The behavioral approach to phobias
Explaining phobias
The two-process model
Proposed by Hobart Mowrer (1960). States that phobias are acquired by classical conditioning and continue because of operant conditioning.
John Watson and Rosalie Rayner created a phobia in a 9-month old boy called 'little Albert'. He showed no unusual anxiety at the start of the study, and when shown a rat, tried to play with it. However, when the rat was presented, a loud noise was made from banging an iron bar close to his ear. This noise is an unconditioned stimulus, which brings about the unconditioned response of fear. The rat (neutral stimulus) became associated with the noise, inducing fear, which is a conditioned response. This conditioned fear applied to similar objects, such as a rabbit, a fur coat and a a santa claus.
Phobias are often long lasting, which Mowrer described as a result of operant conditioning. This takes place when our behavior is rewarded or punished by either positive or negative reinforcement. for negative reinforcement, an individual avoids a certain situation. Therefore, whenever we avoid a phobic stimulus we escape the fear and anxiety we would have otherwise experienced. This reduction in fear reinforces avoidance behavior so the phobia is maintained.
Evaluation
The two-process model was a step forward in 1960 as it goes beyond Watson and Rayners concept of classical conditioning. It explained how phobias can be maintained which had important implications for therapies, as it shows that patients need to be exposed to their fears.
Not all avoidance behavior is the result of anxiety reduction. There is evidence that some avoidance behavior is motivated by positive feelings of safety. Therefore it is done not to avoid the phobic stimulus, as the theory suggests, but to stick with the safety factor. This explains why patients with agoraphobia are able to leave the house with someone they trust. This is a weakness of the two-process model.
Bounton pointed out that the evolutionary factors likely have an important role in explaining phobias. The two-process model does not account for factors such as these, so while classical and operant conditioning may be involved, there are some aspects that need further explaining. Some phobias are adaptive, such as a phobia of snakes or the dark. Seligman(1971) called this biological preparedness-the innate predispostion to acquire fears. This is a weakness as it shows there is more to phobias than conditioning.
Treating phobias
Systematic desensitisation is a behavioral therapy designed to gradually reduce phobic anxiety through classical conditioning. A new response to the phobic stimulus is learnt, called counterconditioning. It is impossible to feel afraid and relaxed at the same time, so one emotion prevents the other. This is reciprocal inhibition.
There are 3 processes involved in systematic desensitisation
2:Relaxation. The therapist teaches the patient how to relax as much as possible. Techniques include breathing exercises, mental imagery techniques or relaxant drugs such as valium.
3:exposure. The patient is finally exposed to the phobic stimulus while relaxed. This takes place in several sessions, starting at the bottom of the anxiety hierarchy. Treatment is successful when a patient is in a situation that is high up on their anxiety hierarchy and they manage to stay relaxed.
1:the anxiety hierarchy is put together by the patient and therapist. This is a list of situations related to the phobic stimulus, ranked from least to most frightening.
Evaluation
Flooding involves exposing patients to their phobic stimulus without any build up to it. It involves immediate exposure to a scary situation. Flooding sessions are typically longer than systematic desensitisation, often taking 2-3 hours. However, one session can be enough to cure a phobia. Flooding works by prohibiting avoidance behavior, so the patient must face the phobic stimulus. They then realise it to be harmless. In some cases patients may experience relaxation in the presence of the phobic stimulus, as they become tired of their own body's fear response. Flooding is an unpleasant experience so informed consent is required to ensure it is ethical.
Evaluation
Flooding is cost-effective as it is a fast and effective process, particularly for simple phobias. That said, for more complex phobias, it is not as effective as other treatments. The biggest issue is that it is a highly traumatic experience, While patients give their full consent, many do not follow through or complete the treatment, meaning their time and money are wasted.
Systematic desensitisation is an effective treatment of specific phobias. It is suitable for a large range of patients whereas treatments such as flooding are not suited to all. It is also preferred by patients, as it does not cause the same degree of trauma as flooding. This is reflected in low refusal rates.
Gilroy et al followed up on 42 patients ho had been treated for arachnophobia in three sessions of systematic desensitisation. Spider phobia was assessed on many levels including the spider questionnaire and by assessing their response to spider. A control group was treated by relaxation without exposure. At both 3 months and 33 months the systematic desensitisation group were less fearful than the relaxation group. this shows the treatment is effective in treating spider phobias and that it has long lasting effects.