Where do phobias come from?: The behaviourist approach

One of the most popular explanations for where phobias come from (and why they're so hard to get rid of!) comes from the behaviourist discipline of psychology. It's my favourite explanation for phobias as it makes the most sense to me, so today I thought I'd write about it and share the knowledge! Please feel free to comment or DM me on instagram if you'd like to chat about the topic more, or if there's anything that's unclear.

First of all, what is the behaviourist approach? Psychology as a science can be divided into various disciplines, each with different beliefs and assumptions about how the brain works and how humans should be studied. Behaviourism was founded in the early 20th century by psychologists such as J. B. Watson, who proposed it as a more scientific way of studying human behaviour than other techniques. Previous to the creation of behaviourism, Freud's psychodynamic approach (which relied on unstable and highly biased techniques such as dream analysis and introspection) had been sweeping the world of psychology. (Of course, the entire psychodynamic discipline was also based on what Freud "decided" certain dreams meant rather than any kind of science, so make of that what you will..!) Behaviourists believed that as thoughts could not be physically seen or measured, studying the physical outcomes of these thoughts was the only way to study them scientifically - thus, they focused on behaviour.

One of the most famous concepts of behaviourism is the idea that all human behaviour is learned from past experience. Learning happens by conditioning, and there are two main types: classical conditioning, and operant conditioning. (Bear with me while I explain them - it's all relevant to phobias!)

Classical conditioning, made famous by Pavlov's study on dogs, is often referred to as learning by association. The rules of classical conditioning state that if a neutral stimulus is repeatedly paired with a stimulus that causes a particular response, in time the neutral stimulus will cause the response by itself. While that sounds confusing, it's actually a simple model that is most easily explained by way of example! Here's a graphic that I spent far too long making earlier (I know, my graphic design skills really are incredible..!):

(Of course, I had to use a picture of my own dog! :-) )

In the first line of the picture, you can see that the bowl of food (an unconditioned stimulus, or UCS) makes the dog salivate (an unconditioned response, or UCR). This is an unconditioned pair of stimuli because it is either an innate or preconditioned response of the dog to food, so in this scenario it doesn't have to be learned. Next, the sound of a bell being rung (a neutral stimulus, or NS, because it has no association yet) happens every time that the food (UCS) is presented. Over time, the dog begins to associate the sound of the bell with the food and therefore starts to salivate as soon as the bell is heard. This is the process of conditioning - the sound of the bell becomes a conditioned stimulus (CS) and triggers a conditioned response (CR) in the dog (salivation).

Classical conditioning is well supported by research and is an effect that we can observe in our everyday lives. For example, when I watch Escape to the Chateau with my parents on a Sunday night, I have a gin and tonic - now, whenever I hear the theme music I crave a G&T! Classical conditioning can be a positive thing (for example when forming new, beneficial habits), but negative associations can also be made - this will come into play later.

The second type of conditioning is operant conditioning. Operant conditioning is a different type of behavioural conditioning, often referred to as "learning by consequence". Instead of pairing stimuli together, behaviour is learned by either positive reinforcement, negative reinforcement, or punishment. Desirable behaviour is rewarded, and undesirable behaviour is punished - eventually, an association is made between good behaviour and reward, and bad behaviour and punishment. This motivates the individual to avoid undesirable behaviour, and repeat desirable behaviour. Once again, this is probably easier to explain with an example!

Imagine that you're a student with homework to do. The benefits of doing your homework might be rewards such as a merit point on your school system, praise from your teacher, or praise from your parents. These things are all positive reinforcement - when you do your homework, you receive a reward which makes you happy, so you're more likely to do your homework again. There are also consequences for not doing your homework - a negative point on the system, detention, or angry parents/teachers. All of these things are punishments - negative consequences of a particular behaviour (not doing your homework). Negative reinforcement is the avoidance of this punishment - you do your homework because you don't want to get a detention!

How does all of this relate to phobias? Well, behavioural psychologists would argue that the onset and maintenance of phobias are due to conditioning. (This dual-process idea of learning was first proposed by Mowrer, 1947 - I'll pop the reference to a summary of his theory at the end of this post. While this simple two-process theory is the topic of some debate now, it has been instrumental in our understanding of phobias and I believe that its main points still stand.)

When a phobia first appears, it is because we make an association between the phobic stimulus and negative outcomes (this is classical conditioning). In the case of emetophobia, this is usually an association between being s*ck and feelings such as pain, anxiety, and despair. The phobia is then maintained by operant conditioning, which reinforces this learned pairing - whenever we are confronted by a triggering stimulus, we fear feeling all of the negative emotions that we have learned to pair with being s*ck. As a result of this negative reinforcement, we often avoid the stimulus by escaping the situation or seeking reassurance. This in turn is positive reinforcement, as avoiding the stimulus reduces anxiety which is very desirable! This means that we are more likely to avoid the stimulus in future. The cycle of operant conditioning continues, and every time we're faced with our triggers the association becomes deeper.

This two-process model is what exposure therapy is based on. Being forced to face your triggers in small, manageable steps helps to decondition the learned association between s*ck and fear. I'll write another post on exposure therapy so I won't go into it in too much detail here, but it essentially helps you to relearn a link between your triggers and feeling calm (rather than anxious).

Personally, the behaviourist explanation of phobias makes the most sense to me. My own phobia was triggered by a traumatic event, and engaging in exposures has been at the heart of my recovery. Furthermore, the empirical approach of behaviourism appeals to the scientist inside me! However, in the world of psychology, nothing can be categorically proven... so I'm always open for the discussion of new angles or ideas about a topic!

What are your thoughts on the behaviourist approach? Feel free to leave a comment!

~ Alice

Some references/places to go for more information:

For Mowrer's summary of his two-factor theory: Mowrer, O. H. (1951). Two-factor learning theory: summary and comment. Psychol. Rev., 58(5), 350-354. doi: 10.1037/h0058956. PMID: 14883248.

A classic example of learned phobia acquisition (the case of Little Albert) - I highly recommend reading about this if you're interested!:

A summary article: https://www.simplypsychology.org/little-albert.html

The original study: Watson, J. B., & Rayner, R. (1920). Conditioned emotional reactions. Journal of experimental psychology, 3(1), 1.

A useful link for an explanation of phobias: https://psychologyhub.co.uk/the-behavioural-approach-to-explaining-and-treating-phobias-the-two-process-model-including-classical-and-operant-conditioning/