need for sickpay or sickness benefits
General evaluation of behavioural treatments (SD and flooding), weakness
A weakness of both therapies is that in some cases they could do more damage than good. If an individual undertaking treatment withdraws before the process is complete, this could reinforce their phobia. The association between their phobic stimulus and fear might be strengthened. This is a weakness because the aim of these therapies is to reduce the individual’s anxiety and improve their quality of life and in some instances this might not be the case.
