One treatment for phobias based on classical conditioning

One treatment for phobias based on classical conditioning Systematic desensitisation

Systematic desensitisation • A behavioural therapy based on classical conditioning • Developed by Joseph Wolpe in the 1970 s • Based on original work by Mary Jones in the 1920 s • AKA graduated exposure therapy

What does it involve? • the client is gradually (systematically) introduced to feared object in a nonthreatening environment (desensitised) • assumes that if phobias are acquired through classical conditioning, the same processes can be used to unlearn old associations and create new ones

Fear hierarchy • • the client creates a fear hierarchy feared object at the top going down in as many stages as they want bottom of hierarchy = something related to their feared object which they feel they could tolerate

Example of a fear hierarchy for Arachnophobia – stage 1: place the picture of the dot on the other side of the room – stage 2: legs could be drawn onto the dot, then it could be moved closer gradually – stage 3: a photo of a small spider is used in a similar way – stage 4: a real tiny spider is used in the same way – Stage 5: a bigger spider – Stage 6: the person is able to be in close proximity to a relatively large spider – Stage 7: handle a spider •

Reciprocal inhibition • A technique based on the idea that certain physiological responses are incompatible with each other • For example it is not possible to relax and be anxious at the same time • The technique is used to teach a new reaction to the anxiety-provoking stimulus

Spiders

Relaxation strategies • The therapist will teach the client relaxation strategies, e. g. meditation, using positive affirmations, aromatherapy, etc • once the client is able to maintain feelings of relaxation and is ready to face the first stage on the fear hierarchy (the black dot) • the object is paired with the relaxation techniques • through classical conditioning the client begins to associate the black dot, (the first point on the fear hierarchy) with relaxation

What happens next? • therapist repeats procedure using each point on the fear hierarchy until the client is able to tolerate the feared item (big live spider out of the tank) • at this point, the old fear response will have become extinct • they have experienced the conditioned stimulus enough times for the maladaptive stimulus/response unit (spider/terror) to become unlearnt • they have stayed in contact with the once feared object instead of avoiding it (which created negative reinforcement and encouraged further avoidance)

Evaluation: Studies • Little Peter, (Jones, 1924) – Case study of a successfully cured little boy with a phobia of rabbits – Jones gradually introduced him to a rabbit over a period of several days while he ate his dinner – the rabbit was brought closer and closer each day – eventually the boy began to stroke the rabbit and his fear was unlearnt.

Capafons (1998) • successfully cured fear of flying in a sample of 20 clients • Pps in the treatment group gave more positive self reports and interviews and showed less bodily stress responses when exposed to their feared situation (a flight simulator) than an untreated control group • TASK: See what extra APFC details you can find out about this study

Competing arguments • Can you think of any competing arguments to counter either of these pieces of evidence? • If you are able to think of problems with this evidence, what does this tell us about systematic desensitisation as a therapy for phobias?

Practical issues: FOR • can be used with wide range of specific phobias • can be a highly effective and relatively quick technique; • client feels empowered as they are in charge of creating the fear hierarchy (in flooding the client is less empowered) • they can understand why therapy should work as it is a plausible explanation

Practical Issues: AGAINST • Some patients can’t maintain relaxation as effectively • may need anti-anxiety drugs to get them into a suitable state for therapy to be effective

Alternatives: Flooding • Flooding involves removing the graduated aspect and simply ‘throwing the person in the deep end’ • works on basis that full scale fight or flight response cannot be maintained for extended periods as it uses energy which will eventually run out • once the person experiences their anxiety falling the stimulus/response unit will become unlearnt

Two extra therapies for you! You don’t need to know about the next two in any depth, although they might be helpful for Paper 3 synopticity. If you have time and want to extend your knowledge by all means , see what else you can find out about them

Use of drugs • anti-anxiety drugs such as benzodiazepines • They increase brain’s ability to make use of GABA, the neurotransmitter which inhibits anxiety and makes a person feel calmer • have some positive effect in treating phobias

Psychoanalysis Uses techniques such as free association and dream analysis to access unconscious memories and desires which may reflect conflict between id and superego thus explaining the latent (underlying) cause of the person’s anxiety

Psychoanalysis cont’d • Freud explains phobias in terms of defence mechanisms • e. g. fear of castration in the Oedipus complex is displaced onto some other object or situation • as the white horse in the Little Hans case study

Applied question Gladys has a terrifying fear of pineapples. She has been offered a free holiday to the Caribbean but the thought of going fills her with horror in case she comes across a pineapple. Explain one treatment/therapy that could be used to help Gladys. (4)

Essay Question Evaluate one treatment or therapy for phobias (8)

Harder essay Gladys has a terrifying fear of pineapples. She has been offered a free holiday to the Caribbean but the thought of going fills her with horror in case she comes across a pineapple. To what extent might the learning theories the biological psychology help Gladys to overcome her phobia? (12)