Story of Psychology - Morton Hunt [384]
Modeling: Albert Bandura of Stanford University developed this technique based on his theory that most human behavior is learned by identifying with and imitating others of personal importance. The heart of the treatment consists of the patient’s watching the therapist behave in a particular way, learning by imitation, and modifying his or her behavior accordingly. As Bandura has pointed out, this is the process by which millions of people, watching and imitating others at Toastmasters Clubs, have overcome their fear of public speaking.60
Modeling, first used to change the behavior of children, was soon found useful in combating phobias in adults. Typically, treatment consists of having the patient watch the model in contact with the feared object in a relatively unthreatening situation, then in a series of increasingly threatening ones. In dealing with snake phobia, for instance, the model first touches the snake, then holds it, and finally allows it to crawl over his body. The therapist encourages the patient to go through the same series of activities, even guiding the patient’s hand and praising him for his efforts. Gradually, the therapist reduces the degree of demonstration, protection, and guidance until the patient, alone and without help, is able to confront the feared experience.61
Operant conditioning: After the success of the experiment in the 1960s and 1970s in which the behavior of hospitalized psychotics was modified by the use of rewards, many mental hospitals instituted programs based on such operant conditioning. Nurses and psychiatric technicians were trained to give tokens (poker chips, cards, or imitation coins) to patients for such desirable acts as grooming themselves, keeping their rooms neat and clean, behaving normally toward other patients, and taking on job responsibilities. The tokens were exchangeable for such privileges as a movie, a special food, a private room, or a weekend pass. Positive results were widely achieved, particularly with patients who had been withdrawn and apathetic for years. “Token economy” programs, as they are called, have also been used successfully with retarded persons, delinquents, and disturbed schoolchildren.62
All in the Mind: Cognitive Therapy
Nearly two thousand years ago, the Stoic philosopher Epictetus composed an apothegm that anticipated the theory behind a major form of current psychotherapy: “People are disturbed not by things but by the view which they take of them.”63
Some may find this shallow, others too pat, but its validity is shown by the effectiveness of cognitive psychotherapy. Albert Ellis, one of the originators of this form of therapy, has summed up its basic principle in what could almost be a rewording of Epictetus’s apothegm: “You largely feel the way you think, and you can change your thinking and thereby change your feeling.”64
Cognitive psychotherapy is often called “cognitive-behavior therapy,” since it incorporates elements of behavior therapy. But though the two forms overlap, they have a somewhat different focus. Behavior therapy often treats the patient like the sheep or pig whose behavior and reactions can be shaped by desensitization and other forms of conditioning; cognitive therapy seeks to modify the patient’s feelings and behavior by modifying his or her conscious thoughts.
The cognitive approach to mental disorders emerged in the early years of the cognitive revolution in psychology. In the 1940s and early 1950s, several psychologists theorized that flawed cognitive processes, rather than unconscious conflicts, were responsible for many neurotic conditions. One of the therapists was Julian Rotter (whose work on internal and external locus of control we looked at earlier); both an academic and a therapist, he devised “social learning” therapy, a method of getting the patient to rethink