Behavior therapies sharply contrast with insight-oriented approaches. They are focused on changing behavior, rather than on discovering insights into thoughts and feelings. Behavior therapies are based on the belief that all behavior, both normal and abnormal, is learned (D. Richards, 2007). People suffering from hypochondriasis learn that they get attention when they are sick; people with paranoid personalities learn to be suspicious of others. Behavior therapists also assume that maladaptive behaviors are the problem, not symptoms of deeper underlying causes. If behavior therapists can teach people to behave in more appropriate ways, they believe that they have cured the problem. The therapist does not need to know exactly how or why a client learned to behave abnormally in the first place. The job of the therapist is simply to teach the person new, more satisfying ways of behaving on the basis of scientifically studied principles of learning, such as classical condi- tioning, operant conditioning, and modeling (Zinbarg & Griffith, 2008).
Therapies Based on Classical Conditioning How can classical conditioning be used as the basis of treatment?
Classical conditioning involves the repeated pairing of a neutral stimulus with one that evokes a certain reflex response. Eventually, the formerly neutral stimulus alone comes to elicit the same response. The approach is one of learned stimulus-response associations. Several variations on classical conditioning have been used to treat psychological problems.
Desensitization, Extinction, and Flooding Systematic desensitization, a method for gradually reducing fear and anxiety, is one of the oldest behavior therapy techniques (Wolpe, 1990). The method works by gradually associating a new response (relaxation) with anxiety-causing stimuli. For example, an aspiring politician might seek therapy because he is behavior therapies Therapeutic approaches that are based on the belief that all behavior, normal and abnormal, is learned, and that the objective of therapy is to teach people new, more satisfying ways of behaving.
systematic desensitization A behavioral technique for reducing a person’s fear and anxiety by gradually associating a new response (relaxation) with stimuli that have been causing the fear and anxiety.
anxious about speaking to crowds. The therapist explores the kinds of crowds that are most threatening: Is an audience of 500 worse than one of 50? Is it harder to speak to men than it is to women? Is there more anx- iety facing strangers than a roomful of friends? From this information the therapist develops a hierarchy of fears—a list of situations from the least to the most anxiety provoking. The therapist then teaches tech- niques for relaxation, both mentally and physically. Once the client has mastered deep relaxation, she or he begins work at the bottom of the hierarchy of fears. The person is told to relax while imagining the least threat- ening situation on the list, then the next most threaten- ing, and so on, until the most fear-arousing one is reached and the client can still remain calm.
Numerous studies show that systematic desensiti- zation helps many people overcome their fears and phobias (Hazel, 2005; D. W. McNeil & Zvolensky, 2000). The key to success may not be the learning of a new conditioned relaxation response, but rather the extinction of the old fear response through mere expo-
sure. Recall that in classical conditioning, extinction occurs when the learned, conditioned stimulus is repeatedly presented without the unconditioned stimulus following it. Thus, if a person repeatedly imagines a frightening situation without encountering danger, the associated fear should gradually decline. Desensitization is most effective when clients gradually confront their fears in the real world rather than merely in their imaginations.
The technique of flooding is a less familiar and more frightening desensitization method. It involves full-intensity exposure to a feared stimulus for a prolonged period of time (Moulds & Nixon, 2006; Wolpe, 1990). Someone with a fear of snakes might be forced to handle dozens of snakes. Though flooding may seem unnecessarily harsh, remember how debilitating many untreated anxiety disorders can be.
Aversive Conditioning Another classical conditioning technique is aversive condi- tioning, in which pain and discomfort are associated with the behavior that the client wants to unlearn. Aversive conditioning has been used with limited success to treat alco- holism, obesity, smoking, and some psychosexual disorders. For example, the taste and smell of alcohol are sometimes paired with drug-induced nausea and vomiting. Before long, clients feel sick just seeing a bottle of liquor. A follow-up study of nearly 800 people who completed alcohol-aversion treatment found that 63% had maintained continuous abstinence for at least 12 months (Sharon Johnson, 2003; Wiens & Menustik, 1983). The long-term effectiveness of this technique has been questioned; if punishment no longer follows, the undesired behavior may reemerge. Aversive conditioning is a controversial technique because of its unpleasant nature.