Sunday, May 22, 2005
The author, George Hotelling, makes reference to another blog, Creating Passionate Users, authored by Kathy Sierra, who put up a picture of herself on a horse. She tells us that she learned a lot about human psychology from her horse. That probably is true, although I think baboons are much better teachers than horses.
She points out that "You can't be afraid and rational at the same time. Pick one." At first, it is not obvious how that applies to Mr. Hotelling's proposal, but it does. Either trust me on that, or go read his post to see how. There isn't any reason for me to explain it here because he explains it just fine himself, and it is not really the point I am trying to make.
Ms. Sierra has picked up an an old idea in psychotherapy, so my point is to outline the history of that idea, and explain why it is so profound. The idea was developed in the 1950's by a psychoanalyst turned behavioral psychiatrist, Joseph Wolpe. His ideas strongly influenced one of my old supervisors, George Curtis, who also had been an analyst but later became a cognitive-behavioral specialist, and who was the director of the Anxiety Disorders clinic at the University of Michigan.
The notion that you can't be afraid and rational at the same time is an example of reciprocal inhibition. This psychological principle was developed as an analogy to a similar principle in neuromuscular physiology.
Most muscles are arranged into opposing groups. In order to move a body part, it is necessary to tighten that group of muscles that perform the movement. At the same time, the opposing muscles must loosen. The brain is wired such that this happens more or less automatically. One does not consciously relax the triceps, so that the biceps can flex the arm at the elbow. Rather, one consciously contracts the biceps, and the triceps seem to relax on their own.
Similarly, in psychology, some emotions are mutually exclusive. If one focuses enough attention on relaxation, then fear is reduced. Also, if one becomes sufficiently bored, then anxiety does not occur. Intellectual curiosity can serve the same function. If one is sufficiently curious about what is going on, then fear does not occur.
The concept of reciprocal inhibition is central to the clinical treatment of anxiety disorders. The idea is simple. Everyone knows that if you have a fear of heights, the only way to get over it is to spend a lot of time in high places. If you go up high enough in a building to feel the fear, then wait for it to wane, and do this often enough, eventually the fear will not occur. In actual practice, it usually takes at least 45 minutes of exposure several times per week. Going to a top floor of a building for 45 minutes every day, and just sitting there, sooner or later you will start to get bored. The more bored you get, the less fear you experience. That is reciprocal inhibition in action.
Almost anyone can do this to overcome most simple phobias; it is extremely reliable. Not all fear stems from simple phobias, though, so sometimes the therapy gets to be more complicated. Sometimes the fear is triggered by situations that cannot be replicated at will.
Sometimes the fear is so great that it seems insurmountable. In such cases, patients feel guilty and inadequate, and often are stigmatized by others. Such judgments may be premature, however, because there may be situations in which conscious control is not possible.
To explain, it is helpful to return to the neuromuscular analogy. There are occasions when the muscles do not respond to conscious will. For example, if you touch a hot stove, your arm will pull back. If the heat is sufficiently great, no amount of willpower will enable you to overcome the reflex. It does not matter how many episodes of Kung Fu you watch, you simply cannot exert executive control over the withdrawal reflex. That is because the reflex occurs in the spinal cord. The pain is felt, reaches a certain threshold, and the appropriate muscle movements are initiated, all before any signal reaches the brain. It is impossible to exert conscious control, because your brain doesn't even know what is happening.
The circuits inside the brain are not understood as well as those in the spinal cord, but it is likely that there are situations in which the drive to avoid the anxiogenic (anxiety-provoking) stimulus is so great, that the avoidance behavior is initiated without the frontal lobes having a chance to intervene. Sometimes it is possible to learn to override this, but sometimes not. We do not know what makes the difference. It is likely that, in some cases, people can override the drive to avoid the situation by modifying their perception. After all, it is not the feared object itself that creates fear; rather, it is our perception of the object that provokes fear.
Some theoreticians and clinicians believe that reciprocal inhibition is the primary means by which psychotherapy is helpful. By helping he patient become curious about his or her own behavior, the fear associated with that behavior is diminished. Although many people think that it is insight that results in change, it may be more accurate to say that it is curiosity that does the job. Personally, I am highly skeptical of any simplistic model that is proposed as an all-encompassing explanation in any branch of psychology. The brain is too complex for that to be true. Even so, the concept of reciprocal inhibition stands as one of the cornerstones in our understanding of the human mind.
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