Systematic Desensitization as a treatment for phobias

One of the topics that has interested me the most in psychology is the treatment of phobias. Perhaps this is because it is an area that we can point to and say that it is effective. I've read various research on the topic and the studies I've read have concluded that systematic desensitization is effective about 90% of the time for treating simple phobias. A simple phobia is one that is only triggered by a specific stimulus, for example, a fear of dogs or a fear of flying in an airplane. The reason that these phobias are easier to treat as opposed to say Generalized Anxiety Disorder or agoraphobia is because they can be treated with systematic desensitization using a combined method of biofeedback and relaxation techniques. Systematic desensitization is a mouthful, but the treatment approach is as you would expect. You gradually and systematically unlearn the phobia. I say unlearn because simple phobias are something learned through reinforcement and a reduction of anxiety by avoiding the stimulus that is causing the phobia. An example will make it clearer:

June is 7 years old and she comes into contact with a stray dog. June attempts to pet the stray dog and the dog bites her. June is frightened and runs away. The next time June sees a dog, June fears she may get bit again and so she avoids the dog. Each subsequent time June sees a dog she avoids it and each time she avoids a dog, her anxiety is reduced. It is this reduction in anxiety by avoiding the dog that produces the learned phobia. Many people think of the phobia as the fear of the dog. That is correct to a point. After all a phobia is defined as an irrational fear. However, the debilitating part of the phobia really has nothing to do with fear as it has to do with a reduction in anxiety. This is what keeps the phobia going, is the person's avoidance of the dog in this example that is reinforced through a reduction in anxiety.

So in using systematic desensitization we can step-by-step unlearn the client's phobic reaction. For example, lets say June comes to me in my office and asks me to cure her of her phobia. The first thing I'm going to do is hook June up to my biofeedback machine which measures heart rate, blood pressure and galvanic skin response. We will use these numbers to establish a baseline reading of her anxiety levels. Then I would ask June to imagine a scenario where she is walking in the park and she encounters a dog on a leash. Lets say that dog is a relatively non-threatening poodle. I would then ask June what her anxiety level is in this scenario based on a scale of 1-10, with 10 being the most anxious. As I note her self-reported anxiety, I would also note the biofeedback readings.

I would then ask June to imagine that the poodle is not on a leash, but is running towards her. Again I would note June's self-report of her anxiety level along with the biofeedback levels. After the poodle scenario, I would ask June to imagine the dog running towards her is a Rottweiler. You probably get the point now that we are trying to establish a hierarchy of June's phobia. Taking accurate biofeedback readings along with June's self reports to establish a baseline of her phobic hierarchy is a key first step.

More to come...

Multiple Intelligence Theory

I made reference to Multiple Intelligence Theory in my last post. If you've not heard of it, and I'm always surprised at the number of people that have not, you can go here - http://www.tecweb.org/styles/gardner.html

The reason that I say I'm surprised at the number of people that are not familiar with it is because it is one of the most profound concepts to come out of psychology in some time. Everyone knows about useless Freudian ideas like the Oedipus Complex or Penis Envy, but not the important stuff! Basically, Multiple Intelligence Theory states that our western way of thinking that intelligence is limited to verbal/quantitative is wrong. That in fact, there are other types of intelligences that don't readily show up on IQ tests. Now, before we get going down this path let me just make the disclaimer that my IQ has been tested and I'm in the 115-120 range. Einstein? No. But I'm above average, so this isn't some attempt fueled by bitterness to discredit IQ tests. And personally, I'm more of a traditional learner, what Gardner would call Logical-Mathematical. However, I also score very high in Gardner's Intrapersonal category and this too makes sense to me given my 15+ years of studying psychology now.

You may know of someone that maybe isn't good with numbers, but they are very good orators - Gardner would classify this type of intelligence as Linguistic. Although Linguistic is measured by traditional IQ tests (as is Logical-Mathematical). Some of his other categories include Visual-Spatial and Kinesthetic. Kinesthetic learners are those that learn better by moving or touching things - like an athlete, dancer or even surgeon.

The important thing to remember here is that we all are capable of learning given any of these methods, but we will have a preference or two when it comes to learning styles. Teachers, trainers and the like should be aware of these possible differences and not expect students (including adult students) to conform to one traditional standard.

Is psychology fading as a stand alone discipline?

When I was an undergraduate back in the early to mid 1990's studying psychology it seemed as if the brief 100 year history of psychology was filled with break through theories and discoveries. From Freud to Skinner to Piaget to Bandura, there seemed to be some breakthrough in psychology every few years. But fast forward about 15 to 20 years and the only significant research or theory that I can think of in psychology that has came to life recently has been Gardner's theory of multiple intelligence. If you aren't familiar with it, it's quite enlightening - you can read more about it at this link (just be sure to come back and finish reading my blog!) - http://www.tecweb.org/styles/gardner.html

I know saying this that there is some PhD student yammering on about research they recently read about that is ground-breaking, but I've maintained a healthy interest in psychology as a hobby over the years despite my veering off the psychology path en route to becoming a public health specialist. Trust me, there isn't anything out there groundbreaking in psychology anymore! And I fear that a lot of what was groundbreaking in the past is not quite as groundbreaking as we once thought in the light of today's research in medicine. Freudian theories have been all but entirely disproved (those that could actually be scientifically tested), behavioral theories (my passion once upon a time) though credible don't give us the big picture when it comes to human behavior and certainly can't account for the development of mental disorders, and things like positive psychology and client-centered therapy sound good and make us feel warm and fuzzy but research has shown that most therapies geared towards such societal problems as depression and bipolar disorder are entirely ineffective.

Now that doesn't mean that psychology is entirely useless, it just means that the field is changing. Areas such as industrial/organizational psychology, training & development, health psychology, etc. - applied areas that used to be the fringe of psychology - are now proving to be the most useful as they blend with other disciplines such as medicine and business. The former "key" areas of psychology like clinical and counseling have failed to produce promised results in "curing" depression, bipolar disorder, schizophrenia, etc. In fact psychology has been proven to be almost totally impotent for treatment of these conditions. Why? Because they are the result of genetic predispositions, not environmental influences. Psychology and specifically behavioral psychology has had some success in areas where it is quite clear that the condition is learned. For example, phobias. Honestly, in this day and age given what we know about psychology, biology and medicine, it is inconceivable to me why anyone would look at clinical psychology specifically as a viable field. The few disorders that are treatable with psychological methods are treatable via short-term therapy with applied behavioral approaches and the more serious conditions such as the aforementioned schizophrenia, depression and bipolar disorder clinical psychology has been completely inept at finding cures. These conditions are only controlled through medications that can be prescribed by a physician.