A behaviourist’s approach to therapy

9 September 2016

Behaviourists explain maladaptive behaviour in terms of the learning principles that sustain & maintain it. Discuss and a behaviourist’s approach in contrast to a psychoanalytic one. Introduction In this essay I will be demonstrating a knowledge of the main behaviourist principles and approach, and how they can be related to maladaptive behaviour. I will then compare this approach with the psychoanalytical approach, evaluating the different approaches and considering the ethical issues. Maladaptive behaviour and the Behaviourist principles

Maladaptive behaviours refer to behaviours that inhibit a person’s ability to adjust to particular situations. This behaviour is often used to reduce one’s anxiety, but the result is dysfunctional and non-productive. For example, avoiding situations because you have unrealistic fears may initially reduce the anxiety, but is non-productive in alleviating the actual problem long term. Behaviourism is a school of thought in psychology based on the assumption that learning occurs through interactions with the environment.

A behaviourist’s approach to therapy Essay Example

Two other assumptions of this theory are that the environment shapes behaviour and that taking internal mental states such as thoughts, feelings and emotions into consideration is useless in explaining behaviour. Behaviourists are unique among psychologists in believing that it is unnecessary to speculate about internal mental processes. The behaviourist theory believes that cultural and sub – cultural conditioning moulds and shapes behaviour and subsequently the personality.

Behaviourists also believe that people are born with only a handful of innate reflexes and that all of a person’s complex behaviours are the result of learning through interaction with the environment. They also assume that the processes of learning are common to all species and so humans learn in the same way as other animals. A human being, according to the behaviourist, has his life determined for him since he is the product of the culture that causes him to be as he is. The theory therefore, is very deterministic.

To the behaviourist, normal behaviour results from acceptable conditioning and abnormal behaviour results from defective conditioning. The behaviourist isn’t concerned in what developmental processes may have influenced a person’s behaviour. They believe that if the patient is taught to understand his environment and how he interacts with it, he will automatically understand himself and his behaviour. The behaviourist functions from the position that if a neurotic behaviour can be learned, then it can be unlearned. In 1924, John Watson a behavioural psychologist, made the notorious claim in his book that …

‘if you 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’. This ideology, later to be called behaviourism, asserted that all psychology must be completely measurable, recordable and scientific. The fundamental principle underpinning this approach was that all behaviour, both ‘normal’ and abnormal, is learned through conditioning. In simpler terms, it proposed that human behaviour is learnt by humans interacting with the world around us as well as the environment operating on us.

The development of ‘behaviourism’ at this point in history has since been viewed as a reaction to the psychoanalytical models of human development presented by Freud and the Neo- Freudians which at the time challenged and confused many and appeared to lack scientific rigour. Behaviour Therapies: CAT stands for Cognitive Analytic Therapy and CBT for Cognitive Behavioural Therapy. There are similarities between these therapies – both are brief therapies with a limit on the number of sessions; both will offer a focus on a limited range of goals and may use similar ways of helping you keep track of your difficulties, e.g. keeping a diary of a particular problem you want to tackle or how you are making changes.

Both are collaborative approaches – working actively with the therapist on your difficulties. Cognitive Behaviour Therapy (CBT) CBT can help you to change how you think (‘Cognitive’) and what you do (‘Behaviour’). These changes can help you to feel better. Unlike some of the other talking treatments, it focuses on the ‘here and now’ problems and difficulties. Instead of focusing on the causes of your distress or symptoms in the past, it looks for ways to improve your state of mind now.

Behaviourism is practical; it concerns itself with behaviours that are incompatible with local community standards. Although there may be causative factors that underlay the target behaviour, (such as emotions like anxiety or anger), behaviourism assumes they do not exist. CBT has been shown to help with many different types of problems. These include: anxiety, depression, panic, phobias (including agoraphobia and social phobia), stress, bulimia, obsessive compulsive disorder, post-traumatic stress disorder, bipolar disorder and psychosis.

CBT may also help if you have difficulties with anger, a low opinion of yourself or physical health problems, like pain or fatigue. CBT can help you to make sense of overwhelming problems by breaking them down into smaller parts. This makes it easier to see how they are connected and how they affect you. These are:  A Situation – a problem, event or difficult situation. From this can follow: Thoughts Emotions Physical feelings Actions Each of these areas can affect the others. How you think about a problem can affect how you feel physically and emotionally.

People referred for CBT may have been diagnosed with disorders such as anxiety, panic, depression, obsessive compulsive disorder etc. CBT has specific, research proven ways of working with such clients using different techniques appropriate for their presentation. People who want to work with their therapist on actively changing their problems tend to do well here. Cognitive Analytic Therapy (CAT) On the other hand, CAT works more interpersonally on relevant, jointly identified issues by creating a working relationship between client and clinician where together they: describe the issues affecting the client aim to understand their origins in previous relationships and experiences, and importantly, use the relationship between the client and therapist to reflect on how those learnt ways of being take place both in and out of the therapy room: the aim here is to practise both recognition (awareness) and change, both in and out of the room then work focuses on changes that the client wants to make now that they feel they have a description and an understanding that makes good sense to them

CAT offers a safe and clinically effective therapy intervention for people who wish to work through these underlying issues. Sometimes, people who have symptoms of, for example, anxiety or depression, have a history of abuse, trauma or neglect underlying their symptoms. A relationally focussed therapy like CAT can be helpful as it accesses and reflects on how the difficulties come up in normal life, and that includes the relationship between therapist and client: the goal here is to respectfully and progressively understand and name the difficulties together, as safely as possible.

There is a great deal of research evidence to show that CBT works effectively in treating depression. This research has been carefully reviewed by the National Institute for Health and Clinical Excellence (NICE). NICE provides independent, evidence-based guidance for the NHS on the most effective ways to treat disease and ill health. CBT is recommended by NICE for the treatment of anxiety disorders. What can CBT help with? NICE recommends CBT in the treatment of the following conditions: anxiety disorders (including panic attacks and post-traumatic stress disorder) depression obsessive compulsive disorder schizophrenia and psychosis bipolar disorder There is also good evidence that CBT is helpful in treating many other conditions, including: chronic fatigue behavioural difficulties in children anxiety disorders in children chronic pain physical symptoms without a medical diagnosis sleep difficulties anger management CBT can be used if you are on medication which has been prescribed by your GP. You can also use CBT on its own. This will depend on the difficulty you want help with.

CBT and eating disorders The eating disorders provide one of the strongest indications for CBT. Two considerations support this claim. First, the core psychopathology of eating disorders, the over evaluation of shape and weight, is cognitive in nature. Second, it is widely accepted that CBT is the treatment of choice for bulimia nervosa and there is evidence that it is as effective with cases of “eating disorder not otherwise specified” (eating disorder NOS), the most common eating disorder diagnosis

Contrasting the behaviourist approach with a psychoanalytical (Freud/Jungian) one The main differences in approach can best be demonstrated when considering case examples the different behaviourist and psychoanalytical approach. The first example I would choose to help demonstrate this is a middle age woman “Mrs X”: Mrs X is happily married after an unpleasant childhood during which her mother committed suicide. Mrs X was subsequently bought up by an austere aunt. She does not work and has an 8 yr old daughter.

Her husband is a banker and the family are well off, but he works long hours. Recently Mrs X has been feeling depressed and has secretly been drinking and indulging in shopping sprees to cheer herself up. With this client, a therapist adopting behaviourist approach may take the view that Mrs X failed to ‘reward’ herself and did not enjoy life, while living with her aunt. They may suggest that this pattern of behaviour has now persisted into adulthood, and the behaviour of drinking and shopping sprees could be seen as failed attempts to provide herself with ‘rewards’ now.

Looking from a cognitive standpoint, the therapist would be interested in what she was thinking as well as feeling and behaving. However, those with a psychodynamic viewpoint would probably be very interested in the death of Mrs X’s mother and the poor support and comfort during childhood. From a psychodynamic perspective, Mrs X’s depression might be related to not being helped to grieve and the poor quality of substitute parenting. A humanist perspective would probably be interested in all aspects of Mrs X’s life, past and present.

From a humanist perspective, Mrs X has never had the opportunity to develop a healthy self-image thus she may be unfulfilled and hence her depression might be seen as a lack of personal fulfilment. A second example, to enable me to contrast approaches, is “Mr Y” a middle aged man. Mr Y is in his forties and discovered he has a talent for jogging. He has entered the London Marathon and despite taking up the sport in recent times, he is tipped to do well. As the day approaches, he trains harder and harder.

The only thing stopping him from being completely happy is that he is mourning for this best friend who dies recently from a heart attack. From a behaviourist perspective, the more Mr Y trains, the better he gets. Mr Y can see this, is gaining more energy, and is boosted by workmates comments. He has lost weight, and feels more attractive as a result. All these factors are reinforcing his running and encouraging him to continue. A cognitive aspproach may credit Mr Y in making a logical decision to improve his fitness following the realisation that he is now at an age when not keeping fit may damage his health.

A psychodynamic approach might instead focus on the fact that Mr Y’s friend died recently and wonder whether his healthy new behaviour is a response to his own fear of dying. From a humanist perspective, Mr Y has discovered a talent in which he can fulfil himself as a person. Additionally, he is gaining positive regard from others which is boosting his self-esteem. This new found self-esteem is then further inspiring him to achieve all he can in his running. Evaluating the different approaches: To the hard-nosed scientist, the behaviourist approach is generally regarded as ‘good solid stuff’.

Theories are easily testable and backed by large bodies of research. The principles can easily be applied in the real world. It emphasises the capacity to change, given an appropriate learning environment. A behaviourist perspective is optimistic and readily lends itself to giving practical help because it emphasises what can change. However, the behaviourist approach reduces the complexity of human behaviour to a few simple principles of learning. Thus, it largely ignores the importance of higher mental processes.

From a psychodynamic perspective, behavioural approaches ignore the importance of relationships and the dynamics of families and groups within which learning takes place. CBT does not suit everyone and it is not helpful for all conditions. The client needs to be committed and persistent in tackling and improving health problem with the help of the therapist, and they will be taken ‘out of their comfort zone’ when tackling situations which cause anxiety or distress. However, many people have greatly benefited from a course of CBT.

The aims of the behavioural psychology – to predict and control behaviour – are also regarded with some suspicion by many psychologists. Such techniques lend themselves equally easily to torture, brainwashing and political oppression. Kohn (1993) has objected to the behaviourist culture of reward and punishment in the workplace, comparing the regime with that of Skinner and his rats. Conclusion The behaviourist approach seems to be highly successful and influential, emphasising the importance of learning behaviour, and this approach places great emphasis on testable concepts and research.

The behaviourist approach has many applications centering around powerful techniques for changing people’s behaviour, but the limitations in behaviourism in its purist form seem apparent and few therapists will describe themselves as pure behaviourists. Therefore, many therapists prefer to draw from several approaches to enable a wider understanding of human mind and behaviour, and hence a more expansive and encompassing treatment.

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