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When Fears Frustrate Contentment
Activate the Brain's Ability to Overcome Useless Fears
A Professionally Established Method
Trevor N. Iskander, M.D, M.Sc.
Published by Gegensatz Press at Smashwords
ISBN
978-1-933237-52-7
Copyright © 2012 by Trevor N. Iskander
Smashwords Edition, License Notes
This e-book is licensed for your personal enjoyment only. This e-book may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each recipient. If you are reading this book and did not purchase it, or if it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy. Thank you for respecting the hard work of this author.
2012
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"This is an understandable, carefully structured instruction book that provides a road map for mental health clinicians and patients to find a safe way back from fear and panic to emotional health. Dr. Trevor Iskander's depth of knowledge and experience is reflected in every page and step along the path."
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Macaran A. Baird, M.D., M.S.
Department of Family Medicine and
Community Health
University of Minnesota Medical School
"Dr. Trevor Iskander has had decades of experience, first as a family doctor, and later as a psychiatrist. He has written this book in simple, jargon-free language for those suffering from emotional problems. The book is easy to understand and offers valuable insights. It is also a useful read for mental health practitioners."
-
Chaitanya V. Haldipur, M.D.
Department of Psychiatry
Upstate
Medical University
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I dedicate this book to my wife Margaret for her love, understanding, and generous support.
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Contents
Chapter 1: What Is This Book About?
Chapter 2: A Few Simple Basics About How Our Brains Work
Chapter 3: Nature's Rules: How We All Learn, Change, Forget
Chapter 4: Why Doesn't Everyone Else Have Problems Like I Do? How Our Brains Mix, Match, and Mismatch Us With Our Experiences
Chapter 5: A First Look at How to Do the Hierarchy Method
Chapter 6: A Detailed Illustration of the Hierarchy Method in Action: The Pet Mouse Problem
Chapter 7: A Lifelike Illustration of Using the Hierarchy Method: Sue Learns to Assert Herself
Chapter 8: Do You Recognize Yourself? Quotes, With Commentary Added, from People Using the Hierarchy Method
Chapter 9: A Last Look Before You Leave
About the Author
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Chapter 1
What Is This Book About?
"I don't feel content with my life."
"I don't understand why I'm like this."
"I know I want to change, but don't know how."
The aim of this book, just like that of other self-help books, is to help you become more satisfied, happy, and content with yourself and who you are. So, is this book really any different from all the others? Yes, in a special and very practical way. You will read about many apparently quite different complaints and how they are caused by the same thing.
I am talking about the magnified way in which people who are especially sensitive to what is happening react to unpleasant experiences, especially new or unexpected ones. The result is that they experience more anxiety and fear than most people would with the same experience. Their reaction, in turn, causes a variety of different problems, but which all have one thing in common, namely avoiding something unnecessarily that wouldn't bother most people. What shape this avoidance takes depends on the circumstances, your background, and the type of experience that upsets you. The types of complaint that stem from avoidance include:
"Feel at everybody's beck and call."
"Always putting things off."
"Can't share feelings of closeness."
"Don't know how to say 'No,' never could."
Or, it may result in the persistent avoidance of a particular object or situation that becomes a phobia. Not infrequently we are so used to having problems such as these that we do not complain about the problems themselves, but do complain of the physical or emotional effects that come from the stress of dealing with these problems.
Fortunately there is a well-established professional psychotherapy method for getting beyond avoidance problems like these, that many can learn to use for helping themselves.
What this method does is make it possible to cut down to manageable size the job of overcoming the discomfort and fear that block you from doing what you really want; rather like tackling a big meal one mouthful at a time. The method is basically no different from what we all do automatically; so we don't think of it as a method, when we just need time to get used to something.
At first sight, the idea of quite different problems responding to a "one size fits all" treatment may sound too simplistic. After all, aren't we all individuals with our own styles and personalities? You will read how the method is a "tool" for working on a particular "substance," namely, avoiding something that causes discomfort or fear, whatever the shape of the substance. The Desensitization Hierarchy Method, described in this book, is based on the systematic desensitization research of Joseph Wolpe. It is a tool for managing change, but its users will always be in charge of deciding both what changes they want to make and how much they want to do at any one time. In fact, it is a bit like an automobile, a means of travel, with the driver deciding where to go, and at what speed. This method will be described in detail in Chapters 5 through 7.
This book is not sufficient for those with serious psychiatric problems, which require professional help; but it is for people whose lives are limited and frustrated by problems, because their anxieties and fears have on occasions been too much to deal with. It is as if people in this group have never lost their natural "startle response," which we normally all have, but lose halfway to our first birthday. People like this have been called hypersensitive, supersensitive, or simply twitchy, and, if unlucky enough with the bad experiences that come their way, end up wanting help. This supersensitive personality trait, for this is what it amounts to, can make life more colorful and enjoyable for some, but for others the opposite is true. Some unpleasant experiences "hurt" too much to be dealt with adequately, and it is the resulting "unfinished business" that causes many of the different problems that people complain of. These are basically about either a normal behavior that is being avoided, the frustration and tension that this causes, or some combination of the two.
The cause for this supersensitive trait appears to be genetic, though it may also follow serious physical or psychological trauma, especially in childhood. Many things can interfere with being content, but this trait in particular is a major contributor. Over ten but nearer twenty percent of the population appear to have it. On the other hand, many people find contentment in spite of burdensome compromises forced upon them by inherited diseases, birth defects, or bad accidents. Those with the supersensitive trait, who have had upsetting childhood experiences which most children would cope with, are much less able to deal satisfactorily with such events. They are more easily frightened than average people and less likely to be able to forget bad experiences, because they have felt them more intensely than most people would. This is not unlike how some people show strong physical reactions to bee stings, because of their increased physical sensitivity to bees.
Supersensitive people can be quite normal apart from their supersensitivity. However, their heightened experience of events, good or bad, produces a greater pressure than most people, in similar circumstances, would experience to settle things down again. The result is that the supersensitive person tends to settle for the quick result, even though it's "second best." For more significant situations, this type of response can end up with real difficulties. Because the "second best" response provides immediate relief, it is likely to be relied upon in the future, resulting in an avoidance habit developing for that particular type of event. As one lady said of her overreaction to unpleasant things:
"Feel I'll never be the person I hope to be. My emotions are always going to control me."
Throughout this book are brief quotes from people who, like this lady, used the treatment method while in psychotherapy with me. Care has been taken to protect all identities.
Here are some brief quotes giving basic illustrations of what people who came for help have said:
"Don't feel confident with myself, never have."
"Can't say 'No' to people."
"Too trusting, naive in a way."
"I magnify the negative, and refuse to give myself credit for the positive."
"Feel like in a room with the door locked ... [and] ... haven't had fun for years."
"The only one who was coming out on the short side was me."
"I always need to know what's going on, if not get panicky."
"I would like to feel at ease sometimes, that's all."
What are the types of things they would avoid? For example, would the one who had problems with "No" avoid resisting another person's demands?
The bottom line is that bad experiences make bigger impacts on supersensitive people and this causes problems. Unfortunately these impacts often persist, because this same trait makes these sufferers wary of tackling their problems. They're "gun shy" of trying to change. They prefer a cautious "the devil I know is better than the one I don't" approach.
In effect, this book is a guide to self-coaching in using a method to deal with problems stemming from anxieties and fears that are really superfluous or "surplus to requirements."
Discussions of mental health problems and complaints often use many confusing ideas. But in fact, much of the information about how we function can be discussed using everyday language. People indeed know a lot about this from their own common sense, even if they cannot put it into words. This does not apply, though, to the understanding of more severe psychiatric diseases and disorders, which are not dealt with in this book.
Information in the early chapters provides the opportunity for you to understand the background information that will help you to use the method effectively. These chapters discuss the basics of "what makes us tick" and why difficulty in managing our emotions can sometimes become a major cause of discontent.
It is not necessary to know what specific past events triggered current difficulties. Present problems resulting from past events are what we need to focus on. Concerns and feelings about the original issues usually subside after successfully working on current problems and, if they do not, can be thought about less emotionally at that point.
Much of what we do occurs without our consciously thinking about it at the time. Walking and eating are two obvious examples. Other activities that we are not aware of include not only those that are useful to us, but also ones that give us problems. The object of this book is to show you how it is possible to manage the often difficult changes that are needed to rid yourself of a common group of problems. How? By learning how to harness your own brain's normal healing capabilities. You will then be able to work on ridding yourself of those unhelpful attitudes and activities that came from past difficulty with anxiety and fears.
The next three chapters outline how our brains function as we learn, forget, and change while becoming who we are today. They will also look at some of the reasons that lie behind how we all become different persons, individuals.
Chapter 8 contains many brief, anonymous quotes from people who worked with the method under my guidance. These quotes, together with comments about them, help in using the method, as well as in recognizing more clearly which issues you may want to work on.
The ideas shared in this book come partly from my own "book learning" as a physician specializing in psychiatry. However, a major contribution has come also from the invaluable practical knowledge that I learned by discussing their experiences with the many people who used outpatient psychotherapy with me.
The people I saw came with many varied complaints, but almost all had one feature in common. This was an underlying awareness of a lack of self-confidence, of not feeling reasonably in charge of their own lives in the way that most people are. Often they could not remember how long, if at all, it had been since they had last felt really content, even though they could recall some really happy occasions. Typically, this problem, lack of confidence, is not mentioned as such during initial discussions, but comes out in one way or another later.
How people see themselves is a reflection of how they habitually think and behave as they go about their daily lives. Sometimes, though, I found that people's actual descriptions of their typical days showed that they were coping better than their complaints had suggested. Many of our habits became established during our pre-adult years, from how we dealt then with our experiences, whether chance ones or while pursuing our wishes and dreams. While there will always be disappointments, we don't win all the battles. Our sense of how we do overall is what determines the level of our self-confidence, or lack of it. We assess ourselves in this respect, based on what we see as reasonable; nobody feels bad at not trying the impossible. Our sense of reasonableness derives from comparing ourselves with how we believe the majority of other people manage. We are likely to lack confidence in our own ability if we feel we are not, at least, coping in a similar way. Supersensitive people, who fail to deal successfully with the uncomfortable situations that most people take in their stride, are less likely to find contentment, more likely to find frustration.
The Desensitization Hierarchy Method, described in detail in later chapters, makes such discomforts manageable as you work to overcome the undesirable habits that, in effect, have trapped you. It calls for identifying and listing in a hierarchy, from slightest to worst, a series of up to fifteen less difficult versions of the problem that you're going to work on. Each of the fifteen is called a hierarchy item. A most important fact is that each time an item is successfully completed, the difficulty or discomfort level of each of the higher items on the hierarchy list is gradually reduced. In fact, the way hierarchies are constructed means that the next item, by the time you are ready to do it, will be of similar difficulty to the one just completed. Our bodies normally adapt automatically to changes around us, unless they are too vulnerable or the changes are too large for them to cope. We sweat when it's hot, shiver when it's cold, in order to keep our core temperatures normal. In a similar way, our brains work to help us maintain an inner sense of balance and contentment as we deal with ever-changing events around us.
A picture of how physicians use our bodies' ability to adapt is seen, for example, when a series of weekly injections is given to treat an allergy and are made increasingly stronger, but do not produce worsening reactions. Note the importance of allowing the body enough time between injections to "get used to" each dose. This is, in effect, what happens with the Desensitization Hierarchy Method when, after each item is successfully dealt with, all the harder ones, higher up on the hierarchy list, automatically become progressively easier. Why this is so will be covered later, but for now let's just say that it has to do with microscopic changes in the brain's structure. The order in which you place the items on your hierarchy list is determined by your own judgment as to how much difficulty you feel you want to take on at that time.
For a problem with speaking to groups, for example, the first item on the list could simply involve being at the edge of a group but not saying anything. The next, nodding agreement with a speaker's remark. Higher, more difficult items could include saying "Yes" when you agree, then saying "Yes" after moving to the front of the group. The items successively involve becoming increasingly more exposed to speaking to an audience. The top, most difficult item of a hierarchy would be something that you would like to be able to do, but couldn't possibly imagine being able to do when starting to overcome the problem. The hardest item might be standing before the group and speaking for twenty minutes. "If I can make twenty minutes I don't think longer would make much difference," would be a typical comment confirming that an item really was the top one for that particular person's hierarchy.
This brief description to introduce you to the Desensitization Hierarchy Method is skimpy and probably raises many questions. The answers should gradually become clearer as you read the chapters describing the method in detail.
I used the same method described in this book to help a middle-aged married mother of five, a successful schoolteacher, with a strong, phobic dread of cats. She would become extremely anxious even at the idea of one getting near her. For instance, friends had to put their cats in their basements when she visited them. She was a sensitive and somewhat worrying type of person. Her story showed that her problem had started from an incident when she was six years old, when her family had warned her to avoid all cats, because there was one suspected of rabies in the neighborhood. This idea of avoiding cats then became "locked" into her thinking as a phobic fear that persisted into middle age, even though she had long realized that avoiding cats no longer made sense. She was otherwise functioning well and emotionally mature. She was able, using the Desensitization Hierarchy Method, to free herself of the phobia in less than four months. An opportunity to inquire how she was doing thirty-five years later confirmed that she had remained free of her phobia. Though she could recall the instructions that she had been given at the age of six, such recall is not necessary for successful use of the method. Neither is an understanding necessary of why an idea can persist when it is no longer relevant. This lady's cat phobia is a particularly simple and clear-cut illustration of how an experience can, in a vulnerable individual, produce an illogical behavior.
Exactly the same basic mechanisms involved in the formation of phobias like that one often lie behind the more complicated attitudes and behaviors of avoidance that develop and prevent many from finding contentment.
During psychotherapy, information offered by the therapist is tailored to suit the particular needs of the person involved. For that reason, this book presents its information in a way that will be useful to as wide a range of people as possible. Some may find it too simple, others too complex; some may find too much detail, while others may, regrettably, not find enough.
Apart from differences in ability, a major difficulty that can affect our understanding of what we read occurs at the purely psychological level. We all have a tendency to see what we want to see, and ignore whatever we want to avoid. To reduce misunderstanding, I have liberally repeated throughout the book several of the main points.
A word of caution: The severity of problems varies. For instance, are they due to mild timidity or a serious psychiatric disease or disorder?
You may well be able to use the Hierarchy Method successfully on your own, but others should do so under the guidance of a professional, while for still others it may not be sufficient. The best way for you to decide what is best for you is, first, to consult a professional for an evaluation.
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Chapter 2
A Few Simple Basics About How Our Brains Work
The next three chapters look at how our brains work to help us deal with our lives, satisfactorily for most people, yet not so successfully for some, who then find themselves burdened with real difficulties. The well-known desensitization treatment method that I describe in detail in later chapters is especially useful for people who are able to work on their own problems, but just need the right tool. What follows now is to help you understand why things have gone wrong for you, and in what ways you can do something about becoming a more contented person. You cannot, of course, fundamentally change the body or nervous system you were born with. On the other hand, you can almost certainly do something about present-day effects left over from bad past experiences, whether you remember those events or not.
The first thing to emphasize about the brain is how its many parts all influence each other. It uses two way "conversations," just as the telephone allows us to talk back and forth with each other. Also special is the order in which the parts are connected: Messages from "higher" parts can control those lower down. The highest parts allow us to be mature adults by taking charge of parts lower in the "chain of command," yet a part that is the "boss" one moment can become the "servant" the next. The flexibility of this type of organization allows either self-control or "letting go." When we get this balance wrong in any one situation, we risk problems. The brain is only too human; it can get things wrong!
The lowest part of the chain, the "primitive" brain, is the first to form in the developing embryo. It is deep inside the head, just above where the highest spinal bone is attached to the skull. This the part that contains the automatic control centers for the heart, breathing, and other survival functions. One of these, of particular interest to us here, is the first responder to any change in what is going on around us or inside us; it stands by on alert, as it were. Any change, however small, sets off an automatic alarm signal that is very closely followed by the rest of the brain checking out what is going on and what to do about it. Normally, only larger significant events get our conscious attention, but the system is always on duty. This reaction to a "something's happening" has been called the "startle response," and the ensuing assessment process, the "orienting response." If there is time, the grown-up, mature brain elaborates this orienting response into a more thoughtful assessment and, if called for, a more elaborate response. However, we can always fall back on and use our primitive and more urgent "fight or flight" response. This happens when we have no time first to think about and properly assess a threatening situation, but need immediate action. This urgent response is when we get panic. When the situation is less urgent, the "fight or flight" can be much less dramatic. "Fight" might become simply a polite objection, or "flight" might be as simple as no longer paying attention. The most mature influences over the rest of our brains lie in the prominent parts just behind the forehead, the frontal lobes.
When facing change, our brains, that is you and I, adapt. Balance and harmony are thus restored among all of each brain's separate parts, so that we "settle down again." For instance, an increase in the primitive brain's emotional sections pressures the restraining, mature influence from the higher part of the brain. Which will win? The primitive brain says, "I must run, the fire's taking hold so quickly," but the mature part of the brain says, "I must struggle to control myself and find my way out by crawling along the floor." The job of each brain's "chief" is to retain our self-control, to decide whether or not to let our emotions have free rein. Mature people's brains, ideally, need to win the "tug o' war" by remaining in charge of the struggle between our emotions and whatever we believe is right for each situation. The question is: Should I "let myself go" or not?
Messages travel between brain parts by passing as minute electrical currents along nerves, just like wires. It is this electricity that provides the brain waves seen in the daignostic brain test called an EEG (electroencephalogram). When a message reaches the end of a nerve, its arrival at the connection to the next nerve or other body part causes the release of minute amounts of chemicals. These then travel or "jump" across the minute separation gap to trigger ongoing electrical messages, and so on. Knowledge about this chemical aspect of the process is what has allowed medications, such as antidepressants, to be developed. In a similar way, understanding the electrical aspect has led to the use of pacemaker-like devices for the brain, such as those used to control certain types of epilepsy.
To summarize, this is how our brains allow us to react and adapt to changes that come both from within ourselves and from our surroundings. The many parts of our brains interact with each other in a two-way, ladder-like system. The "chief," in control at the top normally - and ideally - has the last say. The mature brain has a lifetime of experience available in deciding how to deal with most situations. On the other hand, the primitive brain, with its reaction time quickest among all the parts, is very limited in the type of response it can produce; it is much more "set in its ways." The balance of the influences between these major parts of our brains is, at any given time, reflected in how primitive or civilized our actions are at that time. As one person said about handling anger maturely:
"I saw it was silly to be angry and got over it."
This normal pattern of brain functioning can be disrupted by even one small physical defect, whether inherited or due to injury or illness. However, our brains, given time, show a quite marked ability to compensate, even for quite large defects. At the present state of our knowledge (2012), these physical problems in the brain are best considered as mostly permanent. Dealing with problems caused by such defects then becomes a question of how best to diminish their effects, adapt, and move forward. Often specialist professional help can be really valuable in accomplishing this. Difficulty with reading and writing (dyslexia) and difficulty with math calculations (dyscalculia) are examples of results of defects in small parts of the brain. Some people have shorter than average attention or concentration abilities; others are troubled by being supersensitive or overreactive to events. Other examples of physical brain dysfunction include psychiatric diseases such as manic depression (bipolar disorder) and those causing schizophrenic-like psychotic behavior. Often the effects of any particular brain disorder vary in severity, not only from one person to another, but at different times in the same person. Important factors affecting this severity include whether or not we have the time and the understanding to work around problems and whether or not we can effectively deal with the amount of stress that we are under at any one time, especially if that stress is ongoing.
People with debilitating symptoms realize, or if not, then others do, their need for professional help. Among those who may not seek help, though they realize they're in trouble, are people with certain types of depression. Because such people should not rely on this book, initially anyhow, but seek professional help, depression needs to be looked at in more detail.
There are basically two types of depression problems that need to be considered. The distinguishing and most important feature is that one is associated with a physical disorder of the brain, but the other, not. The physical type causes deterioration in key areas of brain function, not only affecting thought and judgment, producing, for example, suicidal or psychotic ideas, but also attacking other parts of the body. The other type of depression lacks this physical disorder, but is associated with an attitude, an overly and persistently pessimistic way of seeing things.
The physical type of depression is variably named "medical," "clinical," "physical," or "major" depression. Successful psychotherapy can be useful in mild cases, especially toward reducing the chances of relapse, but the severe forms need medical attention and antidepressant treatment. A major feature of this physical type of depression is a loss of drive and energy. Debilitating diseases, such as anemia and low blood levels of thyroid or cortisone hormone, are among other medical disorders that can produce apathy. A seventy-year-old lady's physical depression was characterized by her remarks:
"My daughter says I get this way every fall [autumn]. I'd rather stay in bed all day."
And later, as she started to improve:
"Almost nothing I can think of doing that will make me happy. I don't recognize my [normal] self in this state. I feel overwhelmed."
The following list is provided to help physically depressed people get appropriate help. These listed features of depression can be present without there being any reason that seems significant enough to cause them; they just simply appear. Alternatively, they may be more severe than would be expected from what may seem a mild cause.
Be aware too that it is very possible for people not to complain of feeling depressed, or to deny it, even though their complaints are due to the physical type of depression.
Normal sadness, we must emphasize, is a quite different situation from the physical depression being discussed here.
The list, while certainly not comprehensive, contains many of the features associated with the physical type of depression. People depressed in this way, though, do not necessarily have all of these features:
These are not in any particular order:
1. Day-to-day activities become a real effort.
2. You become unusually irritable.
3. Your normal sleep pattern has changed.
4. You feel persistently unhappy, sad, and/or emotionally miserable. You may be excessively preoccupied with physical symptoms or life situations. Some people, in fact, do not complain of feeling depression as such.
5. You feel slowed down in your thinking, so that even small decisions are difficult to sort out. One person described it as "like walking through molasses."
6. Your appetite has changed.
7. You may be losing or gaining weight
8. You have ideas of hurting or killing yourself.
9. Meeting and dealing with people has become an effort.
10. You have bad thoughts about yourself, such as blaming yourself without good cause, or feeling guilty or worthless.
11. Your normal interest in sex has diminished, or gone.
12. You have difficulty with concentrating, or even paying attention.
13. You often feel worse during the same part of each day.
14. You may cry a lot for no reason.
Because physical depression can affect normal, sensible thinking, self-diagnosis can't always be relied upon. A relative or friend may see what is going on more clearly than you do. Readers who are in doubt about their own situations should get the opinion and advice of a professional in the medical or mental health field.
With the above exception of untreated, serious medical depression, the Hierarchy Method described in this book can be helpful in many cases for people with mild depression. Improved self-confidence and contentment almost certainly have some degree of positive antidepressant effect.
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Chapter 3
Nature's Rules: How We All Learn, Change, Forget
Most people are reasonably content and feel pretty good about "what makes me tick." Are you someone who is not content and looking for a way to change? If your answer is "Yes," then this and the next chapter, which discuss how we "tick," will help you to understand better your own situation and what you can do about it. Maybe having either too little or too much knowledge is a dangerous thing, but having sufficient knowledge makes all the difference. Later chapters describe in detail how to use the Desensitization Hierarchy Method for managing difficult changes.
When something affects you, however slightly, it sets off in your brain a chain of events including those that follow the "rules" by which we learn. By the end of this chapter, you will have started on the road to understanding these events and yourself better, but this is not my first goal. What really matters is that you become able to see how it is possible to do something about your problems. Your tool for doing this, the Desensitization Hierarchy Method, has been used over many years for managing or implementing difficult changes, ones you would normally try to avoid. Just think of how hard it is to kick a bad habit. The method takes you through a series of small, manageable changes that nibble away at the size of the big, difficult one that you need to deal with, until the whole change becomes manageable. Sounds too good to be true? Professionals, myself and those in many different countries, have seen it work often, not always easily, but it is most definitely doable.
From observing life and from your own common sense, you have learned a lot about yourself, but probably in a mostly intuitive way. Now you have the opportunity to be able to spell this out, for your own use, more clearly.
Much of what we learn day-to-day is stored automatically in our memories, usually without our ever being aware of its presence. These stored experiences can sometimes be recalled and thought about consciously, even though we didn't notice them consciously at the time our brains were doing so. For example, hearing that a friend is looking for a particular novel may prompt you to say "Oh, I remember now, I saw a copy in the bookstore window only last week," something you hadn't even thought about until your friend mentioned it. This type of learning, even when we aren't using it consciously, nevertheless can influence our thinking and behavior. It even does this when we are asleep. Have you ever woken up in the morning with the answer to something you had puzzled over the previous evening?
The modern understanding of how learning takes place was developed, in large part, by scientists exploring their observations of animals and birds. This foundation led to our current knowledge about how humans develop elaborate and complex behaviors, thoughts, and attitudes.
At the very beginning of any learning experience, quite simple nerve circuits, called reflexes, each of which produces a predictable event, are switched on. Examples of such built-in and automatic reflexes are the blinking of the eye when it is touched, gagging when the back of the throat is touched, the knee-jerk reflex when the doctor taps just below the kneecap, the attention we give to something new, and how a favorite food "makes your mouth water." While starting from simple, predictable reflexes like these, most of our learning results from the "piggybacking" attachment of further steps that include, for instance, our memories and ideas. A simple example of learning would be how we choose between types of food. If we are starving, it hardly matters what it tastes like, we "gobble it up." On the other hand, if we are fit and well-nourished, we choose the food we really like. Learning leads us, or past experience has taught us, to find our favorite.
We only learn if what is going to be learned becomes "attached" by happening at virtually the same time as whatever triggers one of our survival instinct reflexes, like a fright, food, or sexual opportunity. These instincts are built into all of us and help us to survive. They enable us to deal with danger and hunger, procuring safety and food for ourselves, as well as with sexual needs for producing our descendants. The reflex that looks out for danger is always "on duty," while others, such as appetite, are only switched on when needed, as with hunger.
The reflex of particular interest for the purposes of this book, the alerting reflex, is the one that detects any change in what we are experiencing. Its priority is to assume danger until the situation proves otherwise and allows it to rule danger out. It causes or leads us, consciously or not, to assess and deal with the changes it notices. This "monitor and assess" system is always on "lookout duty." Think of the sleeping mother hearing her baby.
The basic reaction to an event is our so-called "fight or flight" response; think "blind rage" or "blind panic." Usually there is not such urgency to respond, but enough time to assess the event more fully, possibly to find no danger at all, or maybe in fact a helpful, desirable event. Assessing with such questions as "What is it?", "What's going on?", "What's to be done about it?", or "What worked before?" guides us to the appropriate response. "Fight" could take the form of a leisurely debate; "flight" could become a polite "Not interested, thanks," or an "After I thought about it, I realized there was no danger after all."
The important thing to remember is that whatever is present, by chance or intention, at the moment an instinct is switched on, becomes connected and learned, either strongly or weakly, because of this connection. Whatever is connected and learned in this way, however, results in one of only two opposite actions, namely, either to approach it - "I like it" - or to avoid it - "I don't like it."
All our learning, then, starts because something becomes significant to us by arousing, directly or indirectly, one of our instincts, or, in other words, by being connected in time to whatever actually set off one of these instincts. This is so even though we may not have felt, or even been consciously aware of, this happening. What we learn from our experiences results, either strongly or minimally, in our either avoiding or being attracted to similar types of experiences in the future.
To sum up, our alerting or survival instinct, by being aware of changes that affect us, is our first-line security system; and assessing and responding to these changes is the foundation upon which our learning develops. It allows us to be kept informed of, and to assess, what is going on within our bodies as well as around us. Exactly the same learning connections also occur with any of our other built-in instincts. Some events are so tiny that the only signs of them are the small electrical brain signals that researchers can measure and assess.
Timing is critical for the learning process. It's no good if something happened a year ago, is it? Stated in its simplest form, for anything to become learnable, it must occur so close in time to the instinct's trigger event that the response appears to come from both, or feels as if it has. This is why a child's interest in a favorite chocolate is set off upon seeing the familiar wrapper; a plain brown one wouldn't quite do the same, unless, of course ... - but we'll get to that later.
The development of a learning connection also depends on the strength of the bond between the trigger and the aroused instinct. One big fright or beautiful experience is likely to be remembered for a lifetime. For example, "I got a second-degree burn on my hand; I'll never touch that pipe again!" Less dramatic events need several such separate connections before good bonds are established, and the learning remembered.
How about forgetting? A meaningless telephone number is soon and truly forgotten. On the whole, though, it has been shown that it is better to think of things we have learned as becoming merely "inactive" rather than truly forgotten. Something previously learned and apparently forgotten may very well still be influencing us from "behind the scenes," subconsciously.
A most important everyday aspect of learning might be referred to as "piggyback" learning. This is where something already learned becomes the trigger for a further learning experience. To illustrate this, think of a man who didn't enjoy walking. He gets a dog for a pet and starts regular walks for the dog. Eventually, when the dog dies, he finds that he not only misses his dog but really misses the walks themselves and takes them up again. His satisfaction from walking the dog became attached, "piggybacked," onto walking itself, as it were.
What happened with this man? You're not all that surprised at how things worked out, but can you detail what went on in his head? A typical scenario could be that he had learned at a young age that being considerate to others gave him a good feeling, though initially that good feeling actually came from pleasing his parents, obeying their instructions to behave in a polite manner. Considerate behavior, while initially meaningless to him, but done only to get acceptance from his parents, gradually led to his recognition that "I'm a considerate person." In a similar way, the dog walks gave him the satisfaction of being considerate to the dog. By chance, he discovered satisfaction in the walks themselves. Was his satisfaction from walking the dog "piggybacking" onto the walking itself where his satisfaction came from? Who knows? He probably didn't himself.
While looking at only one factor, satisfaction, is helpful in making the point, there could also, of course, have been several other factors at play. For instance, getting out of the house for a while could have been what motivated him to continue the walks. Or maybe it was simply enjoying the morning sunrise that really got him going. On the other hand, a painful arthritic hip could have led to a quite different outcome.
Another example of "piggyback" learning would be children who originally learn to be tidy because they enjoy being praised by their mothers for tidy behavior. As they grow up, they discover new reasons to enjoy tidiness that ultimately replace the original one of pleasing their mothers. For instance, the point comes when they recognize the satisfaction of being able to find their favorite toys readily. Older still, they find that being tidy makes it easier to find the piece of paper they wrote their friends' addresses on. The satisfaction of being tidy that originally came from seeking motherly praise has been replaced by previously unrecognized advantages of being able to find toys or addresses. Even later, simply the idea itself of keeping things tidy could produce satisfaction. At that point, "I'm a tidy person" becomes part of their self-images, how they see themselves. Some may continue to sense their mothers "looking over their shoulders" for decades, but for others, this part slips quietly into their unconscious.
Another outline illustration of "piggyback" learning can be seen by considering a student faced with really difficult questions on her math test. She is concerned, even startled, by their difficulty as she reads the test paper. We hope that she does not run out in panic, but instead, that the more mature part of her brain comes into play and settles her down enough so that she can thoughtfully assess the questions and how to do them. Her response to the threat signals has been broadened over the years from panicky "fight or flight" to one of finding "safety" in a more "grown-up" way. In effect, she holds off the immediate relief of fleeing from the room and does what she needs to do about the exam. At that point, she gets relief from the threat, and ends with "Thank goodness that's behind me."
This example of a student dealing with being faced with difficult math problems may not, in itself, be immediately recognized as based on our primitive, built-in reflex response, "fight or flight," for dealing with danger, but this really is so. In summary, whatever chance event occurs at the same time as some other event that would normally trigger a primitive reflex’s response, has from then on the ability to act like that trigger. Either the trigger or that chance event thereafter produces similar reactions, not necessarily equally strong, but always in the same direction, either to approach or to avoid something like them in the future. This is the foundation upon which more sophisticated responses, like the one to the math situation, are built up over the years from a string of "piggyback" learning experiences. It should be emphasized, however, that the usually "disguised" basic "fight or flight" reflexes remain very capable of showing themselves in their primitive form. We all tend to move toward the primitive end when we are tired, moody, or sick: "I didn't have the patience to think about it properly last night, I was too tired." We need the most mature, least primitive, parts of our brains to give us our patience.
New learning that has "piggybacked" onto previous learning may or may not overshadow that old learning or push it away. Either way, the total result is that we can become more choosy and careful about how we go about our lives; we develop varieties of options and choices. A baby's first cereal later becomes tasteless compared with all the different favorites we learn about as we get older.
As a practical matter, it is useful to look at learning activities from three different angles: (1) conditioned response, (2) trial-and-error, and (3) modeling. It is important to point out, though, that these three variations all follow the same basic features ("rules") of learning. Just to remind you, these rules show that we learn by attaching significance to otherwise meaningless events, because they occurred at just about the same time as whatever triggered our built-in survival reflexes. One such connection may be strong enough for solid learning to be well-established or the connection may be weak and need to be made on several different occasions.
The first variation was recognized by Ivan Pavlov when observing how a dog could be taught to drool just by hearing the sound of a bell or metronome. This was done by consistently making a specific noise just before showing meat to the dog. The meat triggered the dog's natural reflex mechanism for dealing with food. After repeating this noise-plus-meat combination several times, the meat was then omitted, yet the dog still drooled upon hearing the sound. The dog had learned to react to the particular noise, just as if it were meat. This learning occurred only if the dog was hungry; in other words, if its instinct for food was active at the time. What dog isn't ready for food?
Food relieves a puppy's hunger. Later, the sight of food in its bowl, or of the owner reaching for the sack of dog food, act as signs or symbols to the dog that its hunger is about to be satisfied. The sound of the bell acted in the same way, symbolizing food, triggering the flow of saliva. How long till the dog realizes that the noise really doesn't lead to food and it no longer drools when it hears it? Is the answer the same for all dogs? Does such conditioning work for people? Most people, and many dogs, would soon realize that food is no longer coming. Even with knowing that, though, for some dogs the learning connection to the underlying instinct is so strong that the sound causes them, instinctively, at that moment, to look for the food. In the human world, it is no wonder that some of us develop problems that make no sense to us, as we just can't shut out some of our learned reactions.
Past experiences leave packets of information, i.e., ideas or symbolic signals, that trigger thinking about, or anticipating, something about to happen. Thinking in terms of symbols (sometimes referred to as "concepts" or "notions") as triggers helps to understand how past experiences affect what we do, even influencing us without our being aware of that happening.
Are some events experienced or felt by a few people in unusual ways, as if the volume had been turned up? The answer is a definite "Yes." I think of such people as having a "supersensitive trait," others call them "highly sensitive people," and yet others refer to them as having a variation of "sensory-processing sensitivity," but all mean much the same thing. Perhaps not surprisingly, "loud" events lead to "louder," less easily forgotten, experiences. Problems easily take root when such loud experiences are also frightening.
Both pet owners and research scientists know that a few dogs seem unable to get over frights as most dogs normally would. This is true of humans too. Between ten and twenty percent of the general population seem to have varying degrees of difficulty in getting over distressing events. Why is this? In clinical work we see that, for some people, the emotional component of an experience was felt so strongly that they do not get over it; even when the original cause is forgotten something that has "piggybacked" onto it "echoes" and acts like that original cause. When the "loud" emotion is fear or anxiety, it prevents people from behaving in normal sensible ways: "It's my nerves, Doctor." Make no mistake, these nerves are very real indeed.
For problems to develop, original feelings of fear or anxiety certainly were really troubling and genuine. Problems arise when a fear comes from either overreacting to something mild or continuing to anticipate a fear whose original cause no longer exists. Phobias and other problems result, but all have one thing in common: a fear of approaching something. This leads to problems stemming from avoidance of normal activity.
One of the major reasons that someone doesn't get over these avoidance-based problems is that the relief felt from not facing an unnecessarily feared idea or situation encourages continuing to avoid it. The only way, though, to deal with these avoidance problems is to face and overcome them. Unfortunately, simply trying, however hard, is not enough on its own. I make this statement fully aware of another major reason for not facing such problems, namely, that the amount of distress felt is more than most people can deal with at one time. This is the issue that the Desensitization Hierarchy Method is specifically designed to overcome, by breaking these problems down into manageably sized "mouthfuls."
Continuing to avoid dealing adequately with particular life situations, such as meeting new people, not being able to say "No," or being uncomfortable with success, is a common cause of complaints by those seeking help. These avoidance patterns, though not full-blown phobias, develop by exactly the same mechanisms.
The second way of looking at how we learn, described by B.F. Skinner, has been referred to as trial-and-error learning. It is basically the same as the first, with the same rules applying, namely, the conversion of a neutral, meaningless event into a meaningful one, because it occurs very closely in time to an event that directly activates one of our basic automatic instincts, such as fear or hunger. This connection, which often needs repeating before becoming strongly established, causes the neutral event to become meaningful.
The emphasis in trial-and-error learning is on how an initially irrelevant event, whether occurring by chance or planned, is drawn to the learner's attention. The learning occurs because the event is highlighted by the activation, at that same time, of one of the built-in survival systems. A parent's approval, contentment with successful moves in learning to ride a bicycle, or satisfaction from avoiding raising contentious issues with someone who's tired, all illustrate trial-and-error learning. The learned event might be replaced later, via "piggybacking," by something more sophisticated, such as respect for loyalty, respect for the law, or tendency toward altruism.
We all have a built-in instinct to explore, check out our environment, ask questions, solve problems. This is part of our basic survival behavior. Trial-and-error learning by toddlers illustrates this aspect of learning quite well. They soon learn what is of interest and what to ignore as they move around, seeing, touching, and mouthing just about anything they can get at. By trial-and-error, they find out what they like, or in other words, what rewards them: mother, food, drink, or toys, for instance. They also learn from the relief they feel from avoiding unpleasant things, such as avoiding touching something very prickly, because it hurt the first time they discovered it.
This trial-and-error aspect of learning provides opportunity for parents to influence how their children behave with reward consequences for behaviors that they wish to encourage. A hug, praise, the offer of doing an already preferred activity, are among ways of providing this encouragement. One rewarding experience could be enough, but more likely the chance of getting a solid result would call, for a time anyway, for repeating the encouragement whenever the parents see that behavior. Further occasional encouragement may be needed before the desired learning is fully established. Active encouragement is certainly a worthwhile use of parents' energy, but mind you, children discover soon enough how to turn the tables to their advantage. What becomes of the undesirable activities depends on whether they continue to provide children more satisfaction in and of themselves compared with, say, getting Mom's approval. The trick is for parents to stay on top of what children see as rewarding, which is not always the obvious thing, though acceptance and approval are right up there. In situations where children are deprived of loving attention, punishment in itself can be the only way for them to get the attention and any sense of being loved, which children yearn for. Punishment is then "worth the price" for them. The "getting attention" aspect of punishment can in fact promote the bad behavior that it was meant to suppress, however paradoxical this may seem at first glance.
Active punishment, which relies on unpleasant consequences to deter a person from doing the punished behavior, clearly works with some. The punished person tends to focus more on avoiding future punishment than on changing to a more acceptable behavior. The effectiveness of punishment is increased by providing, suggesting, and encouraging appropriate alternative activities. When these become emotionally more satisfying than the punishable behavior, then that bad behavior will normally be dropped.
Child rearing is, of course, nothing quite as simple as all this may sound, but the basics of how random behavior can be cultivated into patterns that parents wish for their children, or that we want for ourselves, holds true.
The third variation, learning by modeling, occurs when we learn from observing something that interests us and then working on how to do it, or to be like it. Again, as in any learning, the basis is the same, i.e., a neutral event is converted into a meaningful one, because it occurs very close in time to a trigger event, which activates one of our basic survival instincts. This connection is then maintained, if it retains its meaningfulness and remains productive. Albert Bandura was among the early thinkers about the modeling type of learning. It could apply equally well to children seeing others ride bicycles or to people acquiring the ethics and standards of someone whom they admire and wish to emulate. This is the type of learning that occurs in "teaching by example" and "learning by example." One person, who faced a particularly difficult time in therapy, put it well when commenting later:
"I decided if you could stick it, Doc, I could stick it."
And she did, eventually with a successful outcome.
The satisfaction that is felt from producing a successful copy encourages or rewards this copying activity, whereas actions that do not fit successfully are dropped. Modeling incorporates the trial-and-error aspect of learning as we acquire and refine our own copies of something that, after we have observed or heard about it, we set about to copy.
This is a good opportunity to illustrate just one of the possible factors in how someone might develop problems because of a depressed or pessimistic outlook on life. Take the situation of a mother who suffers from an ongoing mild medical depression and who, not surprisingly, talks to family and friends about how she feels with comments like "Everything's such trouble." Her young child could easily copy Mom's words and actions. This copying could then progress to the point where it would become part of the child's regular behavior, even though the child is not at all medically depressed. Others, commenting on the child's "depressive" behavior, either directly to the youngster or to others in front of the child could, because of their "paying attention," nurture that behavior. Insecure children, needy for attention, could prolong such "depressive" behavior for so long that they begin to "believe" in it for themselves. How strongly, if at all, the child seeks this attention depends in large part on how secure the child feels. Most children would soon grow out of the mimicry, but a small number would not.