ions as internal properties of clients rather than as hypothetical constructs of therapists has resulted in considerable confusion about the types of changes effected by different approaches to the modification of behavior. It is widely assumed that behavioral and psychodynamic approaches are concerned with fundamentally different subject matters. The latter methods supposedly treat complexes, repressed impulses, ego strengths and mental apparatuses, the underlying causes of behavior, whereas behavioral approaches are believed to modify only superficial behavior. This apparent difference in subject matter, however, exists primarily in the therapists’ conceptualizations, not in actual practice. Ego strength, to take an example, is a www.freepsychotherapybooks.org 235 hypothetical construct and not an entity within the client. One can neither observe nor modify hypothetical constructs. The person’s behavior— broadly defined to include cognitive, emotional, and motor expressions—is the only class of events that can be altered through psychological procedures, and therefore it is the only meaningful subject matter of psychotherapy. Similarly, stimulus variables are the only events that the therapist can modify to effect behavioral change. Psychotherapy, like any other social influence enterprise, is thus a process in which the therapist arranges stimulus conditions that produce desired behavioral changes in the client. If, for instance, a psychotherapist creates conditions that increase the frequency of the behaviors from which ego strength is inferred, the client will be said to have acquired increased ego strength as a function of treatment. On the other hand, if the frequency of www.freepsychotherapybooks.org 236 ego-strength behaviors has been reduced in the course of psychotherapy, the client has suffered a loss in ego strength. Clearly, ego strength is simply a hypothetical abstraction whose presumed behavioral referents are the only reality the psychotherapist can modify. In the final analysis, social-learning approaches and all other existing forms of treatment modify the same subject matter, namely, behavioral phenomena. Most discussions of change-inducing processes, however, focus on treating the inferences made from behavioral events as though these abstractions existed independently and caused their behavioral referents. Philosophers of science have cautioned against the attribution of causal potency to described properties of behavior. Their warnings have had little impact on personality theorizing. Neither traits nor types, as concepts, have www.freepsychotherapybooks.org 237 any real existence. They are merely words, and words do not exist in the eye of the observer nor in the people observed. A man can not be said to have either a type or a trait, but he can be said to fit either a type or a trait. At present the fit will be inexact, for dimensions of personality have not yet been quantified well enough to permit of accurate measurement. In the case of height, the measurement can be precise, and little confusion results from saying that a man has a certain height. Observation and concept are so closely related that the phrase is not ordinarily understood to mean more than it says, namely, that the extent of a given datum of observation in one direction fits a certain section of an ideal dimension of distance. But if an attempt is made to fit some mode of human conduct to the trait of courage, the looseness of correspondence between behavior and concepts leads to mischievous reification. The concept parts company with behavior, picks up undefined notions in its flight from reality, and finally acquires an independent real existence in its own right, so that when it is said that a man has courage, he will be thought of as the fortunate owner of something considerably www.freepsychotherapybooks.org 238 more significant than a certain pattern of behavior [Pratt, 1939, p. 115]. Similarly, a person who is plagued with “weak ego strength” will be viewed as suffering from something vastly more significant than the behavioral referents from which the construct is inferred. For purposes of further illustration, let us designate behaviors in which persons violate social and legal codes of behavior and frequently engage in assaultive activities as the external expressions of an inferred zoognick. Based on prevailing clinical practices, the zoognick would come to represent an intrapsychically functioning agent. An honorific causative power would be conferred upon this hypothetical zoognick, whereas the observed behavior from which its existence is inferred would be depreciated as superficial behavioral manifestations. Before long, www.freepsychotherapybooks.org 239 psychological tests would be constructed to measure zoognick strength on the basis of which diagnosticians would tautologically attribute clients’ behavior to the action of the underlying zoognick. Proceeding on the assumption that “patient variables are not conceived to be behaviors, but constructs concerning internal constellations” (Wallerstein, 1963), psychotherapeutic goals would be stated in terms of removing the pernicious zoognick. On the other hand, direct modification of the deviant behavior would be considered not only superficial but potentially dangerous, since elimination of the symptomatic expressions might force the zoognick to emerge in equally pernicious substitute forms. A sufficiently charismatic exponent of zoognick theory could undoubtedly develop a sizable following with the same extraordinary conviction in the vital importance and causative potency of www.freepsychotherapybooks.org 240 zoognicks as that shown by adherents of libidinal forces. Oedipal complexes, collective unconsciouses, and self-dynamisms. Finally, humanists would embrace zoognick theory as more befitting the complexities of human beings than those simplistic mechanistic doctrines that stubbornly insist that the zoognick is the deviant behavior rechristened. Most treatment approaches devote remarkably little attention to the selection of objectives; when they are specified (Mahrer, 1967), the intended outcomes generally include a variety of abstract virtues described in socially desirable terms, such as reorganization of the self, restoration of functional effectiveness, development of individuation and self-actualization, establishment of homeostatic equilibrium, where there is id there shall ego be and where superego was there shall conscious ego be, achievement of identity, www.freepsychotherapybooks.org 241 acceptance of self-consciousness, enhancement of ego strength, or the attainment of self-awareness, emotional maturity, and positive mental health. While some of these objectives allude to vaguely defined behavioral characteristics, most refer to nebulous hypothetical states. These abstractions convey little information unless they are further defined in terms of specifically observable behavior. Behavioral Specification of Objectives A meaningfully stated objective has at least two basic characteristics (Mager, 1961). First, it should identify and describe the behaviors considered appropriate to the desired outcomes. The term “behavior” is used in the broad sense to include a complex of observable and potentially measurable activities including motor, cognitive, and physiological classes of responses. www.freepsychotherapybooks.org 242 After the intended goals have been specified in performance, and preferably in measurable terms, decisions can be made about the experiences that are most likely to produce the desired outcomes. For example, the statement, “Increase the person’s self-confidence and self-esteem,” designates a therapeutic intent; but it furnishes little guidance, since it does not reveal the kinds of behaviors the person will exhibit after he has achieved increased self-esteem. Once self-esteem and the behaviors that will be esteem producing for a particular client have been delineated, one can arrange conditions that will create the requisite behaviors and thereby produce the condition of positive selfevaluation. In some instances learning vocational skills may be most relevant to acquiring selfesteem; in some cases developing interpersonal competencies that will secure positive responses from others may be most appropriate; in other www.freepsychotherapybooks.org 243 cases eliminating alienating social behaviors may be required if self-evaluation is to be altered; and finally, in cases where a person is relatively competent socially and vocationally, an increase in self-esteem behavior may require the modification of stringent, self-imposed standards of behavior upon which self-approving and self-deprecatory responses are contingent. Similarly, unless the goals specify the behavior that persons will exhibit when successfully self-actualized, internally integrated, self-accepted, personally reconstructed, homeostatically equilibrated, or emotionally matured, such goals provide little

Principles of behavior modification

An evolved module for fear elicitation and fear learning with 4 characteristics is proposed. (a) The fear module is preferentially activated in aversive contexts by stimuli that are fear relevant in an evolutionary perspective. (b) Its activation to such stimuli is automatic. (c) It is relatively impenetrable to cognitive control. (d) It originates in a dedicated neural circuitry, centered on the amygdala. Evidence supporting these propositions is reviewed from conditioning studies, both in humans and in monkeys; illusory correlation studies; studies using unreportable stimuli; and studies from animal neuroscience. The fear module is assumed to mediate an emotional level of fear learning that is relatively independent and dissociable from cognitive learning of stimulus relationships.

Fears, phobias and preparedness: Toward an evolved module of fear and fear learning

Phobias and preparedness

• A carbon dioxide hypersensitivity theory of panic has been posited. We hypothesize more broadly that a physiologic misinterpretation by a suffocation monitor misfires an evolved suffocation alarm system. This produces sudden respiratory distress followed swiftly by a brief hyperventilation, panic, and the urge to flee. Carbon dioxide hypersensitivity is seen as due to the deranged suffocation alarm monitor. If other indicators of potential suffocation provoke panic, this theoretical extension is supported. We broadly pursue this theory by examining Ondine's curse as the physiologic and pharmacologic converse of panic disorder, splitting panic in terms of symptomatology and challenge studies, reevaluating the role of hyperventilation, and reinterpreting the contagiousness of sighing and yawning, as well as mass hysteria. Further, the phenomena of panic during relaxation and sleep, late luteal phase dysphoric disorder, pregnancy, childbirth, pulmonary disease, separation anxiety, and treatment are used to test and illuminate the suffocation false alarm theory.

False suffocation alarms, spontaneous panics, and related conditions. An integrative hypothesis.

https://www.psychology.nottingham.ac.uk/staff/mxh/C83MLP/Phobias/Rachman%20(1977).pdf

The conditioning theory of fear-acquisition: A critical examination.

A single experience of respiratory paralysis can be used to establish a conditioned response (CR) to a hitherto neutral stimulus. Respiratory paralysis to those undergoing it is horrific but not painful. The CR does not extinguish but becomes stronger as time passes despite repeated extinction trial

Characteristics of a conditioned response in human subjects during extinction trials following a single traumatic conditioning trial.

Effects on REM sleep.

Treatment for alcoholism based upon the formation of a conditioned aversion response to alcohol appears to have enjoyed some popularity during the 1940’s. Except in a few clinics, conditioning therapy is in little use today. The present communication describes a pilot investigation of a new method of producing a conditioned aversion response to alcohol which goes some way toward avoiding the difficulties met with in previous techniques.

An Investigation of a New Aversive Conditioning Treatment for Alcoholism

Aversion treatment of alcoholics by succinylcholine-induced apneic paralysis.

THIS communication describes a new technique for conditioning human subjects using a single traumatic stimulus. The need for such a stimulus arises in the conditioned aversive therapy of such behaviours as alcoholism and compulsions. Vomiting has been used frequently as an aversive stimulus1,2 but suffers from two disadvantages: the onset of vomiting is difficult to predict so that the moment at which the conditioned stimulus must be presented to ensure optimal conditioning is uncertain; also vomiting is accompanied by many undesirable side-effects. An alternative technique, which avoids these disadvantages, is provided by a temporary suppression of respiration, induced by succinylcholine chloride dihydrate (‘Scoline’).

S. G. Laverty

Papers

Characteristics of a conditioned response in human subjects during extinction trials following a single traumatic conditioning trial.

Effects on REM sleep.

An Investigation of a New Aversive Conditioning Treatment for Alcoholism

Aversion treatment of alcoholics by succinylcholine-induced apneic paralysis.

Traumatically conditioned responses acquired during respiratory paralysis.