Explaining/Treating

• John Watson believed that we are born tabula rasa (blank slate). In the Little Albert experiment, he introduced a baby who had no fear of rats, to a white rat, alongside a loud bang. Soon, Little Albert displayed a phobia of not only white rats but white fluffy things.
• Orval Hobart Mowrer (1947) proposed the two process model to explain how phobias are learnt.
• Classical Conditioning

  A phobia is acquired through association - for example, Little Albert made an association between a neutral stimulus, the white rat, and a loud noise, an unconditioned stimulus, to produce a conditioned fear response.
• 1. Normal, natural response is unconditioned.
  2. Ringing a bell will get no response.
  3. Conditioning occurs with food and bell, generating association. The unconditioned response is being conditioned.
  4. Both are conditioned.
• Before Conditioning

  • Being bitten (unconditioned stimulus) creates fear (unconditioned response)
  • Dog (neutral stimulus) creates no fearful response

  During Conditioning

  • Dog (neutral stimulus) is associated with being bitten

  After Conditioning

  • Dog (now conditional stimulus) produces fear (conditional response)
• Operant conditioning takes place when our behaviour is reinforced (rewarded) or punished.

  Reinforcement tends to increase the frequency of behaviour.
• POSITIVE REINFORCEMENT: Do something, get rewarded in a positive way, continue doing that for rewards. Think Dogs Behaving Badly.
• NEGATIVE REINFORCEMENT: An individual avoids a situation which is unpleasant. Mowrer suggested that whenever we avoid a phobic stimulus we successfully escape the fear and anxiety that we would have suffered. This reduction in fear reinforces the avoidance behaviour and so the phobia is maintained.
• One strength of the two process model is psychotherapy. A major treatment for phobias involves exposure therapy, or flooding - where the patient is exposed to their phobia in order to reduce negative conditioning. This causes tiring.
• Neglects explaining the cognitive repercussions of phobias. The two process model focuses purely on explaining behaviour; how a traumatic experience can lead to avoidance and negative reinforcement in operant conditioning, whereas there are some irrational beliefs that coincide with many phobias, such as danger.
• However, a strength of this aspect is that it is supported by research into the correlation between traumatic events and phobic stimuli. Evidence comes from a 2006 study from Ad De Jongh, who found that 73% of people with a phobia of dental treatment suffered a traumatic experience in the dentists’ prior, showing that past events can increase the chances of developing a phobia.
• Some phobias don’t require a traumatic experience to trigger them. Many people in the UK have a phobia of snakes, despite the only venomous snake in our country being the adder - which last killed someone in 1975. If there are so few dangers or traumatic experiences to be had with snakes, why do people who have never encountered a snake in a traumatic situation grow up being terrified of them?
• Systematic Desensitisation - Stage One - The Anxiety Hierarchy

  • Put together by patient and therapist
  • A list of situations related to the phobic stimulus that provoke anxiety arranged in order from least to most frightening
• Systematic Desensitisation - Stage Two - Relaxation

  • Therapist teaching the patient to relax as deeply as possible
  • Might involve breathing exercises or mental imagery techniques
  • Meditation may also be used
  • Alternatively, drugs such as Valium may be used
• Systematic Desensitisation - Stage Three - Exposure

  • Patient is exposed to phobic stimulus while in relaxed state
  • This takes place over several sessions, starting at the bottom of the list
  • When the patient can remain relaxed in the presence of a lower level, they are moved up the anxiety levels
  • Treatment is successful when the patient can stay relaxed in situations high on the list
• Flooding teaches a bit of meditation, then the phobic stimulus is introduced. This might be having a spider crawl up you straight away, or bungee jump off a cliff. This should lead to extinction.
• Ethical safeguards

  • Flooding is not unethical but it is unpleasant so it is important to gain informed consent before the traumatic procedure and they are fully prepared
  • A patient would normally be given the choice of SD (systematic desensitisation) or flooding
• There is strong evidence to support SD as a working application. McGrath in 1990 found that 75% of people with phobias were successfully treated by SD. Further support comes from Lisa Gilroy, who, in a 2003 study, followed up a group of 42 people who had gone through SD to treat their arachnophobia. Less fearful.
• Another strength is that SD is more appropriate for patients with learning difficulties. Learning difficulties often accompany phobias, and other methods such as flooding may be deeply traumatic and require complex rational thought.
• A strength for flooding is that it is cost effective. Although the NHS is free for us, the money has to come from somewhere. Systematic desensitisation, because it takes more time to achieve its goal, is more expensive, for all the hours that go into it. On the other hand, flooding is more cost effective - it gets the job done, albeit in a more traumatic and unpleasant way, faster, in the space of 2-3 hours.
• High chance patients will drop out. Sarah Schumacher (2015) found that psychologists rate it as the most stressful option, supporting the idea that this treatment may yield more unsuccessful results. While the patient has given informed consent, it may still appear unethical or harsh. Alternatively, the idea of informed consent is subjective - a patient may sign up to do flooding, but during the practise, may want to opt out. Hard to decipher whether this is a change in consent etc.