Psychotherapies Without Feeling
by Dr. Arthur Janov
Posted June 2005 on primaltherapy.com
Chapter 10: Behaviorism: Pushing Feelings Down Instead of Bringing Them Up
History and Concepts
Behaviorism goes back to the turn of the century with Russian psychologist Ivan Pavlov's famous discovery of the "conditioned reflex." While experimenting with dogs, Pavlov paired the sound of a bell with the appearance of food. Eventually, the dogs salivated in response to the bell, even when no food accompanied it. Pavlov called this response of salivating upon hearing the bell the "conditioned reflex," and the bell was the "conditioning stimulus."
Pavlov's concepts formed the basis of what became known as classical S-R (Stimulus-Response) behaviorism, which got its start in America in 1913 through the writings of John B. Watson. Since that time, several variations of behaviorism have emerged. Each major behavior theorist has his own set of terms and distinctive concepts with which to differentiate his theory from those of other theorists. While these differences are important within the field, they can be legitimately put aside in favor of a summary that reflects the general philosophy or framework of behaviorism as a view of man.
According to behaviorism, people learn to act in certain ways through a process of conditioning and association. Responses that are positively reinforced (or rewarded) become part of our behavior, while those that are negatively reinforced (or punished) drop away. Thus the young child learns that touching the refrigerator door and pulling on it results in food being available (a positive reinforcer), and so he becomes readily adept at opening and closing refrigerator doors. At the same time he learns that touching a hot stove results in pain (a negative reinforcer), and therefore he readily ceases the practice of touching hot stoves. Conditioning or learning results because of the intervening reinforcer. Reinforcement, for better or worse, is the core concept.
Factors other than reinforcement also enter into the learning process. Contiguity -- having one thing follow another in time -- is necessary if we are to associate the reinforcer with the behavior. Thus, if a toddler is to learn to carry out a particular task, he must be told right away that whether or not he is doing it correctly. And, as all mothers know, the child must be reprimanded immediately for fighting with the neighbor boy -- not three hours later.
In the view of behaviorists, Pavlov's demonstration of the conditioned reflex meant that almost anything could be conditioned to our basic responses as long as it occurred at the right time and in the right quantity. It also meant that man was basically an accumulation or conglomerate of all his conditioning experiences. Jerome Kagan summarizes the views of well known behaviorist B. F. Skinner:
"What is man?" has always been a question of priority for philosophers and psychologists ...To B. F. Skinner, [man] is a reservoir of possible actions whose actualized profile is finely controlled by the history of different outcomes that followed close upon each of those actions. The single, powerful assumption that the effects of our prior actions are the hands that sculpt our current behavioral posture, carried to its limit, leads Skinner to question the autonomous control each of us has over our own behavior and to issue a challenge to those who think man has some measure of freedom.
...Here comes Skinner, a little like Copernicus, telling us that our phenomenology is defective and we are deluded if we believe that we control our actions. They are, on the contrary, under the firm stewardship of the past, continually monitored by the invisible happenings of yesterday, by changes that occurred deep within our nervous system on the many times we displayed a particular action in the situation we are in at the moment. Such a challenge to our sense of freedom and dignity has irritated and energized many, and given solace to only a few. [Italics added]
Man "as a reservoir of possible actions" is the starting point for behaviorists, whose primary goals are to discover the laws of learning and behavior that "sculpt our current behavioral posture." The impingement of outer events upon us is seen as the dominant behavior-shaping factor in our lives. While we can do nothing about the permanency of that impingement, we can do something about particular outcomes. That is, our lives are a continuous succession of conditioning experiences; once we understand the underlying principles, we can learn to control their impact on us. Thus, just as we are conditioned to fear an elevator, so can we can be deconditioned, learn to fear it no longer.
For the behaviorists, the deterministic relationship between outer events and resulting human behavior is a complete and lasting one. We do not grow out of it, we do not transcend it, we do not overcome it. Thus, if one is afraid of heights, the therapist might lead the patient toward a high balcony, holding the patient's hand until she "learns" not to be afraid. There is no talk of consciousness or complex mental processes here. They never ask the question, "Why?" We simply learn how to manipulate our behavior to the best of our abilities -- which have also been pre-determined by our past conditioning experiences! Stamped-in behavior must be "stamped out.
It's not unlike the philosophy of some parents: you build character by being tough, by punishing "bad" behavior so that the child will act "good." In many ways, behaviorism is parental bromides dressed up as theory.
John B. Watson
Behaviorism developed in America after the turn of the century, at a time when two major "schools" dominated the young field of psychology. Structuralism viewed the elements of man's consciousness as the proper domain of psychology. Functionalism was more concerned with how we utilize mental processes to adapt to the world than with the exact nature of the processes themselves. "Adaptation" is a big word in their world. And today with the neo-Freudians who have moved toward ego-psychology, it is again important. Because the Freudians who started out as historic-dynamic theorists have come full circle back to the beginning of the twentieth century. They, too, are very concerned with adaptation, and less concerned with internal processes. It was this early impetus that made psychology a "behavioral science" and led psychologists away from notions of the unconscious.
John B. Watson, an animal psychologist and the founder of behaviorism in America, believed that both of these systems of thought were based on unscientific and invalid theories. In his famous article, "Psychology as the Behaviorist Views It," Watson clearly stated what he thought the domain of psychology ought to be:
The time has come when psychology must discard references to consciousness. Its sole task is prediction and control of behavior; and introspection can play no part in its method.
Watson unequivocally disregarded the concepts of mind, consciousness, emotion, and volition as elusive and mentalistic leftovers from the 19th century. He stated that psychology was "the science of behavior," and that its job was to objectively describe that behavior "in terms of stimulus and response." The aim of behaviorism was to be able to predict a response when given the stimulus, and vice versa, to predict the stimulus when given the response. (A simple example of this principle is the knee jerk reflex. You can predict the kick of the knee given the tap of the hammer, and you can deduce the tap of the hammer from the kick of the knee.) Watson proclaimed that this basic principle could be applied to such complex behavior as child rearing. In 1930, he wrote:
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 beggarman and thief, regardless of his talents, penchants, tendencies, abilities, vocations, and race of his ancestors.
In the beginnings of the behaviorist movement in America, Watson disregarded genetics, and innate personality predispositions and capacities. He was saying, in effect, that the newborn child was a tabula rasa, or blank slate, which could be molded into any type of person given the right conditioning experiences even though little was known at that time about how to set up conditioning procedures.
We know today certain changes in behavior may indeed be effected through "behavior modification techniques." A retarded child might learn, for example, that keeping his room clean results in tokens or candy. An autistic child might learn that banging his head results in a mild shock. But these "accomplishments" are very circumscribed. The procedures have been set up in response to very specific and delimited problems.
Sixty years ago, Watson proposed that he could discern and establish all of the conditioning experiences -- moment-to- moment, day-to-day -- that would be necessary to produce the long-range goal of doctor, lawyer, artist, and so on. Although Watson never had the opportunity to sculpt his "dozen healthy infants" into adults, he did carry out numerous experiments on newborn babies in which he explored whether "instincts" ascribed to human beings are truly inborn, or are actually a result of learning (conditioning). He concluded that only a very few responses -- such as sneezing, crying, sucking, hand-grasping, and eye-blinking -- are innate. All others, he stated, were learned responses.
To show how new emotional reactions could be learned, Watson performed his famous experiment establishing "conditioned fears" in an 11-month-old boy. At the beginning of the experiment, the little boy had no fear of animals. Watson's procedure was to bring a small white rat into the boy's reach. Just at the moment the child touched the rat, a loud noise was sounded behind him. Watson's intention was to show how a basic genetic responses, such as a fear of loud noises, could be conditioned to a previously neutral stimulus (in this case, a white rat) so that it was then feared. His own description of the experiment is noteworthy (and chilling):
(1) White rat suddenly taken from the basket and presented to Albert. He began to reach for rat with left hand. Just as his hand touched the animal the bar was struck immediately behind his head. The infant jumped violently and fell forward burying his face in the mattress. He did not cry however.
(2) Just as his right hand touched the rat the bar was again struck. Again the infant jumped violently, fell forward, and began to whimper.
...In order not to disturb the child too seriously no further tests were given for one week...
(1) Rat presented suddenly without sound. There was steady fixation but no tendency at first to reach for it. The rat was then placed nearer, whereupon tentative reaching movements began with the right hand. When the rat nosed the infant's left hand the hand was immediately withdrawn. He started to reach for the head of the animal with the forefinger of his left hand but withdrew it suddenly before contact. It is thus seen that the two joint stimulations given last week were not without effect. He was tested with his blocks immediately afterwards to see if they shared in the process of conditioning. He began immediately to pick them up, dropping them and pounding them, etc. In the remainder of the tests the blocks were given frequently to quiet him and to test his general emotional state. They were always removed from sight when the process of conditioning was underway.
(2) Combined stimulation with rat and sound. Started, then fell over immediately to right side. No crying.
(3) Combined stimulation. Fell to right side and rested on hands with head turned from rat. No crying.
(4) Combined stimulation. Same reaction.
(5) Rat suddenly presented alone. Puckered face, whimpered, and withdrew body sharply to left.
(6) Combined stimulation. Fell over immediately to right side and began to whimper.
(7) Combined stimulation. Started violently and cried, but did not fall over.
(8) Rat alone. The instant the rat was shown the baby began to cry. Almost instantly he turned sharply to the left, fell over, raised himself on all fours and began to crawl away so rapidly that he was caught with difficulty before he reached the edge of the table.
In Systems and Theories of Psychology (1974), Chaplin and Krawiec go on to explain that "Watson went on to demonstrate that Albert, though originally conditioned to fear a rat, generalized his fear to a variety of furry animals and also showed fear of a fur coat and Santa Claus whiskers. Watson suggests that many adult aversions, phobias, fears, and anxieties for which the individual has no rational explanation may well have arisen years before by a process of conditioning."
Here we see an infant made to jump violently, bury his face in the mattress, whimper, withdraw, fall over, start violently, cry, and almost fall off the table in terrified flight. The ethics of such an experiment are certainly questionable -- an experiment that reveals the behaviorist movement's mechanistic oblivion to the realities of human experience. Moreover, to say that phobias and neurotic fears stem from environmentally-conditioned events is to say very little. For centuries mankind has known that pairing one thing with another results in learned association.
We make a logical error when we see an irrational fear and assume its origin is as arbitrary and non-meaningful as the random pairing experienced by Albert. Watsonian conditioning can and does happen, of course. However, I believe that the irrational fears that bring people in for psychotherapy are much more often symptomatic of a clash between traumatic imprints and repression.
Another beacon of behaviorism established by John Watson is the concern over the issues of behavioral prediction and control. Recall that Watson issued the "call to arms" when he declared that the "sole task of psychology is the prediction and control of behavior." Interestingly, Watson was not only shifting the focus of psychology away from consciousness and onto behavior, but shifting it specifically and exclusively to the areas of behavioral control and prediction. Prediction and control constitute the philosophical framework for behaviorism and set a tone that has become a very real part of the American psychological gestalt.
Several names are prominently associated with the contemporary behaviorist movement and with behavior therapy. These include Andrew Salter (1914- ), Joseph Wolpe (1915- ), and B. F. Skinner (1904-1990). Salter and Wolpe are key theorists in behavior therapy.
Andrew Salter's work directly applies the most direct of Pavlov's principles of conditioning to psychotherapy. Indeed, the title of his book, Conditioned Reflex Therapy: The Direct Approach to the Reconstruction of Personality, aptly summarizes his technique. The classic behaviorist philosophy -- that man is comprised of learned reflexes or habits, which are a result of environmental influences -- underlies Salter's approach. In Salter's view, these influences are conditioned into us via a reflex response, which is beyond volition and choice. We are solely the products of conditioning, and conditioning is our sole remedy:
It seems to me, the healthiest trend of all in the college and university work has been the recognition that, for practical therapeutic purposes, the human being is largely a habit machine. Here the thinking of Pavlov presents the most hopeful opportunities for the rapid and deep modification of human personality ...[for] Pavlov's conditioned reflex therapy declares that fundamentally everybody has the same problem and the same cure....
There can be no question that therapy is quick and simple once the therapist realizes that the underlying problem of mental illness is always exactly the same. Then the individual is spared the futile pain of wandering blindly through the swamps of early experiences...At all times the emphasis is on the individual's present -- the things he's doing now. Cure comes through learning healthy personal relationships now, and not stewing over past emotional frustrations.
According to Salter, inhibition is at the root of all neurosis. Parents inhibit the needs and feelings of their children, which is where the trouble begins. The child's natural excitatory behavior (his spontaneous self-expression) is inhibited by parental lists of do's and don'ts: "Don't get dirty," "Stand up straight," "Be careful," "Don't slurp your milk," and so on. Because of this conditioning, the inhibited adult has learned to conceal his true emotions. In his desire to be accepted in life, he tries in vain to be everything to everybody. Consequently he is self-conscious, apologetic, colorless, boring, and a fraud; he is selfish and egotistical, afraid of people and responsibility, inconsiderate and aggressive.
Salter believes that good mental health is characterized by the spontaneous, outgoing expression of feeling. Therefore the goal of his therapy is to change inhibited responses into spontaneous responses. Since the problem is always the same -- inhibition -- the solution is likewise always the same: disinhibit the person so that he can be guided by "the free, vigorous, and rewarding emotions of excitation." The rub is how does one disinhibit a person? What they really mean is to disinhibit behavior, the outward manifestation of feeling; how one acts out a feeling. “I feel hopeless and all alone, I get on the phone and call everyone so I won’t be alone.” Their attempt is to stop the act out, leaving the feeling, dating from perhaps decades previously, alone. Feelings have to be expressed not in words but in the language of feelings. To express your feelings is an oxymoron. Once our patients are plunged into feeling they can then express it but not before.
The patient's past is important to Salter only to the degree that it contains the past conditionings that have made him what he is today. "Having conditioned reflexes," he writes, "means carrying about pieces of past realities." Salter believes that those past realities can be changed by simply reconditioning behavior, so that once the behavior has changed, the feelings change also. This is a kind of an inside-out philosophy where feelings follow behavior instead of vice-versa. In evolution the feeling brain predated the thinking one by millions of years.
The behaviorist strategy leads to the notion that if you condition out alcoholism the feelings about it and yourself will change. Wrong. After years of being off drugs and drink people still feel exactly the same. They still have needs to be loved from their childhood. Still feel bad about themselves. Still feel helpless and in need of guidance. The needs, never addressed are simply hidden and buried. The person is just better controlled.
Since all problems result from inhibition of emotion, Salter's counseling process is the same for all clients, regardless of their symptoms. One of Salter's methods for disinhibiting emotion is to get the patient to talk freely in a feeling way, a kind of free association done with some emotion. He wants his patients to become totally uninhibited and say what's on their minds without regard to all the social amenities. Then the patient "facial talks" -- shows his emotions through facial expressions. He must learn to "contradict and attack." He must use the word "I" as much as possible. He must be able to praise himself, to improvise, and to act spontaneously. The idea is not far from the neo-Freudians. The analyst says good things about you and you feel better about yourself.
Salter believes that patients "do not know what they are talking about," which is why the therapist must carefully direct and structure the therapy. Toward this end, the therapist advises, instructs, persuades, suggests, reasons, and even commands the patient. To help the patient learn new reflexes, the therapist gives him assignments. The idea is to practice a new habit-expression -- such as to tell people what you think regardless of the situation. The rationale is: "If you do the opposite of what you have been doing all your life, you will probably feel the opposite of the way you feel now." Although learning new responses takes time, the patient is assured that with "deliberate practice" the new responses will become fixed into reflexes. This is not therapy, it is exhortation: brainwashing.
Here is a case study from Salter's book, Conditioned Reflex Therapy. Below, Salter's patient is speaking:
My trouble seems to be a psychopathic disturbance of my breathing function. I seem to have a continual spasm of the muscles which control my breathing. About half the time I can't draw a deep breath, which is very frightening. I get severe headaches during which I pant and fight for my breath, and gasp for hours. These attacks come after meals, or when waiting in a theater, or during important business conferences. It is hard for me to carry on a prolonged conversation because I seem to be unable to coordinate my breathing with my speaking.
He has seen "dozens" of psychiatrists, which is probably an exaggeration. Those who were psychoanalysts imply an Oedipus complex; the others counsel him not to "worry so much," and "to get a grip on yourself." He bids them adieu and is a perambulating hypochondriac again.
He is unhappily married to a modern Xanthippe, and has read much but not wisely in psychology. He has the learning attitude, and any "psychological diet list" I give him will be followed implicitly. He owns a racing stable, and it is easy for him to see the importance of training healthy emotional habits in humans as well as in horses...
Salter exhorts the patient:
In this wicked world it is simply a question of fighting for your emotional rights. You never get your privileges anyway. You want nothing that isn't coming to you. The chances are...that if you do the opposite of what you have been doing all your life, you will probably feel the opposite of the way you do now.
We dispose of his childhood in a few minutes. This is the one with the overprotective mother, the uninterested father, the house full of children, and the selling of newspapers when he was ten. There is often no point in going into the background of the case. We see the malconditioned dog before us, and his problem tells us all that we need to know about the kennel from which he came....
He had a total of five hours of consultation, and now, two years later, his claustrophobia is still gone. He feels much freer, and his stomach symptoms occur rarely and with diminished severity. His business activity distresses him substantially less, and in general he is a much happier person.
Salter's case study is an excellent example of the dogmatic, mechanistic, and even animalistic attitudes of the behaviorist at work. He equates therapy with horse training, and he equates the patient with a mal-conditioned dog.
Salter's approach is fundamentally ahistorical. That is, he superficially mentions the patient's past in terms of conditioning experiences, then disposes of it in a few minutes in favor of the presenting symptom. Even though Salter believes that good mental health has to do with expressing feeling, he doesn't understand that it is the feelings that were blocked in early childhood that need expressing, not the neuroticized ones of the present. You can't truly know what today's feelings are when there is a backlog of unexpressed feelings from the past. Most repressed people have no idea what their true feelings are even though they can express what they think are feeling. That's part of the problem; they have to think about what to feel because their real feelings are inaccessible
Joseph Wolpe's position is a bit more systematic than Salter's. In his book, Psychotherapy by Reciprocal Inhibition, Wolpe outlines his philosophy while adding a few new terms to behaviorist jargon. Wolpe views neurosis as a faulty learning habit which can be eliminated through reconditioning -- also called negative conditioning or reactive inhibition. Neurotic habits persist, according to Wolpe, because they are reinforced (or rewarded); each neurotic habit somehow reduces the general anxiety level of the person, thus making it a reinforcer. The more effective the particular neurotic habit is in reducing anxiety, the stronger and more pervasive it becomes. (Drinking and cigarette smoking, in order to relax, are likely examples.)
Wolpe aims to extinguish the maladaptive neurotic behavior by making it non-rewarding. The way to do this is to provoke the original anxiety situation, but only after "reciprocal inhibition" has been established. Reciprocal inhibition simply means that you cannot be fearful and relaxed at the same time. So, to counteract anxiety, one learns how to feel relaxed in the situation that ordinarily evokes the anxiety. This technique, fittingly called desensitization, is widely used in behavior therapy, most prominently as a strategy to overcome phobias and phobic behavior: fear and avoidance of elevators, bridges, heights, freeway driving, spiders, and so on.
Desensitization can be applied in many ways, but there are several factors common to most applications. First the patient makes up a list of his fears, ranking them from the greatest fear to more minor ones. Next the therapist explains the principle that relaxation cannot co-exist with anxiety and teaches the patient relaxation techniques. Several sessions may be spent just learning the progressive relaxation of muscles from head to toe. If the person is hypnotizable, hypnosis will be included. After the patient has learned how to relax he is told to imagine the least fearful item on his list. Once that can be imagined without the usual anxiety response, he moves on to the next item. The therapist helps the patient's imagination; in his mind he is floating on a lake while visualizing snakes. This goes on until he can imagine all the items on the list without anxiety.
Desensitization and relaxation techniques can also be marshalled in treating patients with sexual problems. First the patient is told not to engage in sex until he has a positive desire to do so, since any unpleasant experience would only reinforce his sexual inhibition. He's instructed to expose himself to sexual images while in the relaxed state, eventually working up to actual sexual encounters. In addition, "the patient is told to inform his sexual partner (quoting the therapist if necessary) that his sexual difficulties are due to absurd but automatic fears in the sexual situation and that he will overcome them if she will help him."
In Wolpe's system, it is the therapist's task to carefully structure the therapy in accordance with the "stimulus antecedents" of the patient's past: "Since the procedures of behavior therapy depend on the therapist exactly knowing the stimulus antecedents of the unadaptive responses, it is obvious that a searching behavior analysis is an indispensable preliminary to treatment in every case." Still, only the immediate past is of genuine interest to the behavior therapist. The patient's historical past is considered potentially interesting but not particularly relevant to solving the present neurosis: "Although it would be interesting and perhaps helpful [to explore early history], it is not necessary: for to overcome his neurotic reactions it is of greater relevance to determine what stimuli do or can evoke them at the present time." Thus the patient is an ahistorical being. If the therapist were in touch with his own past and his feelings, there is no way he could eliminate history in the treatment of patients.
When lack of assertion is the patient's problem, Wolpe does not use relaxation and desensitization techniques at all. He instead teaches the patient to behave assertively, which, he believes, automatically inhibits the anxiety response. He explains to the patient how baseless and incapacitating his fears of criticism are, and, like Salter, exhorts the patient to express himself more fully. Wolpe makes "small speeches" to demonstrate how the method can be effective and points out ways to apply assertion in the patient's daily life situations. He also reminds the patient that we generally have a low opinion of people who are spineless and unassertive. In fact:
As much pressure as seems necessary is applied to motivate actual performance of the requisite behavior in appropriate circumstances....These pressures lead to the desired behavior in most cases, though not always immediately.
The possibility that irrational fears might be based on a rational repsonse in childhood is not considered. No one is automatically afraid as an adult. The basis for adult fear is buried in the past. Early experience dictates those fears that were rational in context. What is lost is context, something never to be found in behavior therapy.
Another technique Wolpe uses -- direct conditioning -- is known among some behaviorists more appropriately as aversive conditioning. Direct conditioning is really the reverse of Wolpe's reciprocal inhibition technique whereby a conditioned response of relaxation is used to inhibit the anxiety. With direct conditioning, a conditioned response of avoidance is established by administering a mild shock in the presence of the "anxiety-evoking stimulus." The mild shock produces a motor response of "conditioned avoidance," which theoretically weakens the original anxiety response. In some cases involving obsessions, severe shocks are administered in the presence of the obsession, or as the patient imagines the obsession. The shock has another role, not discussed by Wolpe; it stimulates the production of the repressive chemicals that help shut down Pain. As Pain is repressed, the obsessions are then controlled.
Wolpe's case histories demonstrate how he applies his principles to therapy. In the first interview the patient's historical past is bypassed -- indeed, basically dismissed by the therapist, despite the patient's obvious efforts to go into it -- for supposedly more pressing concerns such as learning how to be assertive while standing in line.
Therapist (T): Good morning, Mrs. Schmidt. What's your trouble?
Client (C): I get very upset sometimes.
T: What upsets you?
C: Lately the children.
T: What is there about the children that upsets you?
C: Uh, before I moved where I am now, I used to -- they used to listen to me and all that. It disturbs me also that my husband is not home enough with them. He doesn't spend enough time with the children and I feel like I am raising them by myself.
T: What does your husband do?
C: He works as a barber now.
T: What prevents him from being home enough?
C: He has long hours.
T: What are his hours?
C: He leaves at seven and comes home at half past eight.
T: Certainly very long. Well, that's a practical problem. Is there anything else that upsets you?
C: Yes, many things.
T: Well, for example?
C: The things that I read in the paper.
T: Like what?
C: Oh, like, uh, I have seen plenty killings in the war and now I feel the same like over here. When I first came here I...I just thought there is no place like this. I...I thought that you could live in peace and there would never be any trouble. You...you couldn't, you wouldn't hear of anything and now, I ...I hear more and more things and I get very upset about it.
T: What year did you come here?
C: In 1947.
T: In 1947. How old were you then?
T: Now let me get one thing clear. If you had gone on feeling the way you felt during those few years, then you would not be here?
C: I would not have to come here.
T: Right. Can you say what happened to make you unhappy again after that?
C: I don't know. It might be...you see, uhm, when I was born my mother died in childbirth and she never wanted to even look at me, my grandmother used to tell me. She didn't even want to hold me once, and as she was dying she was sorry that she was leaving the house behind. She had a feeling for home but she never said that she was leaving the child behind and my grandmother used to always talk about that, which she shouldn't have. And so hard things, I have so many things to talk about.
T: Was your grandmother with you here?
C: No, my grandmother got killed.
T: Oh, well...But, can you say more or less what year you began to feel that you were not so happy anymore?
C: You see, I was disappointed in the family life. I was always looking for somebody like a mother, you know. A somebody. And they would tell me that they would be like a mother to me. And then I found out different -- many things and ever since -- like if I would find somebody and I would get -- I can't get too close to them. When I get too close I am afraid that I get hurt and then I run. There were many times, days that I just didn't feel like going on living. If I had the courage I would have just killed myself many times and I still feel like that. I used to feel like that when I was a child. If I, uh, where I lived with my grandparents, my uncle and my aunt lived there and they just didn't want me. They used to call me all kinds of names and my grandmother used to tell me it would be good if I run away because they didn't want me, and that's the time I started feeling that, I just felt like I didn't want to go on living.
T: Uh-huh. I want to ask you how you react in certain rather common situations. Suppose that you're standing in a line and somebody gets in front of you. What do you do?
C: I don't do nothing. I get upset.
T: If you go into a shop and you buy, say, a woolen pullover like that and when you come home you inspect it and you see there is a little moth hole in the sleeve, what do you do?
C: I don't like to bother people too much. I don't like to -- for that reason I don't like to take it back. I -- if something goes wrong in the house -- they don't fix things right or they don't make them right, my husband has to force me to talk and he, he tells it often that I can't do it. He says that's why people take advantage of me, because I don't have the courage to speak up.
T: Well, that is very much a matter of habit. Now, it's a thing that one can learn to change. I want to tell you how you can succeed. Look, let's take this little example that we used first where somebody gets in front of you in the line. Suppose you're in a hurry and somebody does that. You get cross. You are annoyed. But when you, when you have any thought of doing anything about it, you're kept back at the same time by feeling you don't want to hurt his feelings, you don't want to distress him, maybe it will make a scene, things like that. Now, what I want you to do in the future in this little situation is express these feelings. Now, of course it's difficult, but if you will express this feeling that you have and say, "Will you kindly get to the back of the line?" then, in the act of doing it, you will push back the fear feelings. You will push them down to some extent. And if you do that, the next time it will be a little easier.
C: I will try. [italics added]
All Wolpe has to say in response to this woman's unusually traumatic past is "Uh-huh," and "How do you react in certain rather common situations?" This is a perfect example of the behaviorist's myopic focus on the present. And when this patient says she doesn't have the courage to speak up for herself, Wolpe says, "Well, that is very much a matter of habit," something "one can learn to change." He calls the after-effects of not being wanted by the mother, not even being held by the mother, losing the mother to death within a few hours of birth, being abused by relatives and told openly that she wasn't wanted...a matter of habit
But what does it really mean to say something is a habit? Webster's defines a habit as "an acquired mode of behavior that has become nearly or completely involuntary." But what is the force behind acquiring a painful or unpleasant mode of behavior? What compels us to repeat that painful mode of behavior involuntarily, and over and over again? Neither nature nor human behavior is random, so it’s clear that painful habits serve some meaningful, biological purpose that is connected to the storing and processing of trauma. Reverberating circuits of Pain form the neurological basis for the experience of what behaviorists call neurotic "habits."
A woman I saw some years ago had a lock obsession. She had to try the locks on her house at least twenty times a day. She could only feel safe for a few minutes before the feeling of being unsafe came back and she had to try the locks again. The focus was on the present but the feeling was from the past. She was in constant terror of a drunken father and a volatile, angry mother. She never felt safe for a minute, and there was nothing she could do about it. As an adult, with no access to her past, there was something she could do about it: obsess and control her feelings with some kind of action, however symbolic.
Back to Wolpe's client; her early experiences with abandonment and rejection is the reality imprinted within her. If she had felt that reality fully as an infant and child it would almost certainly have killed her. Remember that when feeling the feelings in a primal therapy session the body temperature and heart rate can skyrocket. Such Pain can only be diffused bit by bit in a gradual accumulation of neurotic symptoms.
This woman must feel the early abandonment that now does not allow her to speak for herself. She must clear her system of the stored Pain by living it for the first time. She must feel the force behind her neurotic habits, the force that constellates and binds the symptoms into a neurotic whole. The only way she can really come to assert herself is to feel why she can't. Any current rejection sets off the original rejection, which is catastrophic. She controls the triggering off process by avoiding anything in the present that could set off the past, and that means any rejection.
If her self-assertion is to be genuine, it must spring from real contacts with her past experiences, or they will only be imitations forced over a repressed foundation. Wolpe is more right than he realizes when he tells her, "In the act of doing it, you will sort of push back the fear feelings. You will push them down to some extent." Here he is telling his patient what is precisely the thesis of this chapter: that behavior therapy requires further repression, further pushing down and pushing back, in order to "succeed."
In the second interview, Wolpe applies relaxation/desensitization techniques to a situation which Mrs. Schmidt has told him causes her anxiety:
Wolpe is speaking:
Well, now Mrs. Schmidt, I'm going to show you how to relax your muscles. As you know, when you relax you become more comfortable, and if you're anxious you feel less anxious. Now, I'm going to show you how to bring about a deep relaxation so that you can fight the anxiety more effectively than you have been able to in the past.
He shows her how to systematically tighten and release muscles throughout her body.
Well, let's go on now to the next step. I want you to close your eyes. Now, with your eyes closed I want you to try and make use of all the information I have just given you and get as relaxed as possible. So, let's go through these muscles in a systematic order OK, now, you are quite nice and relaxed. Now, keep your eyes closed and I'm going to ask you to imagine some scenes. Now, you will imagine these scenes very clearly, and generally speaking they will not affect your state of relaxation. But if by any chance anything does affect your state of calm, you'll be able to signal that to me by raising your right forefinger about an inch.
Now, I want you to imagine again that you're walking on the sidewalk and you see, moving toward you, Selma and you get ready to greet her, and she seems to see you but she walks right on -- she doesn't greet you.
Now, stop imagining this. If you felt any disturbance at that...
She raises her right forefinger.
...Okay. Thank you. Now, just keep relaxed. Now, don't think of anything except muscles. Let yourself sink more and more deeply into this calm, relaxed state. Now, again imagine that you're walking along the sidewalk and you see selma approaching and she seems to see you, and you expect her to make some response but she just walks right on. Stop imagining this scene -- just relax. Again, think only of your muscles. Just be calm and comfortable.
He repeats the exact procedure again.
Again imagine that you're walking along the sidewalk and you see Selma coming toward you, but there are also other people on the sidewalk, and you think she sees you but she walks right past without greeting you. Now, stop imagining. Now, if you felt any disturbance when you imagined this last time, raise your finger now.
She raises her finger.
Okay. Now, if the amount of the disturbance that you have been feeling, if the amount is getting less, do nothing. If it is not getting less, raise your finger again.
She does not raise her finger.
Okay, now, just keep relaxing as well as you can...Again imagine that you are walking along the sidewalk and Selma approaches and passes you without recognition or greeting. Stop the scene. Only relax.
She does not raise her finger.
Now, again imagine that you're walking along the sidewalk and you see Selma coming and she seems to see you, and then you pass each other without her greeting you. Stop imagining. If there was any disturbance this last time, raise your finger.
She raises her finger.
...If the amount of disturbance is still getting less, do nothing. If it is not getting less, raise your finger. (finger does not rise) All right. Keep on relaxing. Think only of relaxing.
He does it another time for good measure.
You're walking along the sidewalk and you see Selma approaching. You expect her to recognize and greet you but she just walks straight past. Stop the scene. Just relax...
Again imagine that you are walking on that sidewalk and you see Selma approaching and she seems to see you, and you are ready to greet her but she just walks past without any recognition. Stop the scene. If there was any disturbance, raise your finger. (Finger does not rise,) Okay, now just relax. Now, I'm going to count up to 5 and then you will open your eyes and feel calm and refreshed. 1-2-3-4-5.
And the session is over.
What must be recognized is that a transient, trance-type state of relaxation, achieved through the laborious repetition of suggestions, is not the same state of permanent relaxation that occurs in a person in touch with himself and his feelings.
In evaluating Wolpe's approach, Patterson points out several major problems. First, he questions the legitimacy of assuming that human neuroses are analogous to experimental neuroses in animals, stating that "Wolpe's arguments are not highly convincing." Secondly, Patterson indicates that Wolpe's technique of reciprocal inhibition is the same concept of extinction or counter-conditioning, and that the ultimate outcome of Wolpe's approach is the inducement of behavior Wolpe himself deems therapeutic. Wolpe achieves this by "encouragement, support, suggestion, command and...hypnosis."
Patterson claims that the main force of Wolpe's therapy is really not the objective, scientific application of learning theory, but the very subjective impact of Wolpe's personality on his patients. In making this point clear, Patterson quotes Rotter's review of Wolpe:
Apparently, what has frequently been referred to in the past as prestige-suggestion is the method he [Wolpe] relies on most heavily. The patient is led to expect that his problems will be solved if he will do as the therapist suggests, and at least in many cases the patient is willing to try out these behaviors.
Again it appears that, though minimized by Wolpe, the relationship [between therapist and patient] is important -- a relationship in which the counselor wants to help the client, using methods which he strongly believes in and is able to lead the client to believe in.
For all of Wolpe’s conditioning schedules, he is using the age-old archetype of the wise, omniscient Father whom the trusting child is lead to strongly believe in. Ironically, while stripping all humanness out of his theory, Wolpe must in fact rely upon that very humanness if his approach is to "succeed."
Wolpe claims a very high success rate, so high, in fact, that Patterson writes:
The claim of success (90 percent apparently cured or much improved) must be viewed with some skepticism. As Wolpe recognizes, in order for his figures to be comparable with data from other methods, which usually report much lower rates of success, two assumptions must be made. The first is that the clients are similar, and that they are not selected in any way which would bias the results. While this assumption cannot be disproved, neither is there any evidence to support it. Wolpe does limit his clients to those diagnosed as neurotic. The case examples which he uses indicate that some were severe cases; on the other hand, many, if not most, would appear to present rather minor or limited problems.
The second assumption is that the criteria for success are similar to those applied by others. There is no evidence for this assumption. The evaluations were made only by Wolpe. Some of his clients were not included in his tabulations, clients being included only if they have had an "adequate" amount of therapy. Therapy is naturally regarded as adequate in every patient who is either apparently cured or much improved. In those who have benefitted less, it is regarded as adequate if a reasonable trial has been given to each of the reciprocal inhibition techniques that seem applicable to the case. Such selection of clients must be considered in any evaluation, both in terms of the kinds of problems for which an approach is applicable and in terms of the results with clients who are accepted. Stevenson notes that if we were to take the entire series of 295 cases which Wolpe reports having seen for at least an intake interview, the success rate drops to 65 percent.
Behavior therapy is generally characterized by the surprisingly high success rates which Wolpe claims. The problem with such statistics is that, in order to give them the degree of significance they merit, we must understand exactly what they are reporting. For example, claiming an 85% success rate in the treatment of phobias does not tell you the criteria upon which the measurement was based; it does not tell you how the 85% was arrived at. Was it based on patient reports that they no longer experienced their phobias? On patient reports corroborated by friends and relatives (in case of patient self-distortion or complaisance)? On objective test situations successfully executed by the patient in the presence of an objective observer? Was there any long-term follow-up to verify that the "cure" was permanent, and not tied to the therapeutic relationship or its immediate after-effects?
But even including all of the above points in the criteria for measurement of cure would not be sufficient. The ultimate criteria for cure -- the ultimate indication that the symptom had been fully removed from the person's system -- should be objective physiological measurements of that system. If the anxiety in the form of a symptom had been fully removed, it would be reflected in all of the patient's vital sign measurements. For example, in the past we have done stress hormone studies. If the patient lost her phobias but the stress hormone levels were still high we would be suspicious that the therapist had played tricks on the patient, convinced the patient she was well when in fact she was under great stress. But I don't think there are any behavior therapists who would bother to carry out such involved physiological measurements, because, in general, they believe that if you get rid of the symptom, you've gotten rid of the neurosis. This belief in itself circumscribes the procedures they are likely to use in measuring their success rate. It is again the phenotypic treatment of appearances (for those who have no internal access) versus the genotypic approach (dealing with root causes).
Success rates claimed by behaviorists such as Wolpe can be very misleading. The presenting symptom may be apparently gone, but unless the person's total system is monitored, there is no way of knowing whether it is truly gone. Symptoms have a rationale! They are part of the defense structure.
B. F. Skinner
B.F. Skinner came into the public limelight a few decades ago with the creation of what came to be called (but not by Skinner himself) the Skinner Box. Skinner designed the box to demonstrate how the behavior of his experimental rats indicated the need for a new concept of the conditioning process. He called this new concept "operant conditioning," and showed how it differed in significant ways from the earlier stimulus pairings conditioning paradigm upon which behaviorism had been founded. In operant conditioning, the future probability of a behavior is affected by what happens after it. Some events make a given behavior more likely, some events make a given behavior less likely; these events are called reinforcers and punishers, respectively. Stimuli present during conditioning, and motivational variables (e.g., hunger or satiation), also affect the probability of a behavior occurring at a given future point in time.
Skinner maintained that application of the scientific method to the study of human behavior should yield knowledge that could make the world a more agreeable place. While he emphasized empiricism and being atheoretical in approaching the subject matter, he leaned heavily on operant conditioning as an explanation for what humans do. For this, he was widely criticized. To me, he applied his concept of reinforcement with such conceptual exactitude that no trace of human feeling or life remained; everything reduced down to "not the feeling but the thing felt." Since reinforcement is the all-critical link in Skinner's chain of conditioning, it seems fair (and logical) to ask why something is reinforcing? What is the nature of reinforcement? What mediates reinforcement? What conditions contribute to reinforcement? Chaplin and Krawiec note:
If the question is pressed as to why reinforcers are reinforcing, Skinner points to the obvious biological significance of reinforcers such as food and water. From a broad evolutionary point of view, any response that reduces deprivation is likely to be reinforced and that leads to the repetition of the response. However, Skinner does not find that attempts to analyze the nature of reinforcement are of practical benefit in his system.
But Skinner really goes further, saying that:
There is no important causal connection between the reinforcing effect of a stimulus and the feelings to which it gives rise...Stimuli are reinforcing and produce conditions which are felt as good for a single reason, to be found in evolutionary history. Even as a clue, the important thing is not the feeling but the thing felt. It is the glass that feels smooth, not a "feeling of smoothness." It is the reinforcer that feels good, not the food feeling.
Men have generalized the feelings of good things and called them pleasure and the feelings of bad things and called them pain, but we do not give a man pleasure or pain, we give him things he feels as pleasant or painful. Men do not work to maximize pleasure and minimize pain, as the hedonists have insisted; they work to produce pleasant things and to avoid painful things. Epicurus was not quite right: pleasure is not the ultimate good, pain the ultimate evil; the only good things are positive reinforcers, and the only bad things are negative reinforcers.
What is maximized or minimized, or what is ultimately good or bad, are things, not feelings, and men work to achieve them or to avoid them not because of the way they feel but because they are positive or negative reinforcers. (When we call something pleasing, we may be reporting a feeling, but the feeling is a by-product of the fact that a pleasing thing is quite literally a reinforcing thing...We call a reinforcer satisfying, as if we were reporting a feeling; but the word literally refers to a change in the state of deprivation which makes an object reinforcing).
In effect, Skinner denies the reality of inner states of being while amplifying the significance of the "things' we react to as either reinforcing or punishing. He says that the reaction or feeling is not important, only the thing which triggered it. Relevant to this issue, there are three positions possible. You can take Skinner's viewpoint and say that it is the thing that reinforces which is important. You can take the opposite viewpoint and say that it is the feeling of reinforcement which determines a reinforcer in the first place, so that's the important element. Or you can view the process dialectically and recognize that there is a dynamic relationship between man and environment, between the things that reinforce and the feelings to which they give rise.
Skinner's viewpoint is so one-dimensional that it ultimately travels in its own circle. Although he says that, "there is no important causal connection between the reinforcing effect of a stimulus and the feelings to which it gives rise," it is the very "feelings to which it gives rise" that act as the internal mechanisms of evaluation and discrimination. It is our feeling states that recognize an experience as either rewarding or punishing, that tell us that we want the reward and we don't want the punishment. If we need approval desperately from the past, then a flatterer can "buy" us and get us to do almost anything. But if we have had a lifetime of approval, then flattery will be seen as a kind of manipulation not to be taken seriously. It is, in effect, past unfulfilled need that requires reward in the present. Internal feeling states are the necessary preconditions to anything being reinforcing to us.
So while Skinner reduces all behavior to things that reinforce and things that punish, he ignores the link that we must experience reinforcement in order to seek it and experience punishment in order to avert it. When he maintains that what's important "is the glass that feels smooth, not a 'feeling of smoothness,'" he misses the point that it is the feeling of smoothness which occurs within us and which determines our response to the glass as a reinforcer. The glass thus becomes a reinforcer because we "like" (are reinforced by) the feeling of smoothness.
Perhaps Skinner has it backwards: feelings are not the by-products of reinforcers, they determine reinforcers. Things are reinforcing because of how we feel about them. Things as reinforcers vary from culture to culture, and from century to century. But the feelings we experience that make something into a reinforcer remain constant. Feelings are the thread of continuity along which evolution proceeds. If, as Skinner believes, there is no consciousness as determining, no feelings which guide, then all of our humanness counts for nothing and we are but robots to be conditioned. It is our human feelings that make us kind and generous, concerned about our fellow man, wanting to construct and design and create, not just some "positive reinforcer."
On the Self
To Skinner, the self represents a personification whereby man attempts to see himself as the originating cause of action in his life: "The self," he writes, "is most commonly used as a hypothetical cause of action. So long as external variables go unnoticed or are ignored, their function is assigned to an originating agent within the organism.
Skinner feels that, from the point of view of scientific method, this notion of the self as an originating agent is not valid. Instead he views the self as "a device for representing a functionally unified system of responses." He admits that...
...the concept of a self may have an early advantage in representing a relatively coherent response system, but it may lead us to expect consistencies and functional integrities which do not exist. The alternative to the concept is simply to deal with demonstrated covariations in the strength of responses.
Stated more graphically:
The self is a repertoire of behavior appropriate to a given set of contingencies...the picture which emerges from a scientific analysis [of man] is not of a body with a person inside, but of a body which is a person in the sense that it displays a complex repertoire of behavior.
This is truly the definition of behaviorism. Nothing else counts; no internal processes, no imprinted memories that drive us, just what we do and how we do it. It is the ultimate non-reflective act. There is no human there, just a bunch of behaviors to analyze.
Contrary to Skinner’s theories, it’s more likely that behavior not only emanates out of what is going on the "now" but from one's history -- driven by imprints that we respond to before other considerations. Early imprints are based on reactions that involved survival; the defense is life-saving. Therefore, under current stress the system scans its history for what worked in the past and relies on it to get us through.
For Skinner, "emotions are excellent examples of the fictional causes to which we commonly attribute behavior." He believes it is futile to view emotions as inner states of being that cause us to behave in this way and that. Rather it is the environment which, impinging upon us, causes us to respond in this way and that:
As long as we conceive of the problem of emotion as one of inner states, we are not likely to advance a practical technology. It does not help in the solution of a practical problem to be told that some feature of a man's behavior is due to frustration or anxiety; we also need to be told how the frustration or anxiety has been induced and how it may be altered. In the end, we find ourselves dealing with two events -- the emotional behavior and the manipulable conditions of which that behavior is a function -- which comprise the proper subject matter of the study of emotion.
Therefore, in the Skinnerian universe, it is not important to say that a man committed a crime because of anger, or Pain, or fear. Rather we should say he committed the crime because he was out of a job and desperately needed money. The solution would then be to manipulate the outer conditions by getting the man a job. Skinner's viewpoint is plausible for this example. Conceivably, a healthy man who is forced to grapple with an extended period of unemployment during which time his family's future hung in the air might attempt a theft of some kind. The act would be a very circumscribed act, arising out of very circumscribed circumstances. It is also conceivable that a simple manipulation of the outer environment would provide a legitimate solution in that the man would never again commit such a crime.
However, the emotional problems which are the subject matter of psychology and psychotherapy are rarely so circumscribed. More often, the emotional states being manifested in the present have been triggered by circumstances which are complexly woven into the past. The rage and desperation a person feels at being fired may have less to do with the loss of the job than it has to do with painful, prototypic events from the past. A simple manipulation of outer environment will therefore act only as a temporary measure, and the next time a similar jolt occurs, the same emotional response will be triggered.
Skinner's problem here makes the assumption that present emotional behavior is a function of present manipulable conditions. Everyone knows that a person can have everything in terms of wealth, friends, and work, and still be plagued by depression, still abuse his wife and children, still be an alcoholic. What outer conditions would Skinner then manipulate to solve such a person's problem. And what about the person who was raised in a ghetto, where outer conditions were as bad as they could get, yet the person is not depressed, does not abuse his wife and children, is not an alcoholic? Would he still choose to manipulate the environment? His rationale is appealing because it is simplistic. Push button two and you can resolve the problem. Throw money at the crime problem, build more prisons, punish the criminal more severely and you will solve the problem of crime.
Believe it or not, this is the prevailing theory of today, perhaps not so explicitly stated, but it forms the underpinning of our attitudes about all sorts of social problems. In other forms it is cognitive therapy. Take what you see, don't bother about other deeper factors, and condition this with punishment, money, exhortation, moralizing, etc
Clearly, the relationship between the outer environment and the inner environment is far more complex than Skinner's model would have it. The outer environment is the initial problem. But we now know that that original environment in the form of a specific traumatic event is then neurologically imprinted into the organism. The hate for one's father is engraved not as an idea which will respond to lectures or punishment, but as a neurophysiologic experience. To solve it, it must be experienced and expressed, not suppressed. The difference is between expression and repression. Those who are repressed prefer this mode of treatment. Those open to their feelings are more interested in expression. It is not just a matter of philosophy; it is a matter of personality, which forms the basis for one's outlook. Skinner never would have said that feelings are fictional if he had the tools in those days to measure the processing of feelings and of imprints. Feelings are anything but fictional. When blood pressure goes over 200 during a feeling it is not a fictional state we are dealing with. It is a life-and-death event where catastrophic helplessness and hopelessness are preeminent.
For Skinner, to know the self is to know what things act as positive reinforcers, and what things act as negative reinforcers -- for it is those differences in reinforcement that determine the "complex repertoire of behavior" we call man. The particular alternation between positive and negative reinforcers turns out to be responsible for what is commonly referred to as repression. According to Skinner, repression is not an internal response mechanism or process in itself, but an outer behavioral adaptation to aversive stimulation (punishment): "We do not appeal to any special act of repression but rather to competing behavior which becomes extremely powerful because it avoids aversive stimulation."
Thus, when a child is punished for whining but not for smiling, the smiling behavior is automatically reinforced in comparison with the results of the whining behavior. Smiling behavior then becomes the "competing behavior which becomes extremely powerful because it avoids the aversive stimulation" evoked by the whining behavior. The repression of the whining behavior is therefore due to the activation of the smiling behavior, which has won out by virtue of the environmental (parental) contingencies of reinforcement.
We now know so much more about repression and the brain chemicals involved in the process to make it clear that repression isn't just a matter of negative reinforcement, of avoiding certain things and approaching others. It is a matter of how much Pain is involved and whether nerve pathways are open to pass the message on. When Pain is too high, the pathways shut down and the message of Pain is not passed on. Repression is now in effect.
Skinner describes the field of psychotherapy as "rich in explanatory fictions," chief among these being the construct of neurosis:
Frequently, the condition to be corrected is called "neurotic," and the thing to be attacked by psychotherapy is then identified as a "neurosis." The term no longer carries its original implication of a derangement of the nervous system, but it is nevertheless an unfortunate example of an explanatory fiction. It has encouraged the therapist to avoid specifying the behavior to be corrected or showing why it is disadvantageous or dangerous. By suggesting a single cause for multiple disorders it has implied a uniformity which is not to be found in the data. Above all, it has encouraged the belief that psychotherapy consists of removing certain inner causes of mental illness, as the surgeon removes an inflamed appendix or cancerous growth or as indigestible food is purged from the body.
We have seen enough of inner causes to understand why this doctrine has given psychotherapy an impossible assignment. It is not an inner cause of behavior but the behavior itself which -- in the medical analogy of catharsis -- must be "got out of the system.
With inner causes out of the way, therapy can then proceed with the rearrangement of behavior.
Therapy does not consist of releasing a trouble-making impulse but of introducing variables which compensate for or correct a history which has produced objectionable behavior. Pent-up emotion is not the cause of disordered behavior; it is part of it. Not being able to recall an early memory does not produce neurotic symptoms; it is itself an example of ineffective behavior. It is quite possible that in therapy the pent-up emotion and the behavioral symptom may disappear at the same time or that a repressed memory will be recalled when maladjusted behavior has been corrected. But this does not mean that one of these events is the cause of the other. They may both have been products of an environmental history which therapy has altered.
If most views of psychotherapy involve explanatory fictions, then what does effective psychotherapy truly involve? Skinner charts the following sequence of events by way of explaining, in non-fictional terms, how change occurs:
When a therapist encounters a patient for the first time, he is presented with a "problem." The patient usually shows a novel pattern of disadvantageous or dangerous behavior, together with a novel history in terms of which that behavior is to be understood. The particular course of therapy needed in altering or supplementing this history may not be immediately obvious. However, the therapist may eventually "see what is wrong" and be able to suggest a remedial course of action; this is his solution to the problem.
Now therapeutic experience has shown that when such a solution is proposed to an individual, it may not be effective even though, so far as we know, it is correct. But if the patient arrives at the solution himself, he is far more likely to adopt an effective course of action. The technique of the therapist takes this fact into account. Just as the psychoanalyst may wait for a repressed memory to make itself manifest, so the nonanalytic therapist waits for the emergence of a solution from the patient.
But here again we may easily misunderstand the causal relation. "Finding a solution" is not therapy, no matter who does the finding. Telling the patient what is wrong may make no substantial change in the relevant independent variables and hence may make little progress toward a cure. When the patient himself sees what is wrong, it is not the fact that the solution has come from within him which is important but that, in order to discover his own solution, his behavior with respect to his problem must have greatly altered....
Therapy consists, not in getting the patient to discover the solution to his problem, but in changing him in such a way that he is able to discover it.
Most patients don't present a "problem": They are the problem. It is an uncomfortable state of being. How do you fix that? What do you do about chronic depression? There is nothing to manipulate. It is all internal. Of course, neurosis is a "fiction," a theoretical construct which encompasses many physical systems. But it is also real in that there are measurable changes in these subsystems, taken as a gestalt we call it neurosis. It involves a certain level of repression, a certain degree of deviation from normal, not just in behavior but in neurochemical systems.
The whole idea in behaviorism is that if you change behavior the rest follows. As if you could change brain circuits by the manipulation of behavior. By controlling rage, for example, one's feelings are supposed to follow. All the control does it help build the rage up to the breaking point.
Skinner maintains that we do not have knowledge, nor do we have skill. We only have behavior that results from "contingencies involving a great variety of reinforcers." A person does not drive a car well because he has the necessary knowledge and skill, but "because of the contingencies of reinforcement which have shaped and which maintain his behavior."
Similarly, we do not have originality. That greatest gift, supposedly belonging to man alone, actually belongs to the environment. Original ideas, according to Skinner, emerge out of novel contingencies, which in turn generate novel behavior:
We may acknowledge the emergence of novel ideas, in the sense of responses never made before under the same circumstances, without implying any element of originality in the individuals who "have" them. Man is now in much better control of the world than were his ancestors, and this suggests a progress in discovery and invention in which there appears to be a strong element of originality. But we could express this fact just as well by saying that the environment is now in better control of man. Reinforcing contingencies generate novel forms of behavior. Here, if anywhere, originality is to be found.
On one hand, Skinner is saying that the environment is
responsible for the progress in the world we live in: "the environment is now in
better control of man." On the other hand, he also says that man "is indeed
controlled by his environment, but we must remember that it is an environment
largely of his own making."
From one angle,
, contingencies of
reinforcement are seen to shape the environment, while from another one it is an
environment largely shaped by man himself.
Skinner arrives at a uni-dimensional definition of a multidimensional phenomenon. The above contradiction well exemplifies the two variables Skinner tries in vain to isolate and pigeonhole in terms of a one-directional, cause-and-effect relationship. He tries to label the environment as the determinant of human behavior, yet must also concede that the environment is a product of that human behavior. There are no genetics, no history, no abilities inbred and hereditary. All is external behavior.
Why is someone so adept at basketball and another at piano? Is it all just reinforcement? There are those who take a few lessons on the piano and become great musicians. Others who study and are rewarded and approved and get nowhere. Clearly, there are inbred differences. With the behaviorists it is a matter of the shoemaker sees only shoes in the world. All that is missing from the behaviorist scheme is the human being; to them it is only an evolved rat.
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_From a Forward by Jerome Kagan in The Skinner Primer: Beyond Freedom and Dignity, by Finley Carpenter. New York: The Free Press, 1974, pp. vi-vii.
John B. Watson, Psychological Review, 1913, 20, pp. 158-167.
John B. Watson, Behaviorism (New York: Norton, 1930.) (2nd. Ed) p. 82.
J.B. Watson, Psychology From the Standpoint of a Behaviorist, J.B. Lippincott, 1919.
James P. Chaplin and T.S. Krawiec, Systems and Theories of Psychology (3rd ed.). New York: Holt, Rinehart, & Winston, 1974, pp. 478-479.
Andrew Salter, The Case Against Psychoanalysis (New York: Citadel Press, 1963, 3rd edition), pp 154-156.
Andrew Salter, Conditioned Reflex Therapy (New York: Farrar, Straus, & Young, 1949), p. 58.
 Salter, ibid., p. 36.
Andrew Salter, Conditioned Reflex Therapy, op. cit., p. 61.
Andrew Salter, op. cit. (Conditioned Reflex Therapy), pp. 61-63.
Joseph Wolpe, Psychotherapy by Reciprocal Inhibition (Stanford, CA: Stanford University Press), 1958.
Patterson, Theories of Counseling and Psychotherapy, op. cit., p. 161.
Arthur Burton, What Makes Behavior Change Possible? (New York: Brunner/Mazel), 1976, p. 64.
G. H. Patterson, Theories of Counseling and Psychotherapy, p. 159.
Cited in G. H Patterson, Theories of Counseling and Psychotherapy, pp. 164-167.
Patterson, op. cit., pp. 167-173.
Patterson, ibid., p. 174.
Ibid., p. 177.
Ibid., p. 177.
Ibid., pp. 173-174.
Ibid, p. 284.
B. F. Skinner, Beyond Freedom and Dignity, (New York: Knopf, 1971), pp. 107-108.
B. F. Skinner, Science and Human Behavior (New York: Macmillan, 1953), p. 283.
Ibid, p. 285.
Ibid., p. 286.
B.F. Skinner, Beyond Freedom and Dignity (New York: Knopf, 1971), p. 199.
B.F. Skinner, Science and Human Behavior, op. cit., p. 291.
Ibid,. p. 373.
Ibid., p. 378.
Ibid., pp. 381-382.
Ibid., p. 255.
Skinner, Beyond Freedom and Dignity, p. 215.