Phobias

• what is the two-process model?

  • phobias are acquired through classical conditioning and maintained by operant conditioning
• describe how phobias are acquired via classical conditioning

  • process of learning by associating two stimuli together to condition (learn) a response
  • we learn toassociate something we do not fear (neutral stimulus), for example a lift, with something which triggers a fear response (unconditioned stimulus), for example being trapped.
  • After an association has formed, the lift (now a conditioned stimulus) causes a response of fear (conditioned response) and consequently, we develop a phobia of lift, following a single incident of being trapped in a lift.
• describe how phobias are maintained by operant conditioning

  • phobias can be negatively reinforced.
  • This is where a behaviour is strengthened because an unpleasant consequence is removed. For example, if a person with a phobia of lifts always takes the stairs, then they are constantly avoiding their phobia.
  • This avoidance reduces the person’s feelings of anxiety and so negatively reinforces their behaviour, making the person more likely to repeat this behaviour (avoidance) in the future.
  • As a result, a person will continue to avoid lifts and maintain their phobia.
• strengths of the Behavioural Approach to Explaining Phobias (1)

  • Research evidence supports the behavioural explanation of phobias. Watson & Rayner (1920) demonstrated the process of classical conditioning in the formation of a phobia in Little Albert, who was conditioned to fear white rats. This supports the idea that classical conditioning is involved in acquiring phobias in humans and that generalisation can occur to other phobic stimuli.
• strength of the behavioural approach to explaining phobias (2)

  • application to therapy. The behaviourist ideas have been used to develop treatments, including systematic desensitisation and flooding. Systematic desensitisation helps people to unlearn their fears, using the principles of classical conditioning, while flooding prevents people from avoiding their phobias and stops the negative reinforcement from taking place. Consequently, these therapies have been successfully used to treat people with phobias, providing further support for the effectiveness of the behaviourist explanation.
• limitations of the behavioural approach to explaining phobias

  • The behavioural explanation for the development of phobias ignores the role of cognition (thinking): phobias may develop as a result of irrational thinking, not just learning. Furthermore, the cognitive approach has also led to the development of cognitive behavioural therapy (CBT), a treatment which is said to be more successful than the behaviourist treatments.
• limitation of behavioural approach to explaining phobias

  • There is a claim that the behavioural approach may not provide a complete explanation of phobias. Evolutionary psychologists suggest that some phobias (e.g. snakes and heights) are not learned but are in fact innate, as such phobias acted as a survival mechanism for our ancestors. This innate predisposition to certain phobias is called biological preparedness (Seligman, 1971) and casts doubt on the two‐process model since it suggests that there is more to phobias than learning.
• describe systematic desensitisation

  • uses counter-conditioning to unlearn the maldaptive response to a situation or object, by eliciting another response (relaxation)
  • there are three critical components to systematic desensitisation

  1. fear hierarchy
  2. relaxation training
  3. reciprocal inhibition
• what is a fear hierarchy?

  • rank the phobic situation from most to least terrifying
• what is reciprocal inhibition?

  • two emotional states cannot exist at the same time
  • a person is unable to feel anxious and relaxed at the same time and the relaxation should overtake the fear
• strength of systematic desensitisation (1)

  • research evidence demonstrates the effectiveness. McGrath et al. (1990) found that 75% of patients with phobias were successfully treated using systematic desensitisation. This was particularly true when using in vivo techniques in which the patient came into direct contact with the feared stimulus rather than simply imagining (in vitro). This shows that systematic desensitisation is effective when treating specific phobias, especially when using in vivo techniques.
• strength of systematic desensitisation (2)

  • Further support comes from Gilroy et al. (2002) who examined 42 patients with arachnophobia (fear of spiders). Each patient was treated using three 45‐minute systematic desensitisation sessions. When examined three months and 33 months later, the systematic desensitisation group were less fearful than a control group (who were only taught relaxation techniques). This provides further support for systematic desensitisation as an effective treatment for phobias in the long‐term.
• limitations of systematic desensitisation (1)

  • However, systematic desensitisation is not effective in treating all phobias. Patients with phobias which have not developed through a personal experience (classical conditioning), such as a fear of snakes, are not effectively treated using systematic desensitisation. Some psychologists believe that certain phobias have an evolutionary survival benefit and are not the result of learning. This highlights a limitation of systematic desensitisation, which is ineffective in treating evolutionary phobias which have an innate basis.
• strengthof systematic desensitisation (3)

  • favoured as a treatment for phobias in comparison to flooding, as it is more ethical in nature. many patients report a preference for systematic desensitisation as it does not cause the same levels of distress. This is reflected in the high number of patients who continue systematic desensitisation providing low attrition rates. It is therefore considered a more appropriate treatment for individuals since learning the relaxation techniques can be a positive and pleasant experience.
• describe flooding

  • exposes the individual to the anxiety‐inducing stimulus immediately
  • This intense exposure is done over an extended period of time in a safe and controlled manner.
  • a person is unable to avoid (negatively reinforce) their phobia and through continuous exposure, anxiety levels eventually decrease.
  • Since the option of employing avoidant behaviour is removed, extinction will soon occur since fear is a time‐limited response to a situation which eventually subsides.
  • individual may begin to feel a sense of calm and relief which creates a new positive association to the stimulus.
• strength of flooding (1)

  • cost‐effective treatment for phobias. Research has suggested that flooding is equally effective to other treatments, including systematic desensitisation and cognition therapies (Ougrin, 2011), but takes much less time in achieving these positive results. This is a strength of the treatment because patients cure their phobias more quickly and it is therefore more cost‐effective for health service providers who do not have to fund longer options.
• limitation of flooding (1)

  • can be highly traumatic for patients since it purposefully elicits a high level of anxiety. Wolpe (1969) recalled a case with a patient becoming so intensely anxious that she required hospitalisation. Although it is not unethical as patients provide fully informed consent, many do not complete their treatment because the experience is too stressful. Therefore, initiating flooding treatment is sometimes a waste of time and money if patients do not engage in or complete the full course of their treatment.
• limitations of flooding (2)

  • highly effective for simple (specific) phobias, the treatment is less effective for other types of phobia, including social phobia and agoraphobia. Some psychologists suggest that social phobias are caused by irrational thinking and are not caused by an unpleasant experience (or learning through classical conditioning). Therefore, more complex phobias cannot be treated by behavioural treatments and may be more responsive to other forms of treatment, for example, cognitive behavioural therapy (CBT), which treats the irrational thinking.
• limitations of flooding (3)

  • An issue for behavioural therapies such as flooding and systematic desensitisation is symptom substitution. This means that although one phobia may be successfully removed through counter‐ conditioning another may appear in its place. If symptoms are treated and removed, the underlying cause may remain and simply resurface under a new guise. Research in this area is mixed, however, and heavily disputed by behaviourists.
• limitations of behaviourist treatments of phobias

  • The behavioural explanation for the development of phobias has been criticised for being reductionist and overly simplistic in its reduction of human behaviour to a simple stimulus‐response association. It ignores the role of cognition (thinking) and cognitive psychologists suggest that phobias may develop as a result of irrational thinking.
• limitations of behaviourist approach to phobias (2)

  • The behavioural approach is a nomothetic approach that has created universal laws regarding the formation and maintenance of phobias. Yet, if we accept individual cognition plays a part, a more idiographic approach may be effective.