Behave yourself

Can you teach pigeons to play table tennis? Yes, with enough patience. You have to watch the birds until one of them makes a move towards the ball, and then reward it with food. Each time it, or its partner, makes a further chance move of the right kind you reward it again. It may take a very long time but in the end you’ll have them playing, even if they never learn to keep score. Behavioural reinforcement is the key.

You can do the same with human beings. My daughter, aged three, persisted for months in waking up at midnight and staying awake for at least an hour. It was exhausting. Then, following the ideas of the behaviourist Professor Eysenck, I told her that every night she slept through, and only then, her furry monkey would have a penny in the morning to take to Mrs Minty’s sweet shop. For several mornings she was disappointed, but one great night she earned her penny. After that, it was plain sailing. It took about a fortnight. She has been a good sleeper for the last five decades.

Behaviourism, as a method of treating personal psychological problems, became popular during the later 20th century. It largely replaced psychoanalysis for the purpose because it was so effective. For example, psychoanalysis might once have been used to cure a “bedwetter” by exploring problems in the unconscious mind, where a behaviourist would have prescribed a wake-up bell triggered by dampness. Apart from the better results, behaviourism was quicker and far cheaper. My daughter’s sleep cure cost a shilling.

Behavioural treatment methods vary widely according to the issue involved. A good example is provided by the treatment of phobia. Imagine that you have an irrational terror of cats. This may have been triggered by a frightening incident involving a cat, perhaps years before. Each time you have encountered a cat you felt panic and left the room. And the sense of relief at escape simply rewarded your evasive behaviour. That phobia, being continually reinforced, could remain with you for life, unless you had the good fortune to meet a behaviourist.

He might ask you to create a hierarchy of cat experiences, starting with incidents so minor that you felt no fear, and leading up to incidents so proximate that they caused terror and panic. Having taught you deep relaxation as a skill, he would first ask you to imagine the most minor incidents, checking that you were able to maintain relaxation. You would then move, item by item, up the hierarchy – being encouraged to extend your relaxation at each stage — until, by associating relaxation with increasingly threatening situations, the fear was quenched. It would be unlikely to return.

A contrasting example is provided by a patient who had a preoccupation with bed linen and towels. He simply could not help himself from pinching them. His therapist put him into a hospital, and required him to spend all day moving towels into and out of the hospital store. After a few days of intense activity he became fed up with the sight of a towel, and no longer felt any temptation to touch another.

My favourite case is a man who developed asthma as soon as he was in bed with his wife. His therapist merely turned the picture of his mother-in-law to the wall. (True story, not a gag.)

To me, the most intriguing therapy is Eye Movement. It is used for those with truly distressing memories with which they cannot cope. The patient is asked to move his eyes continually from side to side while reimagining the memory in all its aspects as graphically as possible. Gradually the memory is detoxified so that it loses its intensity, and can then be handled normally. A possible explanation comes from “rapid eye movement” sleep in which the memory sorts itself out as we unconsciously digest our memories.

Behaviourism can be applied to a wide range of fears, anxieties and even simple, but dysfunctional reluctances. Depression, claustrophobia, insomnia and many other conditions have been cured. It will not always be effective, but the measurable results have been impressive. And once we have understood the link between our behaviour and the stimulus which reinforces it, therapy can in some instances be self-administered. Indeed, a therapist may, in appropriate cases, teach their client how to work at their cure between consultations.

Nevertheless, there is something missing. At least psychoanalysis works at exploring the unconscious to enable understanding of the origins of trauma and to come to terms with it. This is a consolation in itself, although often an expensive one. By comparison, treatment aimed only at behaviour may seem reductionist, and even disrespectful to the dignity of our nature. As the pigeons show, the training of behaviour alone is equivalently effective when applied to the lower animals. Instinctively we prefer to look for answers which reflect both human understanding as well as human behaviour.

But the seventh cavalry is on its way – in the form of cognitive behavioural therapy. As its name suggests, this treatment retains the therapeutic force of behaviourism, while addressing our understanding directly. But the focus is on the present rather than the past. If you tell a cognitive behavioural therapist that you hiccup because your mother tried to drown you as a baby, he will raise an eyebrow and invite you to consider instead why you hiccup nowadays. This therapy is thought to be so valuable that it is actually state-sponsored. We will look at it in due course.

About Quentin

Portrait © Jacqueline Alma
This entry was posted in Bio-ethics, Catholic Herald columns, Neuroscience and tagged , . Bookmark the permalink.

24 Responses to Behave yourself

  1. Lincluden says:

    Dear quentin,at last a blog that does not try to undermine catholic teaching.i look forward to some of your”disturbed” often heretical commentators applying their minds to a proven therapy for sick people.please continue with similar entries

    • Vincent says:

      I am a little surprised by this comment. I am not sure whether Lincluden is criticising Quentin or us, or all of us. i do hope he will tell us a little more of his concerns.

  2. Brian Hamill says:

    I do love the way Lincluden, and some others, gaily throw words like ‘heretical’ around with such joyous abandon. It is almost universally inaccurate and worse, just plain discourteous and offensive. It is the equivalent, mutatis mutandis, to saying that his ‘opponents’ are guilty of adultery. I was once accused by a priest, who was a theology teacher, of holding an heretical opinion. The fun thing was that about five years afterwards that same priest was promulgating the same opinion in his preaching. Somehow or other he had either digested my opinion and worked out what I meant, as opposed to what he thought I meant, or he came across someone whose authority he accepted and who also offered the same opinion. The fact that I still remember the whole incident indicates, I think, how much it hurt at the time and also how carefully we should use such heavily charged expressions. Anyway Karl Rahner once said every good Catholic holds, unwittingly, at least four heretical opinions.

  3. St.Joseph says:

    Brian Hamill
    You are probably right in what you say,however the other side of the coin would suggest that Catholics have a blind faith and that is not a bad thing.
    It is not always blind obedience we have the spiritual ability to understand Truth when we see it..
    Jesus came not to change Scripture but to explain it.

    • milliganp says:

      St. Joseph, the correct term is “bring it to fulfilment”. Jesus quoted Jonah but we don’t go looking for giant whales in the Eastern Mediterranean or the ruins of ancient cities that take three days to cross.

      Simple faith and blind faith are not the same thing. I remember a simple ( but sadly irredeemably anti-Semitic) Irish lady who argued with our (Jewish by birth) Parish Priest that Mary couldn’t be Jewish as she was a Catholic.

      If we take the ‘simple is best’ approach then we can throw away Augustine, Aquinas, Bonaventure, Scotus etc. This is not a ‘simple faith’ blog.

  4. John Nolan says:

    When it came to heresy, Karl Rahner could claim some expertise! Seriously, though, Brian is right that it should not be bandied about indiscriminately. It’s one thing to argue that an opinion may or may not be heretical; it’s quite another to call a fellow-Catholic a heretic.

    It’s interesting that in the last thirty years or so in the secular world certain opinions, however well-argued, are deemed ‘unacceptable’ and uttering them can have serious consequences. Those who impose the new orthodoxy don’t even have the excuse of revealed truth or divine mandate to fall back on. But step out of line on issues such as rape, homosexuality, and anthropogenic climate change and see the modern secular Inquisition swing into action.

  5. milliganp says:

    John, given that Rahner was far smarter than most of us it is only natural that he should be able to hold more heretical views. On a more serious note I was once told the maxim ‘all heresies are truth taken to extreme’. You only have to read the comments on the Catholic Herald website to see numerous examples of truth taken to extreme (usually the EF Mass or burn homosexuals at the stake).

    On a final note, I had a Blackadder moment reading your post “anthropogenic, Darling write that down and remind me to use it more often!”

    • John Nolan says:

      Paul, what’s extreme about the classic Roman Rite? As for homosexuals, I don’t want to see them consigned to the flames, or even banged up in Strangeways. I just wish they would be a tad less strident.

      I suppose that the greater the intellect, the more the propensity to ‘think outside the box’, but I tend to have more admiration for those (like Newman) who use their talents in defence of orthodoxy. The problem with heretics is their tendency to arrogate themselves and their opinions; compare Kung with Ratzinger, for example, or Cranmer with Fisher.

      Mind you, Manning considered Newman a heretic …

      • milliganp says:

        John, I was not intending to criticise the Classic Roman rite (or EF, even what you call it indicates a position). A small but significant number of those attached to the rite post vociferously on every open blog and their language often shows intolerance even of the mainstream of the church. Similarly Communion in the hand, girl altar servers and any hymn written since 1960 are treated as signs that the church is now essentially Protestant.

  6. Singalong says:

    Concerning behavioural issues, I think the right training can be enormously beneficial, but there can also be dangers as Quentin’s Post implies, in leading us to think of people as robots who only need a particular form of programming to ensure that they conform to acceptable standards.

  7. milliganp says:

    This is my own, true, story. From 11-14 I was at the Junior Seminary. A priest had been given responsibility for our “welfare”. Sadly he was devoid of any personal orientation to or skill in the role. Life was utterly, utterly horrid. If you weren’t being caned for minor infractions you had detention, lines, and constant criticism. I have no recollection of him (or most of the staff, who were all priests) smiling or being warm-hearted. As examples I was caned for having Jesus on the Cross at the fourth sorrowful mystery of the rosary and for receiving communion with mud on the soles of my shoes. I ended up with an ulcer at 13 and suffered near-constant anxiety sweats.
    I had my first nervous breakdown just under 10 years ago while suffering bullying at work. I’ve been on anti-depressants almost constantly since, I’ve done 3 rounds of psychotherapy and 2 lots of CBT. It was only in the third round of psychotherapy that the abused child’s voice finally got to speak.
    I can say with personal certainty that CBT is not appropriate for deep-seated problems –it’s the equivalent of putting a band-aid on a compound fracture. CBT is now seen as a panacea because it is cheap. It is incredibly important that we don’t abandon deeper therapies or spend enough time with patients with mental health problems to discern those who might need more specialised help.
    There is more to being a fulfilled human being than being chemically coshed with medication and behaviour-modified by a nurse who’s done a course.
    As a final, humorous, note my grammar checker is trying to substitute ‘cared’ for ‘caned’ as it thinks the word is out of context.

    • Quentin says:

      Thank you for sharing those terrible memories with us. I will be writing a little more on CBT in due course, but here are a couple of points.

      CBT is by no means infallible, and will not be appropriate for all cases. As you will know it can be used in conjunction with medication. It has been shown to be effective with depression (as well as several other conditions) but it is unlikely to be adequate, at least on its own, for severe cases.

      The wide provision of CBT was intended to help the large number of people who would otherwise not have been treated. There are two levels – one for relatively minor problems and one for the more serious. The latter therapists usually have a background in, say, a psychology degree before they start training. (As it happens I have a granddaughter who is training as a CBT therapist right now.) While there are well-evidenced CBT techniques, I don’t think one can ever overlook the qualities and skills of the individual therapist.

      I have written in the past on ‘righteous indignation’; your story would seem to be one of ‘righteous cruelty’. Corruptio optimi pessima.

  8. Singalong says:

    How dreadful, and what a contrast to the account of Bishop Francis Walmsley’s time at a Junior Seminary, Mark Cross, which I have just been reading. His training was interrupted by national service in the navy, he later became the Catholic chaplain to the Forces, and has called his book, From Sea to See.

    The attempt to mould you into blind faith and obedience obviously did not work, and it is quite amazing that your desire to continue in the Catholic faith and to be so active survived such treatment.

  9. St.Joseph says:

    My daughter last year took in rescue dog a Jack Russell.His owner was an elderly lady who died.
    He will stay in a dog cage while she goes shopping and with a carer who has other dogs but will not stay on his own in the house as he never was in a house on his own.
    He gets cranky if isn’t in his bed by 8 his usual time with his last owner ,he sleeps all night.A real creature of habit.

  10. Nektarios says:

    My heart goes out to you for what you have been through and it seems periodically still suffer.

  11. Singalong says:

    I wonder if the programming of pigeons to play table tennis involves cruelty and how it compares to techniques used with humans, obviously there can be no attempt to engage understanding and choice about the aims of the training.

    Would it be too flippant to ask if there is a YouTube video of the pigeons actually playing? I imagine they have to stand on the table, and I suppose they use their beaks to hit the ball, their wings could hardly become bats. The cooperation between two birds must be impressive, or perhaps four, have they advanced to doubles?

  12. Claret says:

    Having arrive late at this particular blog subject I was pleased to see that it only cost Quentin a shilling to alter his daughter’s behaviour because when I first read it I found myself calculating what five decades of money would add up to ! After all, allowing for inflation a penny a night would not have sufficed for long and as she grew older then the cost of her good behaviour would have risen considerably. Thankfully as I read further on I found that my calculations were unnecessary.

    Still I do wonder what any of this has to do with Science and Faith.
    Are we programmed to be Catholics of one sort or another ? Milligamp’s experience of Junior Seminary is horrific but even though I was spared such hardships in catholic schooling the fear of God was installed on us children daily from the age of four, ( or rather the fear of hell.) In some ways I am almost grateful for it as it kept me on some kind of moral code that hopefully adheres pretty much to the ten commandments ; but were my experiences, and those of untold millions of infants some kind of CBT ?

    • St.Joseph says:

      The love of Jesus was more important to my grandmother who I spent a lot of time with as a child.
      She never mentioned hell.
      I went to a funfair in Ireland with my mothert about 7 or 8 yrs old She gave me sixpence to buy a ticket on a hurdy girdy to pick a large statue of the Sacred Heart , I prayed my number would come up and it did. The man offered me a teddy or something,I ‘said no I wanted Jesus for my Nan’
      With the help of my mother I carried it home to see the delight on her face was the prize for me. The priest came next day and blessed it.
      It was beside her bed until she died and now stands in my lounge window sill Mother carried it back from Bray from Glendalough in Ireland where she died in a convent. I could not go as I was pregnant in 1962 and not too well.
      I have loved Him ever since 1948.

  13. Ignatius says:

    Milligan P,
    I’ve been down your path, albeit for different reasons and with different chronology. My experience of CBT was quite recent as a serious head injury from cycling and the subsequent post concussion syndrome stirred up the clinical depression that has dogged my steps for nearly 50 years now. Like you I found CBT a bit of a mixed bag but that’s partly because I’m pretty well versed in most self help modalities by now. The thing about CBT that struck me was that if one is in the habit of the examen or any such Christian reflective discipline then to a degree one already has an intuitive grasp of these processes and is probably operating them on a routine basis. There really isn’t much to recommend about the misery of anxiety and depressive illnesses except that they do make a person quite tough in many ways while at the same time being able to well empathise with the lives of others. Personal experience of profound unhappiness, personal failure and deep misery not to mention high levels of personal anguish are all very helpful when dealing with other people!!

  14. Ignatius says:

    Just to catch up with stuff..I’ve read a bit of Karl Rahner by now, he’s too complicated to be an author of heresy as no one understands him in the first place. I like him.

  15. Ignatius says:

    The other thing of course about high levels of anguish is that they tend to push a person towards reliance upon God. I find the incidence of depressive illness among Clergy to be quite high. I have also noticed that some of the men and women whose spirituality I have profoundly admired all turned out to have suffered the blackness of despair. There is a gift in all things, the gift however may be wrapped after a fashion so as to make it utterly unpalatable to the touch.

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