In the last article we discussed psychoanalysis and humanistic therapies. Both therapies generally target non-psychotic people who need to enhance their self awareness and position themselves to gain insight into their unresolved and unconscious tensions. Behavioral therapy approaches peoples psychological problems in terms of how they can change the way they behave, replacing a more constructive way to think and act, replacing maladaptive behaviour. Cognitive therapy is applied to those suffering from major depression, anxiety, panic attacks, bipolar disorder and the like…the very disorders that are more commonly today treated with drugs. In this article we will explore in a little more detail these therapies.
John B Watson – Classic Conditioning
“Give me a dozen healthy infants, well-formed, and my own specified world to bring them up in and I’ll guarantee to take any one at random and train him to become any type of specialist I might select – doctor, lawyer, artist, merchant-chief and, yes, even beggar-man and thief, regardless of his talents, penchants, tendencies, abilities, vocations and the race of his ancestors”
Behaviorism is based on all behavior that is acquired is through learning from the environment and acquired from classic conditioning and operant conditioning. John B watson (1878-1958) an American psychologist who published his famous article in 1913 ‘Psychology as the Behaviorist views it’ proposed that classic conditioning as explored by Pavlov such as emotional response or speech were simply patterns of stimulus and response. This point of view is conveyed in the quote above, defining classic conditioning as a learned new behaviour through the process of association. In Watson’s famous ‘Little Albert’ experiment involving a 9 month old child that was presented with a white rat, a rabbit and a monkey showing no fear toward any of the animals. Then behind the child a steel bar was struck hard with a hammer making a sudden loud noise that made Albert cry. At the age of 11 the experiment was repeated with the same results and over a series of weeks Albert would begin to cry as soon as he saw the white rat without the loud noise. Furthermore this experiment created a phobia in Albert associating anything that resembled the white rat..a piece of cotton wool, a Santa Claus beard, a fur coat etc. By today’s standards this would be considered an unethical experiment, but luckily Albert eventually lost (called extinction) his phobia toward the white rat.
Stimulus-Response & Systematic Desensitization
The rationale of such an experiment shows for example that a positive emotional experience associated with learning only reinforces the learning experience, and the interaction of nature (biology) over nurture (environment). Ivan Pavlov (1849-1936) a Russian physiologist in 1902 showed how classic conditioning works to make a a dog salivate to the sound of a bell by associating the sound of a bell with the availability of food. (Unconditioned Stimulus, Unconditioned response). In a cartoon caption the dog speaks to another dog and says “ Look what I can make Pavlov do as soon as I drool, he smiles and then writes something down in his little book”. Therapy using Classic conditioning involves also ‘systematic desensitization’ developed by South African Joseph Wolpe (1915-1997), working on the theory humans cannot be simultaneously anxious and relaxed, and that phobias and fears are a learned response that can be equally unlearned. This is achieved by first learning to relax the whole body and once in this condition the associated fear of phobia can gradually be introduced ensuring that at all stages the body remains relaxed until the fear or phobia become associated with a relaxed state not an anxious state.
B.F Skinner – Operant Conditioning
B.F Skinner an American psychologist, social philosopher and another behaviourist at least acknowledged the existence of the human mind, unlike Watson who denied completely the existence of mind and consciousness. Skinner thought that Watson’s view of classical conditioning was too simplistic and that the best way to view behaviour is through causes of an action and its consequences. ( which he termed ‘Operant conditioning’). Skinner demonstrated operant conditioning defined as ‘the changing of behaviour by the use of reinforcement given after a desired response’ in his designed ‘Skinner Box’. In this box he would place a rat who could move freely around it, also the box contained a lever and if accidentally touched by the rat a food pellet would appear in a container next to the lever. Soon enough the rat learned that touching the lever would deliver food. In this experiment positive reinforcement occurs when the rat is rewarded with food. It is a bit like going to work and receiving a paycheck (positive reinforcement to come back to work tomorrow…lol),
Cognitive Therapy- I
Accept the things you can’t change
Have the courage to change the things you can
Have the wisdom to know the difference
Up to this point we have discussed rudimentary behavioural therapy targeting a particular focus such as fear of a phobia, by changing its association from a negative standpoint to a positive standpoint, but in terms of disorders that maybe have no obvious targeted focus such as anxiety, panic attacks, depression, Schizophrenia etc the approach needs to be altered. Cognitive Behavioural Therapy (CBT) directed toward psychological disorders seek to understand not the person’s direct emotional response to an event, but to the person’s thoughts in response to the event. Cognitive behaviour also finds its roots in a discipline of Philosophy called ‘Stoicism’.
“You are not your body and hair-style, but your capacity for choosing well. If your choices are beautiful, so too will you be.” – Epictetus
Epictetus (55 AD-135 AD) existed around 2,000 years ago, he was a greek Stoic philosopher whose known quotes describe the principles of Behaviourism:
“To accuse others for one’s own misfortune is a sign of want of education.
To accuse oneself shows that one’s education has begun.
To accuse neither oneself nor others shows that one’s education is complete.”
Philosophy and Psychology are intrinsically linked, since they are a ‘voice’ of the human mind in thought and deed and their education is essential (in my opinion) to understanding true Human-beingness. If people who are wrapped in disturbing thought, allowing life to engulf their very self, attempting to obtain ‘worldly goods’ and strive to rub shoulders with wealth, can only just take a step back and understand themselves they will experience the great marvel of life itself.
Stoicism is a particular school of Hellenistic philosophy founded in Athens Greece in the early 3rd century BC, that was built on the principles of virtue (e.g wisdom) that brings happiness and judgment which should be based on behaviour not words ( I am sure you are aware of the phrase ‘Action speaks louder than Words’). To also realise that we cannot control nor rely on external events, only ourselves and our responses. Stoicism teaches that the world is unpredictable, and our existence within it is just a short fleeting moment in time, and while we are a part of it we must be strong and be in control of ourselves, and finally to be aware that the origin of our dissatisfaction is our impulsive dependency on our reflexes rather than logic. Even one of the greatest US presidents George Washington, introduced to Stoicism when he was much younger, organized a play Cato, a ‘Tragedy’ written by Joseph Addison in 1712, based on the last days of Marcus Porcius Cato Uticensis (95-46 BC) a Stoic who was unwilling to live in a world dictated by Julius Caesar eventually committed suicide. The exploits and courage against Roman tyranny was supposed to inspire Washington’s men during a dark winter at Valley Forge in Dec 1777 during the American Revolutionary war.
Seneca, also a stoic, born in southern Spain and educated in Rome, an admirer of Cato was eventually executed by Nero thinking Seneca was part of a plot to assassinate him, but Seneca’s published works found a place on Thomas Jefferson’s nightstand on the night that he died. Stoic writing was synonymous to spiritual exercises like a yoga session than just a boring bunch of philosophies. Although Seneca was wealthy as the advisor to emperor Nero, he did suggest that people ( including himself..what did he do..give all his money away ??) should set aside a certain number of days/month to practice poverty by fasting, wearing their worst clothes and to put themselves out there face to face with want (…that’s easy for you to suggest but sitting here in the middle of Rome with a begging bowl is my daily routine..I have no other choice…Spare a talent for an old ex-leper….lol). I wonder if Seneca was a little hypocritical since he stated that:
“Comfort is the worst kind of slavery because you’re always afraid that something or someone will take it away”.
(so if you can not anticipate, but practice misfortune, then chance loses its ability to disrupt your life)
Cognitive Therapy – II
Albert Ellis was an American Psychologist (1913-2007) who developed his version of cognitive therapy which excludes the past of an individual, what they have learned in their childhood etc, Ellis operates in the now. His form of cognitive therapy is called Rational-Emotive therapy. He believed that individuals internally express 2 points of view given any situation or external event so for example they might say:
“I disapprove of what I have done , and I dislike my behaviour“
The corresponding irrational internal expression would be:
“ ..and because I dislike my behaviour I am no good, I am worthless“
So this irrational statement is not based on anything tangible, only based on some twisted faith of hopelessness, as opposed to something factual, feeding their anxiety, guilt, depression or other forms of self defeatism. Similarly they might say:
“I don’t like your behaviour or opinion”
and instead of following this statement with:
“ ..and although I dislike your behaviour, your opinion I will attempt to change it”
They irrationally say:
“I can’t stand your behaviour…you should not be the way you are, you should be ashamed of yourself “
It is these irrational statements that upset the individual and only fuels the negative way they feel, so as Seneca said some 2000 years ago “we cannot control nor rely on external events, only ourselves and our responses”. So although the individual may have learnt these self defeating traits when they were a child they are still re-indoctrinating himself with the same self-defeating ideologies. The idea of the therapy is to teach the individual to work and practice re-evaluating, and re-assessing their own philosophical assumptions to work toward improving and thus changing their internal attitude toward an external event. This is achieved by giving the individual tasks that allow then to learn for the rest of their lives to challenge and question their own basic value system and rethink and re-evaluate their response particularly when they feel miserable, anxious, depressed etc. One of the classic examples is referred to as Magnification or Catastrophizing where one thinks the worst possible outcome from any given situation. Albert Ellis is counselling a young woman Gloria who wants to meet the right man but is overly concerned that she may not show her best side and end up being rejected by possibly the best man she could ever have, instead of just being herself and risk the consequences like most normal people would be. Ellis explains to her how, if she just be herself, without role playing, the meeting would flow naturally and if the encounter works, than fine, if it fails, tough than she was not meant for him or vice versus. Here is the Youtube link to this counselling session:
From a normal thinking perspective it may appear trivial, but when people are depressed, it is very real to them to the point where is shapes shifts their character and thinking and feeling about every possible situation in a negative way is normal to them. Humans view the world through a lens of emotion, so if an external event occurs we always experience the emotion first, and then our cognitive process ‘kicks-in’ like an imaginary lawyer to explain that set of emotions..” My client is happy your honor”. In some cases we make decisions based on out emotions rather than logic, so in cognitive therapy the questions are asked “What can we do to change Resentment to Acceptance, or Apathy to Action?”, changing beliefs that surround questions such as “Am I a victim, or am I in control?”. Finally changing the mind also involves embodiment ( body movement and posture).
Aaron Beck at the age of 96 is an American psychiatrist who is professor emeritus in the department of psychiatry at the University of Pennsylvania, who, like Ellis seek to remove the dark glasses through which depressed people view life. As Beck explains, each psychological condition possesses their own cognitive constellation, and once this has been identified it can be therapeutically addressed. For example, in panic , the patient is very calm when they visit the therapist, which is natural in the presence of an authoritative figure. Within the therapy session it is essential to simulate a panic attack in order to identify what sensations they are misinterpreting, and in the process of the attack the therapist helps the patient become aware of the internal sensations which the patient can re-label them not as a threatening or catastrophic sensations but as normal, explainable biological occurrences. In contrast the depressed patient is depressed inside or outside of the therapist office, so recreation is unnecessary, furthermore, their depressed condition has nothing to do with the interpretation of senses but it’s the way they feel about themselves now, how they felt about themselves in the past and in the future which can be addressed the same way as Ellis dealt with Gloria.
Behavioural therapy is used in an attempt to discover the way people behave, and then converting any maladaptive behaviour into something more positive, whereas the cognitive approach is designed to help individuals with more serious disorders like anxiety, depression etc. There is another aspect worth discussing social psychology that approaches the world of the cognitive impaired a little differently which we will explore in the next article. Since I always end my articles sometimes on a lighter note I have included the initial scene in the Movie ‘What about Bob’ which is a classic movie that you can watch many times. It is quite clever the way the Therapist Dr Leo Marvin suggests an ‘Active’ approach to help Bob Wiley who has multiple disorders Panic attacks, anxiety, Tourettes Syndrome.
Bob Wiley: “The simplest way to put it, I have problems.I worry about diseases,so,I have trouble touching things,In public places it’s almost impossible.I have a real big problem moving”.
Dr. Leo Marvin: “Talk about moving”.
Bob Wiley: “As long as I’m in my apartment, I’m ok. But when I go out, I get weird !”.
Dr. Leo Marvin: “Talk about weird”
Bob Wiley: “Well, I get disease spasms, nausea, Cold sweats, difficulty breathing, difficulty swallowing, Bird Vision,involuntary trembles, Dead ends, numb lips, fingernails sensitivity, Pelvic discomfort”.
Dr. Leo Marvin: “So the real question is, what is the crisis ?” What is that you’re truly afraid of ..”
Bob Wiley: “What if my heart stops beating ?What if … I’m looking for a bathroom , I can’t find it…and my bladder explodes…”
Dr. Leo Marvin: “Bob, there’s an old saying, that the best psychiatrist in the world, is the one right inside of you”’
Bob Wiley: “Yeah…”
Dr. Leo Marvin: “I can help you, yes.”
Bob Wiley: “Thank you.”
Dr. Leo Marvin: “Bob, there is a ground-breaking new book, that has just come out, Now, I have written this book, of course it applies to you, but,I’m sure that you can see when you see the title, exactly how it could help”.
Bob Wiley: “Baby Steps ?”
Dr. Leo Marvin: “It means setting small reasonable goals for yourself one day at a time, One tiny step at a time..Baby steps, For Instance, hum…
When you leave this office, don’t think about everything you have to do in order to get out of the building, just think to what you must do to get out of this room, and when you get to the hall, deal with that hall, and so … You see ? Baby steps !”
Bob Wiley: “Baby steps”
Check out the Previous Articles in this series:
- What is Stoicism Daily Stoic
- Psychology Book 1995 David G Myers
- John B watson, Valley Forge, Joseph Wolpe, B.F Skinner, Marcus Porcius Cato Uticensis Wikipedia
- Movie quote ‘What about Bob’ 1991 Wikiquotes
- Quotes Epictetus Goodreads
- Albert Ellis Counselling session with Gloria 1965 Youtube Video
About The Author: Eric Malouin
In terms of my heritage I am not a thoroughbred, I am half English from England and half French Canadian from Quebec. Having spent the last 10 years in Medical research I thought that it was time to share my passion for true health to anybody interested in maintaining health without using conventional medicine. Once in the distant past I lived off conventional grocery shelves until you visit the man in the white coat and then a light shines through the darkness that you had not realized you were in… I was in..the twilight zone….I cured my own problems using natural methods, although they were not a big deal since I have always exercised..jogging every morning and tennis 12 hours/week, swimming but I was eating a lot of devil food that was causing my body to become unbalanced..an easy fix..reprogrammed my taste buds and gave the food back to the devil…lol
I hope you enjoy the articles……
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