“A phobia is an intense fear that interferes with daily life” (Anna May., Brittany Rudy., Thompson Davis III., Johnny Matson., 2012). A phobia is more intense than a simple fear, as it leads to heightened anxiety and may even affect the persons social abilities such as leaving the house. Phobias affect numerous people worldwide; with over 8.7% of Americans suffering with a specific phobia, and a further 6.8% suffering from social phobia (Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE., 2005) If you experience one phobia, you’re around 75% more likely to develop another phobia in your life time (Curtis, G., Magee, W., Eaton, W., Wittchen, H., & Kessler, R. 1998) It’s been suggested that phobias can occur via principles of conditioning deriving from the behavioural approach. This approach focuses on the environment claiming we are born with a tabula rasa, meaning blank slate, so everything that we learn originates from the environment we are raised in. This essay will discuss the reasoning behind phobias from a behaviourist perspective.
Behaviourism is what some may call the cornerstone of all human behaviour. A phobia in terms of behaviourism thinking is a neutral stimulus which becomes associated with fear and therefore develops fearful qualities (S.Rachman., 1976). Conditioning techniques such as operant and classical conditioning originate from this approach with origins stemming from the work of Ivan Pavlov. However, the origins of phobias, fears and anxiety are often associated with the work of John Watson (Paul Eelen, Bram Vervliet., 2006). Classical conditioning refers to the action of a once neutral stimulus, for instance a spider, being paired with an emotion such as fear, through this association the neutral stimulus develops fearful qualities (S.Rachman., 1976). Due to this maladaptive association, the individual becomes fearful of the stimulus, in this case a spider and avoids it at all costs.
On the other hand, operant conditioning works on the principles of rewarding or punishing behaviour. A famous example of this conditioning technique comes from Watson and Rayners study, Little Albert, in 1920. Watson demonstrated that avoidant responses toward a once neutral stimulus can be learnt (Field., 2005). In the case of Little Albert, Watson conditioned him to be fearful of all things fluffy, generalising his fear not only for rats but to dogs, Santa and various other objects that shared the same qualities to that of a rat. Operant conditioning of fear is
Uncued panic attacks may also trigger phobias in certain situations. For instance, if one was to experience a rise in heart rate, like that at the start of a panic attack, it may become a conditioned stimulus which would trigger a larger rise in heart rate (Dean Acheson, John Forsyth, Erica Moses., 2011)This increase may trigger an anxious response in the individual which in turn may manifest itself in the form of a phobia. The symptoms of a panic attack are very similar to that of a phobia, for instance if someone with arachnophobia were to encounter a spider, they may have feelings of losing control or impending doom which is incredibly similar to that of a panic attack (James N Butcher, Jill M Hooley, Susan Minkea.2013)OST Hugdahl performed a study on 106 adult phobic clients and found that 58% of them cited their phobias as occurring due to traumatic events including that of uncued panic attacks (Butcher et al., 2013)
Whilst these causes are common and foundations in our understandings of phobias, the behaviourist approach tends to ignore factors such as biology or evolutionary influences. For instance, it has been suggested that the role of the amygdala may play an important role in the expression and acquisition of a fear (Liesbet Goossens, Stefan Sunaert, Ronald Peeters, Eric J L Griez, Koen R.J Schruers., 2007) The behaviourist approach fails to account for preparedness, first proposed by Seligman in 1971. Here we see that we learned to fear things quickly if they were a threat to our survival, such as dogs prior to domestication. Due to this quick association between stimulus and emotion, we are able to survive longer and thrive whilst we developed. However, now we no longer fear dogs due to domestication which shows that phobias are a relative concept that adjust over time to suit the culture and time period we’re living in. Another critique of this approach is that not all people who experience a trauma or fear develop a phobia (Rachman 1977). For instance, many people may fear the dentist after a traumatic incident however some people can experience the same traumatic incident and not develop a fear of the dentist. The behaviourist approach cannot explain why some people develop phobias whilst others don’t, and this reduces the validity of this approach (Lautch., 1971).
Behaviourism treatments vary in intensity and effectiveness. Systematic desensitisation, first developed by Wolpe, treats patients by taking them through stages of fear. Systematic desensitisation is based on principles of reciprocal inhibition which are used to overcome persistent habits of phobias (Wolpe.,1951). Reciprocal inhibition refers to the way in which people cannot experience two contrasting emotions at any one time, for example you cannot feel relaxed and anxious at the time. In order to start the therapy, the individual must construct a fear hierarchy starting with the situation the fear the least to the situation they fear the most. For instance, a person with arachnophobia may fear the word spider the least and fear a spider on their body the most. The patient would then be taught relaxation techniques before being brought through each stage of the fear hierarchy. If the patient becomes anxious, they are simply taken out of the stage, relaxed again and then they return back to the stage they couldn’t work past. If treating a child with systematic desensitisation, one might reward the child for completing a stage with a prize or a sticker to reinforce the good behaviour for confronting their phobias (May et al., 2012). This is an effective treatment as it allows patients to face their fears in a safe, relaxed environment where should they feel uncomfortable, they could stop at any point.
Whilst systematic desensitisation is an ethically sound therapy,flooding is also an effective therapy used to treat phobias. Flooding involves the individual being exposed to their fear for prolonged periods to the phobic situation in either in-vitro or real life (J.C. Boulougouris, I.M. Marks and P. Marset., 1970). The client must agree to a time period that they must be flooded with the phobic object and during this they cannot leave the situation. This treatment is more extreme than that of systematic desensitisation however it’s a good treatment for social phobias or environmental phobias (H. Watkins., 2018) However, it can also be seen as extremely unethical. For instance, if the patient were to feel anxious or embarrassed then the therapy violates principles of protection from harm and shouldn’t be used again on the patient. If the individual participating in flooding were to experience extreme anxiety is may backfire and actually reinforce the phobia rather than weaken it.
Lastly, cognitive behavioural therapy (CBT) is also used to treat phobias in people of all ages. Whilst it may be partly cognitive based, it is also heavily influenced by the behavioural approach in psychology. CBT assumes that feelings of fear or anxiety are fully normal and expected and that genetics have influenced our fear responses to certain stimuli (A. Albano, P. Kendall., 2002). However, CBT aims to unpair such maladaptive thinking with the object and talk about the irrational thinking behind such association so that the individual can realise that the object is nothing to fear. It uses principles of exposure therapy by gradually exposing the patient to their fears much like the fear hierarchy in systematic desensitisation. Whilst CBT is the go-to therapy for many of those suffering from a phobia, it takes many weeks for the therapy to work efficiently. For instance, it took 12 to 23 weeks to treat patients with a phobia of vomiting (L.Walker, D. Veale, C. Chapman, F. Ogle, D. Rosko, S. Nahmi, L.M.Walker, P. Maceachern, T.Hicks., 2016). It is also a relatively expensive therapy, costing the NHS around £100 pound a session, which has to be used for a long period of time before the therapy works efficiently.
To conclude, the behavioural approach is an excellent approach in describing how phobias are acquired. Through this approach we can understand that we ourselves have learnt to fear objects through maladaptive thinking and how we can easily be treated to overcome such fear. However, we must consider the other approaches response to such claims. The behavioural approach doesn’t take into account genetics in our influence on phobias or evolutionary influences. All in all, the behaviourist approach is effective at explaining how phobias are acquired and treated however it could be a stronger approach should it take into account other perspectives such as biological.