Classical Conditioning and the Treatment of Phobias
Classical Conditioning in the Treatment of Phobias
Phobias are emotional reactions that often interfere with one’s life on a chronic basis or acutely when the person is confronted with certain situations. While everyone has fears, people afflicted with phobias will often suffer from panic attacks when faced with phobic stimuli. Potential physiological responses of a panic attack are a release of stress hormones, increased heart rate, cold sweats, and racing thoughts of going crazy or feeling trapped. Anxiety and phobias can often lead to negative rumination and an avoidance of potential situations, thus severely limiting the sufferer’s ability to fully enjoy life. Due to the potentially debilitating nature of these conditions, much study has been conducted regarding possible treatments.
It is believed that these phobias are a product of classical conditioning. The theory is that the sufferer must have experienced fear in the presence of the phobic stimulus in a past event. Therefore, the stimulus now holds power over that person and can produce an anxious and fearful reaction henceforth. So how are we to break this pattern once it has been established? Several ideas exist as to the best method of reducing phobic reactions; extinction, counterconditioning, and systematic desensitization.
The extinction idea suggests that the sufferer should be exposed to the stimulus for an either an extensive amount of time or on a repeated basis. The thought is that the more time that an individual is in contact with a phobic stimulus, the greater their anxiety and of that stimuli will dissipate. However, the problem that many with phobias encounter is that they try to avoid specific phobic stimuli. While this may prevent a phobic reaction in the short-term, it does nothing to actually treat the underlying issue.
The counterconditioning idea suggests that the sufferer can be taught or “conditioned” to produce a non-fearful emotion to the phobic stimuli. Just as they were conditioned to be fearful of certain stimuli, they can be reconditioned to be fearless and unafraid instead.
Systematic desensitization relies on achieving a state of relaxation and then visually progressing through an anxiety hierarchy. In this hierarchy, small successive steps are added until full contact with the phobia is achieved. To demonstrate systematic desensitization, I will create a sample anxiety hierarchy for someone who has a phobia of dogs.
Imagining that there is a dog inside of a house, our goal will be to enter the house and pet the dog. Beginning at the bottom (the least threating step), we will work our way upward (the most threatening step).
5. Pet the dog.
4. Approach the dog.
3. Enter the room with the dog.
2. Enter the house.
1. Enter the yard.
From a state of complete relaxation, the phobia sufferer and therapist are able to visualize these steps one at a time and counter any phobic reactions which may occur. Systematic desensitization usually culminates in the real-world application of the items set forth in the anxiety hierarchy thus resulting in full contact with the primary phobic stimulus.
Lately there has been a trend toward a more direct approach in relieving phobias. Exposure treatments, which are a form of desensitization, expose the phobic person to increasing doses of their feared stimulus. Each dose builds upon itself until the phobic stimuli is fully realized. This forces the phobic person to control their anxiety in successive steps. This method has shown to be very effective given the belief that extinction occurs at a faster rate after anxiety levels risen then fallen (Carver, 2008).
While these practices are often able to reduce fear in those with phobias, these methods show promise in other aspects as well. By understanding that these behaviors are caused by classical conditioning, people are better able to understand their own emotions. Additionally, some of these methods can be adapted to form relaxation techniques which can be used to cope with other difficult situations that may be encountered (Goldfried, 1971; Goldfried & Merbaum, 1973).