Does behaviorism work?
Behaviorism was one of the now-discredited psychological theories of the last century, championed by B.F. Skinner, according to which mental states do not matter because behavior can be programmed directly. Mario Beauregard and I talk a bit about this in The Spiritual Brain.
Actually, the mere mention of the placebo effect should be enough to sink behaviorism as a theory. Basically, for many illnesses, mental states play a huge role in how well treatments work (placebo effect) - or DON'T work (nocebo effect).
Of course, W. H. Auden took a down-to-earth approach to how the theory was used in practice. He said,
Of course, Behaviourism "works". So does torture. Give me a no-nonsense, down-to-earth behaviourist, a few drugs, & simple electrical appliances, & in six months I will have him reciting the Athanasian Creed in public.
Behaviorist treatments for obsessive compulsive disorder have, for example, included forcing compulsive handwashers to touch toilets in public washrooms, after which they were forbidden the wash their hands. As a result, many refused to seek treatment. And if that's a new standard in enlightenment, we might as well move back to the Dark Ages.
Hat tip Toronto journalist David Warren for the Auden quote. Here are some other fun quotes about psychological and educational bad ideas.
Labels: behaviorism, placebo effect
posted by Denyse @ 12:23 PM
4 comments
4 Comments:
Denyse,
One question I had while I was reading your book, was why you did not touch on dreams at all. I would suspect that this would be an area relevant to the general theme of your book.
Dreams often seem remarkably coherent. Coherent enough, at least, that we can often recount them as stories and often find some sort of meaning in them. As far as I am aware, according to a purely materialistic perspective, dreams are nothing but the result of the random firing of neurons in the brain (basically another epiphenomenon). If this is the whole story, it seems incredibly remarkable that dreams have any intelligibility at all. In that case we should expect dreams to be utter nonsense, and definitely incoherent. Did Mario and yourself analyze (or think about analyzing) the neuroscience of dreams at all, in a fashion similar to work done with the Carmelite nuns.
Thanks!
Mohammed, no, we didn't get into dreams in the book.
We were over our word count as it was, and it was good of our publisher not to demand cuts.
However, re dreams, some have indeed argued that dreams are merely random firing of neurons. I confess I do not know on what ground.
On the other hand, a different materialist school, the Freudians, has argued that all dreams are deeply significant and deal with basic (usually sexual) desires.
From what I can tell - speaking as a layperson - dreams are not bound to literal reality, but they do usually express emotional reality. They tell us how we feel about what we are experiencing, often better than waking thoughts do.
Once, a woman who felt overwhelmed by stress at work told me that she had dreamed that her office was about to be overwhelmed by a tidal wave.
Reflecting on that, she recalled that she had seen a TV program about tidal waves/tsunamis.
So in her dream, she had merged the idea of the overwhelming water wall with her awareness of the unhealthy stress she was experiencing from being "overwhelmed" by unrealistic deadlines. Dreams often do rely on language puns, which suggests that there is a rational element, which is perhaps being playful.
I am sure that many people have experienced something similar.
Regarding Behaviorism, here is the Statement of Purpose from the Behavior Analysis Association of Michigan (BAAM). I believe it is representative of behaviorism generally:
"The Behavior Analysis Association of Michigan has been organized to support and promote scientific research on the basic principles of behavior and the extension of those principles to create demonstrably effective and humane outcome-based therapies with the primary goal of establishing and enhancing functional independent living skills."
Sounds like a true nightmare to me. People using carefully designed programs of rewards to help people learn important skills they might not otherwise have. My background is with people with severe developmental disabilities and autism. I have to think you would not actually prefer to go back to the pre-behaviorist period when having a developmental disability or autism meant lifelong custodial institutionalization, often physically restrained or drugged into submission. I wouldn't. Perhaps you would.
In any case, it seems like there are quite a few behaviorists around too, more than ever before, judging from the continued rapid growth of the Association for Behavior Analysis and from the satirical page, "Behaviorism Deathwatch" on the BAAM website.
http://www.baam.emich.edu/baammiscpages/baamdeathwatch.htm
As for OCD, it is easier, I suppose, to trivialize a standard and uncontroversial treatment like Exposure and Response Prevention (ERP) by presenting it in extreme and uncompromising terms than to do the harder work of presenting it as it is. People sit on waiting lists to have the their troublesome, sometimes debilitating, anxiety disorders--phobias, OCD, PTSD, panic attacks, agoraphobia, trichotillomania, and many other problems--reduced or eliminated by the systematic presentation of the anxiety-producing stimuli in a safe and controlled manner. ERP is one of the most successful forms of therapy in all of psychology because it relatively brief, far more benign than the conditions it is applied to, and highly effective in the short and long term. Social validity measures show ERP to receive very high client satisfaction ratings. Treatment refusal? The problem there is not refusal after treatment starts, but being afraid to be treated at all, by any means at all. Compulsive handwashing might be a fun notion to flog in a blog. But consider the plight of someone whose days and nights are consumed with dozens of unnecessary trips to the sink, occupying hours of time, courting serious health risks due to the skin damage that occurs. And touching a toilet? There are far worse things to touch--like kitchen counters and other people. (What condition is your toilet in?) And, not hand-washing for a while? That's what the client wanted and was paying for. A normal rate of washing.
(Seriously, don't you suppose a competent therapist, using what is technically described as "flooding," would have made sure everything was safe; that the client was fully aware of what he or she had volunteered for; was fully aware that he or she could leave treatment at any time; was informed of why things were being done as they were. And if there was a heightened state of anxiety for a while, big deal. That's normal. Perhaps you have a column about the lack of ethics of oncologists because chemotherapy often creates far worse symptoms than the person is having from the cancer. And, oh those dentists!)
Really. Who is being forced to do anything? Are you imaging teams of roving behaviorists searching for phobias to eliminate and habits to reduce? We already have more than enough to do with all the people who come unsolicited to us seeking the most empirically validated and effective treatments psychology has to offer. The Dark Ages? That was before behavioral treatments were available. It has only a been a few decades since psychiatrists considered OCD and similar problems essentially intractable--largely because they were unable to do anything about them. Maybe you'd prefer drugs. Are years, maybe decades, of taking selective serotonin reuptake inhibitors, with all their side-effects and relatively low rate of effectiveness for anxiety disorders--really better than a few sessions of confronting an irrelevant fear or a few weeks of gradual exposure to the world, learning to take a walk outside for the first time in years. In the old days, if you had OCD, you had OCD. Autism was called "childhood schizophrenia," and the kids were shoved into the back wards because nothing could be done with them. Now, treating OCD and related conditions are among psychology's success stories. And, as we have seen, those kids with developmental disabilities have the advantage of good, science-based contingency management procedures to help them learn the social and academic skills they aren't learning on their own.
One of my favorite quotes is relevant here. It is from Mont Wolf, Todd Risley, and Hayden Mees's classic 1964 article, “Application of Operant Conditioning Procedures to the Behavior Problems of an Autistic Child"--the first of its kind and a model for all that followed.
"According to a report from the mother six months after the child's return home, Dicky continues to wear his glasses, does not have tantrums, has no sleeping problems, is becoming increasingly verbal, and is a new source of joy to the members of his family."
All those nasty behaviorists, with their objective, empirically validated, reinforcement based, outcome oriented treatments--bringing joy to families. What a curse for the world to have such people in it. I dunno. Maybe God intelligently designed them to be here.
James T. Todd, Ph.D.
James T. Todd, it sounds as though you have not read The Spiritual Brain and have no idea what we are talking about. Classical B.F. Skinner behaviourism assumed no intermediate role of consciousness between stimulus and response.
I have little doubt that modern behaviourists have airbrushed all that.
But, while your post contains some valuable information, it also features many warning flags for me, especially, "Seriously, don't you suppose a competent therapist, ... "
Quite honestly, given what I know from news stories about "competent therapists", I wouldn't suppose anything except this: Anyone who feels a reason to become alarmed by what they are hearing should just leave immediately. They can sort it out later.
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