Although we have already done a main review of the history of the Psychotherapy and main psychological currentsbehavior therapy and modification is fundamentally linked to behavioral assumptions, and its academic research and subsequent application to the population is what has generated a greater number of techniques for the treatment of disorders, although it is true that other currents, perhaps without So much variability in techniques introduces equally effective therapies and treatments (mainly cognitive and systemic orientations).
The first attempts: Paulov and experimental neuroses
Paulov’s theoretical explanations of the mechanisms underlying experimental neuroses represent one of the first attempts to understand psychopathology in terms of psychophysiological vulnerability (Vila and Fernández, 2004).
For Paulov, the key to behavior was in the creation of neuronal connections of an excitatory or inhibitory nature between stimuli and physical (first signal system) or symbolic (second signal system) responses. Abnormal behavior arose when a conflict occurred between the processes excitatory and inhibitory physiological. This conflict could have its origin in specific learning experiences, both aversive and appetitive. But the experiences alone were not enough to explain the disorder. Extreme temperaments, according to Paulov, were vulnerable to manifesting neurotic behaviors if individuals suffered conflictive or traumatic experiences (Vila and Fernández, 2004).
Part of this research has been reflected in various subsequent studies on different studies psychopathological observed in the context of learning with animals (learned helplessness, psychosomatic ulcers, superstitious behavior); and was taken up by the Yale group, constituting the most immediate antecedent of behavior therapy.
The Yale Group
The Yale Group It was made up of a group of experimental psychologists, clinical psychologists, psychiatrists, sociologists and anthropologists who worked at the Institute of Human Relations at Yale University under the scientific leadership of Clark Hull. Among the most prominent members of the group, apart from Hull himself, was Hobart Mower. Mower was one of the first to translate Freudian concepts into the language of learning theory in order to facilitate their empirical verification. The operationalization of concepts such as instinct, anxiety or conflict were key to definitively laying the foundations for experimental research on motivational processes.
In this context, Hull’s (1943) theoretical approaches were of decisive importance, particularly his ideas about impulses as fountain energizing of behavior in the nature of internal physiological stimuli, which can be innate (biological) or acquired by conditioning (psychological), and which in addition to pushing the behavior, facilitate the learning of those responses that are followed by the reduction of the impulse (the source of reinforcement). There are countless experimental studies that were carried out on impulse from this perspective and which ended with the proposal, years later, of two sources of motivational energy, one of an internal or push nature – the physiological aurosal – and another of an external or push nature. of attraction (the incentive). The experimental studies on anxiety and conflict carried out by Mowrer, Miller and Brown (1939) and the rest of the Yale school researchers are indisputable classics that had and continue to have a decisive influence on current research.
The treatment of experimental neuroses was studied, and the work of JH Masserman (1943) should be mentioned when establishing experimental models of neurotic anxiety with cats that would significantly influence Wolpe. The study of hypnosis was initiated in Paulov’s laboratory (considering hypnosis an analogue of sleep), and taken up by Hull (who considered the hypnotist a CS). In 1932, Dunlap developed the technique called negative practice, which was used originally for the treatment of enuresis, homosexuality and masturbation.
At the end of the thirties Mower and Mower (1938) created the grid and bell technique for the treatment of enuresis based on their theoretical analysis (in terms of classical conditioning) of the problem. The 1940s began with the use of drug-induced aversive states in the treatment of alcoholism by Voegtlin and his associates (Lemere and Voegtlin, 1940).
On the other hand, Andrew Salter highlighted the importance of assertive behavior for the treatment of any psychological disorder in conditioned reflex therapy (1949). In 1941, Estes and Skinner designed a procedure called conditioned emotional response, better known as conditioned suppression, to measure state anxiety through its effect on behavior.
From these experiments it was concluded that punishment can lead to the elimination of the execution of a behavior but not to its elimination. unlearning. However, the most important contribution of the Yale group with respect to treatments was the theoretical proposal of approaching therapy from a perspective consistent with experimental models consistent with laboratory research on animal psychology (Vila and Fernández, 2004).
Breath control techniques
Proper control of our breathing is one of the strategies easier to cope with stressful situations and manage the increases in physiological activation caused by them. Correct breathing habits are very important because they contribute to the organism enough oxygen for our brain.
The current pace of life favors incomplete breathing that does not use the full capacity of the lungs. The objective of the techniques of breathing It is to facilitate voluntary control of breathing and automate it so that it can be maintained in stressful situations. Series of breathing exercises:
- Exercise 1: Abdominal inspiration The objective of this exercise is for the person to direct the inspired air to the lower part of the lungs. For which you must place one hand on your belly and the other on top of your stomach. During the exercise you should perceive movement when breathing in the hand located on your belly, but not in the one located on your stomach. At first it may seem difficult, but it is a technique that is controlled in about 15-20 minutes.
- Exercise 2: Abdominal and ventral inspiration The objective is to learn to direct the inspired air to the lower and middle area of the lungs. It is the same as the previous exercise, however once the lower part is filled, the middle area must also be filled. You should notice movement first in the hand on the abdomen and then in the hand on the belly.
- Exercise 3: Abdominal, ventral and costal inspiration The objective of this exercise is to achieve a complete inspiration. The person, placed in the position of the previous exercise, must first fill the abdomen area with air, then the stomach and finally the chest.
- Exercise 4: Exhalation This exercise is a continuation of the 3rd, the same steps must be performed and then, when exhaling, the lips must be closed so that when the air is released a brief snort is produced. The exhalation should be paused and controlled.
- Exercise 5: Inspiration – expiration rhythm This exercise is similar to the previous one but now the inspiration is done continuously, linking the three steps (abdomen, stomach and chest). The exhalation becomes similar to the previous exercise, but you should try to make it increasingly quieter.
- Exercise 6: Overgeneralization This is the crucial step. Here you must use these exercises in everyday situations (sitting, standing, walking, working, etc.). You have to practice in different situations: with noise, with a lot of light, in the dark, with a lot of people around, color, etc.
Exposure techniques
The live exhibition of the phobic stimuli without escape behavior until anxiety subsides. The key to treatment is to prevent avoidance or escape from becoming a “safety signal” Explanatory mechanisms of fear reduction during exposure: Habituation, from a psychophysiological perspective
Changing expectations, from a cognitive perspective Extinction, from a behavioral perspective
Exhibition paradigm:
- Classical conditioning theory (CC) which partially explains the extinction of phobias but does not explain their acquisition.
- Operant conditioning theory (CO) which does not explain its acquisition and only particularly explains its extinction
Exhibition modalities:
- Live exposure is the method of choice for phobias and relaxation alone has no therapeutic effects on phobia disorders.
- Exposure in imagination raises the problem that anxiety-inducing stimuli in vivo arouse fear in the patient despite habituation to them in imagination, but it is of interest in cases in which exposure in vivo is difficult to apply and involves motivation. additional for patients who do not dare to start treatment with in vivo exposure.
Group presentation:
- Comparable results are obtained with individual and group exposure.
Exposure in imagination is especially indicated when:
- The patient lives alone The patient lacks social skills
- The patient maintains a conflictive relationship
- Self-exposure is another type of exposure that is proposed due to the high percentage of dependency that phobic patients present.
The objectives of the exhibition are to reduce the patient’s dependency, shorten the time of professional dedication and facilitate the maintenance of results.
It is much more powerful than patient-directed exposure. The success of the self-exposure lies in the protagonism of the patient and the attribution of success to his own efforts. The main problem with the exhibition is the persistence in its practice. Virtual reality is another exposure technique that aims to generate an interactive and three-dimensional environment in which to immerse the patient.
The main field of activation has been the phobia of flying (North and North, 1994), agarophobia, phobia of driving and PTSD in ex-combatants. Long exposure sessions are more effective than short ones because they facilitate habituation rather than sensitization. The effect is enhanced with a short interval between sessions.
The differentiating factors of a sensitizing exposure versus a habituating exposure depend on the duration of the exposure, the time interval between trials and perhaps the change in meaning of the anxiety stimulus. The exposure gradient should be as rapid as the patient can tolerate. Potentiation of exposure can be achieved by: modeling by the therapist, reinforcement contingent on the progress of treatment,…