Phobia

What are the behavioural characteristics of phobia?

Panic, avoidance and endurance (unavoidable)

What are the emotional characteristics of phobia?

Anxiety and unreasonable emotional responses

What are the cognitive characteristics of phobia?

Selective attention to phobic stimulus, irrational beliefs and cognitive distortions

How does the behaviourist approach explain phobia?

The two process model (Mowrer)

What is the two process model?

The behavioural approach emphasises the role of learning in the acquisition of behaviour. Hobart Mowrer (1960) proposed the two-process model based on the behavioural approach to phobias. This states that phobias are acquired by classical conditioning and maintained by operant conditioning.

What is acquisition by classical conditioning?

Classical conditioning involves learning to associate something of which we initially have no fear (a neutral stimulus) with something that already triggers a fear response (an unconditioned stimulus).

What study links to acquisition by classical conditioning?

Little Albert

Describe the Little Albert study

• Albert showed no unusual anxiety at the start of the study. When shown a white rat he tried to play with it (NS). However, the experimenters then set out to give Albert a phobia. Whenever the rat was presented they made a loud, frightening noise (UCS) by banging an iron bar close to Albert’s ear. Eventually through classical conditioning Albert learned to be frightened when he saw the rat without the loud noise being made (CS).

• This conditioning then generalised to similar objects. They tested Albert by showing him furry objects such as a non- white rabbit, a fur coat and a Santa beard. Little Albert displayed signs of distress and fear at the sight of all of these objects. Little Albert shows how phobias may be acquired through classical conditioning.

What is maintenance by operant conditioning?

Operant conditioning takes place when out behaviour is reinforced or punished. Reinforcement, both positive and negative, tends to increase the chances of a behaviour being repeated whereas punishment makes it less likely. This is true for both negative reinforcement and positive reinforcement. In the case of negative reinforcement an individual avoids a situation that is unpleasant. Such a behaviour results in a desirable consequence, which means the behaviour will be repeated. Mowrer Suggested that whenever we avoid the phobic stimulus we successfully escape the fear and anxiety that we would have experienced if we had remained there. This reduction in fear reinforces the avoidance behaviour and so the phobia is maintained.

Give 1 strength of the two process model

• One strength of the two-process model is its real-world application in exposure therapies. E.g. systematic desensitisation. The distinctive element of the two-process model is the idea that phobias are maintained by avoidance of the phobic stimulus. This is important in explaining why people with phobias benefit from being exposed to the phobic stimulus. Once the avoidance behaviour is prevented it ceases to be reinforced by the experience of anxiety reduction and avoidance and therefore declines. In behavioural terms the phobia is the avoidance behaviour so when this avoidance is prevented the phobia is called cured. This shows the value of the two process approach because it identifies a means of treating phobias

Give 2 limitations of the two process model

• One limitation of the two-process model is that it does not account for the cognitive aspects of phobias. Behavioural explanations, including the two-process model, are geared towards explaining behaviour. Key behaviour is avoidance of the phobic stimulus. However, we know that phobias are not simply avoidance responses - they also have a significant cognitive component. For example, people hold irrational beliefs about the phobic stimulus (such as thinking a spider is dangerous). The two-process model explains avoidance behaviour but does not offer an adequate explanation for phobic cognitions. This means that the two-process model does not completely explain the symptoms of phobias

• AN INCOMPLETE EXPLANATION OF PHOBIAS- some phobias cannot be explained using classical and operant conditioning. Bounton (2007) suggests that evolutionary factors probably have an important role in some phobias. For example, we easily acquire phobias of things that have been a source of danger in our evolutionary past, such as snakes or the dark. It is adaptive to acquire such fears. Seligman (1971) called this biological preparedness- the innate predisposition to acquire certain fears. However, it is quite rare to develop a fear of cars or guns, which are actually much more dangerous to us today than spiders or snakes. Presumably this is because they have only existed very recently and so we are not biologically prepared to learn fear responses to them. This idea is a problem for the two-factor theory because it shows there is much more to acquiring phobias than simple conditioning.

What is the behaviourist approach to treating phobias?

Systematic desensitisation and flooding

What is systematic desensitisation?

Systematic desensitisation is a behavioural therapy designed to gradually reduce phobic anxiety through the principle of classical conditioning. One of the reasons why phobias may persist is that phobics avoid the phobic stimulus and therefore there is no opportunity to learn that their feared stimulus is not so fearful after all. Essentially a new response to the phobic stimulus is learned (phobic stimulus is paired with relaxation instead of anxiety). This learning of a different response is known as counterconditioning. Wolpe (1958) developed a technique where phobics were introduced to the feared stimulus gradually. It works on the basis of reciprocal inhibition which is the inability to experience two opposing emotions at the same time i.e. it is impossible to feel relaxed and afraid at the same time.

Describe the three processes involved in systematic desensitisation

• 1. The anxiety hierarchy - put together by the patient and the therapist. It is a list of situations related to the phobic stimulus that provoke anxiety arranged in order from lest to most frightening.

• 2. Relaxation - the therapist teaches the patient to relax as deeply as possible. This could be through relaxation techniques such as breathing exercises or the patient might learn mental imagery techniques. Alternatively, relaxation can be achieved using drugs such as Valium.

• 3. Exposure- finally the patient is exposed to the phobic stimulus while in a relaxed state. This takes place across several sessions, starting at the bottom of the hierarchy. When the patient can stay relaxed in the presence of the lower levels of phobic stimulus they can move up the hierarchy. Treatment is successful when the patient can remain relaxed in situations high on the anxiety hierarchy.

Give 2 strengths of systematic desensitisation

• IT IS EFFECTIVE - research shows that SD is effective in the treatment of specific phobias. For example, Gilroy (2003) followed up 42 patients who had been treated for spider phobia in three 45-minute sessions of systematic desensitisation. Spider phobias were assessed on several measures including the ‘spider questionnaire’ and by assessing response to a spider. A control groups was treated by relaxation without exposure. At both three months and 33months after the treatment the SD group were less fearful tha the relaxation group. This is a strength because it shows that SD is helpful in reducing the anxiety in spider phobia and that the effects are long-lasting.

• A further strength of SD is that it can be used to treat people with learning disabilities. Some people requiring treatment for phobias also have a learning disability. However, the main alternatives to SD are not suitable. People with learning disabilities often struggle with cognitive therapies that require a high level of rational thought. People with learning disabilities may also feel confused and distressed by the traumatic experience of flooding. This means that SD is often the most appropriate treatment for people with learning difficulties who have phobias

What is flooding?

• Instead of a step-by-step approach patients go straight to the top of the hierarchy and imagine, or have direct contact with, their most feared scenarios. The idea is that patients cannot make their usual avoidance responses and anxiety peaks at such high levels it cannot be maintained and eventually subside.

• Flooding sessions are usually longer than SD sessions, one session often lasting 2-3hours. Sometimes only one long session is needed to cure a phobia. Flooding is also based on classical conditioning and the idea of extinction.

• A learned response is extinguished when the conditioned stimulus (white rat in the case of Little Albert) is encountered without the unconditioned stimulus (the loud noise in the case of Little Albert). The result is that the conditioned stimulus no longer produces the conditioned response (fear).

Describe the ethical safeguards regarding flooding

• Flooding is not unethical but it is an unpleasant experience so it is important that clients give fully informed consent to this traumatic procedure and that they are fully prepared before the flooding session. A client would normally be given the choice of systematic desensitisation or flooding.

Give 1 strength of flooding

• IT IS COST- EFFECTIVE - flooding is at least as effective as other treatments for specific phobias. Studies comparing flooding to cognitive therapies have found that flooding is highly effective and quicker than alternatives. This quick effect is a strength because it means that patients are free of their symptoms as soon as possible and that makes the treatment cheaper

Give 2 limitations of flooding

• One limitation off behavioural therapies, including flooding, is that they only mask symptoms and do not tackle the underlying causes of phobias (symptom substitution). For example, Persons (1986) reported the case of a woman with a phobia of death who was treated using flooding. The fear of death declined, but her fear of being criticised got worse. However, the only evidence for symptom substitution comes in the form of case studies which, in this case, may only generalise to the phobias in the study.

• THE TREATMENT IS TRAUMATIC FOR PATIENTS- perhaps the most serious issue with the use of flooding is the fact that it is a highly traumatic experience. The problem is not that flooding is unethical, as patients must give consent, but that patients are often unwilling to see it through to the end. This is a limitation of flooding because time and money are sometimes wasted preparing patients only to have them refuse to start or complete treatment.