Transcript Lecture 11 - Nic Hooper, PhD

Behavior Analysis
Lecture 11
Counter conditioning
Review
 So far, we have talked about ways to increase or decrease the rate of
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operant behavior
Remember that operant behavior is the kind of behavior that we think
of a voluntary or willful
 More precisely it can be defined as behavior modified by its
consequences
Respondent behavior, on the other hand, is modified its antecedents
 Operant behavior is often voluntary, while respondent behavior is
often reflexive or involuntary
But the best way to remember the distinction is in terms of
consequences and antecedents
In this course we have talked about how to change operant behavior,
Today we will talk about how to change respondent behavior with
procedures based on Pavlovian conditioning
Pavlovian procedures
 The great giant of respondent behavior is Ivan Pavlov
No doubt the name rings a bell ; )
 Pavlov was a Russian physiologist whose special interest was in
digestion
 In particular, he was interested in the function of the salivary
glands
 Before long, however, he began to witness that the dog would start
to salivate before it received any food
 The dog would begin salivating when it saw the food, or even the
person bringing the food, or even upon hearing the footsteps of the
person bringing the food
 Pavlov actually found this pretty annoying, because his research
was focusing on the amount of saliva different foods produced,
but the dogs were salivating even before they received any food!
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Pavlovian procedures
 On seeing this effect, Pavlov changed his research
area to study why dogs salivated before they received
the food
 What he found was that salivating could be induced
by any object that had regularly been paired with
food
 For example, if you repeatedly rang a bell and then
put food in the dogs mouth, then soon the dog would
salivate when it heard the bell
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Pavlov even found that the dog would salivate at the sight of a
geometric form, like a circle!
Pavlovian procedures
 Pavlov called this procedure conditioning
Pavlovian Conditioning: any procedure by which an
event comes to elicit a response by being paired with
an event that elicits that response
 Pavlov began by noting that if you put food into a
dogs mouth, it would salivate.
 Pavlov called the food an unconditional stimulus,
and the salivating an unconditional response
 He called a bell that elicits salivating a conditional
stimulus, and salivating at the sound of the bell a
conditional response
Pavlovian procedures
 Now if Pavlovian conditioning involved only bells
and salivating, Pavlov's work would be of little
interest to us.
 But Pavlov's work has huge implications for the
treatment of behavior problems
 In fact, Pavlov spent much time writing about these
things
 All sorts of events can become conditional stimuli,
and all sorts of respondent behavior can become
conditional responses
Pavlovian procedures
 Pavlovian conditioning has helped us to understand all emotional
reactions
 But fear has been of special interest to behaviorists because it is the
basis of so much human suffering
 In one example British behaviorist Hans Eysenck treated a man for
impotence.
 After interviewing, he found that the client only had trouble in his
own bedroom. When he was on holidays he had no problems.
 He also found that when the man was younger, he had an affair with
a married woman and was caught and beaten up by the husband.
 Eysenck hypothesized that the painful beating might serve as an
unconditional stimulus for fear, and anything that was in the
environment when the beating happened might have become a
conditional stimulus for fear
Pavlovian procedures
 What are some things that might have become conditioned
stimuli?
 The man who beat him
 The wife
 Or even intercourse itself
 However, the man who beat him and the love affair wife are not
present in the bedroom with his current wife, and he manages to
have intercourse whilst on holidays
 That tells us that the CS has to be something in his home,
maybe something in his bedroom
 It is likely that there is something in the room that is similar to
something in the room he was beaten in
Pavlovian procedures
 In order to find the CS Eysenck asked the client to describe the
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room and see if there were similarities with his current bedroom
It was found that wall paper in both bedrooms was very similar!
The wallpaper had become a CS for fear, which prevented him
from performing sexually
He had no problem having sex on holidays because the wallpaper
was different in hotels rooms
Note: there seems to be very little thinking with Pavlovian
conditioning i.e. the client did not put together all of the pieces of
the puzzle to explain his behavior. Instead it was reflexive. It just
happened.
We don’t have to think about our environment before it can
affect our behavior!
Pavlovian procedures
 Ok, lets say Wall paper guy is your client. How do you cure
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the problem?
How about repaper his bedroom. If you take the CS away
then it can no long function as a CS!
Eysenck advised the client to do just this, and the
impotence problems went away!
The wall paper guy gives us an example of how Pavlovian
conditioning can contribute towards behavior problems
But this case is far from typical, most people who seek help
for unpleasant emotional reactions cannot just remove the
item that arouses the fear
Counterconditioning
 For example, the person who is scared of spiders
cannot remove all spiders in the world, and the
business executive who is scared of flying cannot be a
business executive if he never flies.
 Fortunately, they can often be eliminated by
conditioning
 The use of conditioning to undo the undesirable
effects of conditioning is called counterconditioning
Counterconditioning: the use of Pavlovian
conditioning to undo the adverse effects of earlier
conditioning
Counterconditioning
 The first time counterconditioning was ever used was a with a three
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year old boy who was scared of rabbits
Peter would become very upset any time a Rabbit was placed near
him.
The researcher, Mary Jones, assumed that this fear occurred
because rabbits, or something close to rabbits had been paired with
some fearful event.
So Jones decided to see if she could undo his fear with conditioning
In order to do this Jones put the rabbit a little distance from Peter
while he ate crackers and milk.
In this way Jones paired the conditional stimulus (rabbit) with an
unconditional stimulus, or negative stimulus with a positive
stimulus
Counterconditioning
 Each day Jones brought the Rabbit a little closer to Peter
 This continued until Peter was happy to have the rabbit on his
lap
 Counterconditioning counters the effects of naturally
occurring conditioning
 It consists of pairing a stimulus that elicits inappropriate
respondent behavior with a stimulus that elicits appropriate
respondent behavior.
 There are two main types of counter conditioning:
 Desensitization training
 Sensitization training
Desensitization training
 In desensitization training, counterconditioning is used to
reduce the strength of a negative emotional response to a
particular kind of stimulus and situation
Desensitization training: any form of counter conditioning
that reduces an inappropriate negative response to an event
 This is accomplished by pairing the stimulus that elicits the
negative emotional reaction with another stimulus that
elicits a positive reaction
 Although this can be done in various ways, the most
popular technique is called systematic desensitization
Systematic Desensitization
 Systematic desensitization was developed by Joseph
Wolpe, who was a famous behavior therapist.
 It is best used in the treatment of phobias but has
been used with other anxiety based disorders as well
 The procedure consisted of three steps:
 Constructing a hierarchy
 Relaxation training
 Counter conditioning
Constructing a hierarchy
 This refers to identifying the kinds of situations that arouse fear
and arranging them into a hierarchy from least to most upsetting
 At the top of the ladder would be the situation that makes the
person most uncomfortable i.e. having a snake around one’s neck
 At the bottom of the ladder would be something that creates no
discomfort i.e. seeing a picture of a snake
 It is important to note that the hierarchy is created by the
reactions of the client, and not by social convention or intuition
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Usually, in addition to interviewing the client about these things, therapists may
also gather information via self report questionnaires
One could even take a physiological measure, like skin conductance
Constructing a hierarchy
 Wolpe also talked about ‘subjective units of disturbance’
(SUDS)
 SUDS is a scale that attempts to measure the degree of
disturbance caused by situations
 E.g. the bottom item on the ladder should have a SUDS
score of 0, whilst the top item should have a SUDS score of
100.
 There is no prescribed number for how many steps should be
in a hierarchy, but many say 10 items is the minimum, with
many ladders having 30-40 steps.
 Importantly, the lowest item should be not disturbing, the
highest item should be very disturbing and the items in
between should only be separated by small steps.
Relaxation training
 Once the hierarchy is constructed, the next step is
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relaxation training
A physician named Edmund Jacobsen realized that many
people tense their muscles without knowledge
He therefore designed a training program that aimed to
enable clients to spot tense muscles, and have the ability
to relax them
Wolpe thought that this training could be used in
systematic desensitization
So that consistently pairing a frightening situation with
relaxation, the situation will come to elicit relaxation
rather than fear
Counter conditioning
 The third and longest step in systematic desensitization is
counterconditioning. In this step the therapist pairs situations in the
hierarchy with relaxation
 The procedure is this:
 Client is asked to describe a step on the ladder, usually with eyes
closed
 If at any time the client feels anxious he has to raise his index finger
 When this happens, the therapist asks him to stop imagining the
scene, and to relax
 After relaxing several seconds, the client is to return to imagining the
scene
 When the client is able to imagine the scene for 10 seconds and to
relax he is closer to the next step
 When the client has done this twice, they are ready to move onto the
next step
Counter conditioning
 By repeatedly pairing the imagined situations in the
hierarchy with relaxation, the client is able to work
up the ladder without ever feeling too much
discomfort
 Treatment can take anywhere between 1 session to a
few months depending on how severe the phobia is
 And often the therapist will ask the client to take
their new skills and practice them at home
Queries
 ‘Are we suggesting that people can overcome their fears by simply
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imaging scary situations? Does the therapist not have to expose the
client to the actual situation?’
Usually imagining works fine. Of course the client is encouraged to
participate in real situations related to their hierarchy, but only if they
don’t arouse anxiety
Its hard to believe that when a person is able to imagine a situation that
they are then ready to be in that situation
But what were talking about here is generalization; changes in behavior
in one situation occur in other situations as well
I guess systematic desensitization is surprising because the training and
testing situations are very different
However much research show that improvements in therapy sessions
do generalize to real life
Systematic Desensitization
 Wolpe’s procedure has proved remarkably effective
with a wide variety of clients and problems.
 Since Wolpe introduced the system several
variations of the procedure have been tried
 These include
 In vivo desensitization
 Self desensitization
 Flooding
In vivo desensitization
 It is possible to use systematic desensitization in actual
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situations
This is called in vivo desensitization
 The words ‘in vivo’ literally mean ‘in life’.
Instead of imagining a disturbing scene, the client actually
confronts that scene!
The therapist still goes through the three steps, only situations
involved are real rather than imagined
You may wonder why all systematic desensitization is not in vivo.
The answer is that is just is not practical, possible and convenient
most of the time
Research also suggests that both ways have similar clinical
outcomes i.e. they both seem to work as well as each other
Self desensitization
 Another variation of Wolpe’s procedure is for the client
to undergo the procedure without the help of a therapist
 This is called self – desensitization
 The idea is that people can build hierarchies, teach
themselves relaxation and perform counter conditioning
by themselves, provided they receive some basic
instruction
 Research suggests that this variation can also be
successful. Unfortunately however, without the structure
and support of a therapist many never fully complete the
procedure
Flooding
 The critical difference between systematic desensitization and
flooding is that the latter abandons the hierarchy and the gradual
pace of therapy
 Instead the client is asked to imagine the worst possible situation
right from the beginning!
 The exposure continues until the conditional response, the
anxiety, no longer occurs
 Flooding has two main drawbacks
 The therapy session is anxiety provoking. The object is to
expose the person to the fearful situation until it no longer
evokes discomfort
 Second, there is less room for error in flooding – there is more
chance of severe reactions from clients
Sensitization training
 So far all of the procedures we have talked about
concern desensitization training
 Sensitization training, on the other hand, is used to
reduce the strength of a positive emotional response
Sensitization training: any form of
counterconditioning that reduces an inappropriate
positive response to an event
 This is accomplished by pairing the stimulus that
elicits a positive emotional reaction with another
stimulus that elicits a negative reaction
Sensitization training
 Sometime people struggle to understand why it is a
problem to have a positive emotional reaction
towards something
 But the word ‘inappropriate’ is most important here.
 There are many situations in which people feel
inappropriate positive emotions towards something
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E.g. an obese person probably feels inappropriately positive
about food
How about pedophilia? This literally means love of children,
but the term refers to sexual interest in children
Aversion therapy
 So sensitization involves reducing inappropriate positive reactions with
counterconditioning
 This can be done in various ways, but perhaps the most commonly used
procedure is aversion therapy
 Aversion therapy is a form of counter conditioning where the
conditional stimulus is paired with a stimulus that elicits a negative
emotional response
 The idea is to reduce the attraction that the person feels towards the
conditional stimulus
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One classic example of aversion therapy was reported by Raymond (1956) who treated a
patient that liked to destroy hand bags and baby carriers!
In order to treat him, Raymond presented a baby carrier or handbag to pram man just
before a nauseating drug took effect.
The man would look at one of these objects and then feel sick to his stomach
Pram mans problems were gone within a couple of weeks of treatment
Covert sensitization
 Aversion therapy is the best known sensitization procedure,
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another popular one is covert sensitization
Like aversion therapy covert sensitization involves pairing an
object/situation that arouses positive feelings with one that
arouses negative feelings
The difference with covert sensitization is that the objects or
situations are merely imagined
Again it may be seem surprising that imagining a situation could
translate to the real world, but imagination can have strong
effects!
Its important to note that evidence for sensitization training is
very poor, for example many researchers have tried to stop
problematic behavior with this procedure, like smoking, but
never could
Rules for counter conditioning
 Many experimental studies with counter
conditioning have demonstrated that it is an effective
way to modify respondent behavior
 However, this will always depend on using the
procedure in the right way
 There are four rules that are especially important
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Define the target behavior
Identify the stimuli to be paired
Pair the appropriate stimuli
Monitor the results
Define the target behavior
 As always, it is essential to have a clear idea of what
behavior is to be changed
Identify the stimuli to be paired
 Counter conditioning is Pavlovian conditioning used
to counter the effects of past learning.
 In counter conditioning, a stimulus that elicits an
inappropriate response is paired with one that elicits
a very different reaction
 To do desensitization or sensitization training
properly, it is necessary that the appropriate stimuli
be identified before the training begins
Pair the appropriate stimuli
 Correctly pairing the appropriate stimuli means
presenting them so that the one that elicits the
inappropriate response begins slightly before the one
that elicits an appropriate response
Monitor the results
 In any intervention we have to monitor the results
 If used properly counter conditioning procedures can
have immediate effects
 If desired effects are not being obtained, the
intervention must be evaluated to determine why it
is not being effective.
Flash card
 Pavlovian conditioning
 any procedure by which an event comes to elicit a response by
being paired with an event that elicits that response
 Counter conditioning
 the use of Pavlovian conditioning to undo the adverse effects of
earlier conditioning
 Desensitization training
 any form of counter conditioning that reduces an
inappropriate negative response to an event
 Sensitization training
 any form of counter conditioning that reduces an
inappropriate positive response to an event