Behavioral/cognitive
perspective- Sp ’01 #1
Classical Conditioning is another important aspect of this case. Initially operating room and I.V. drips (UCS) would cause him have rapid heartbeat and feel tense(UCR). [He had pain in his throat.] However, now George associates going outside (CS) with rapid heartbeat and tension [in his face](CR). This goes back to when he was 7years old and had a routine tonsillectomy. After the operation, his mom commented that she hoped he would live to be 21 years old. That made an impression on George. Coincidently, at age 21, he started to complain of physical ailments.
It appears that operant conditioning plays
a role in this case. His mother
becoming antagonistic to the therapy when George went alone has decreased the
probability that he would continue to go.
In addition, her complaints of the therapist “corrupting his morals”
when George dated has decreased the probability that he would date again. Both of these instances represent
punishment because the possibility that his behavior will continue has
decreased.
George’s behavior was also negatively reinforced. His anxiety was removed (or no longer present) when he stayed in the house, so he became agoraphobic. By not leaving his house (at least alone), he didn’t suffer from the “panic attacks”.
It seems to be that George is modeling
his mother’s behavior. She was
described (by her sister) as being both “overprotective and nervous”. George has imitated her over-protective behavior by spending all his time with his
mom and even turning down opportunities (college) because he didn’t want
“abandon” her. He soon became “the man
of the house” and took care of his mom.
He has also displayed nervousness, too, similar to his mother. Another key to this case is stimulus
control. George’s “panic attacks”
happen specifically when he attempts to leave the house without his mother.
Lastly, George exhibits cognitive distortions as well. His mother said that his nerves make him “too sick to leave home.” Therefore, when George goes outside alone and begins to feel anxious, he immediately thinks that she must be right. He concludes that he must be ill and that something is really wrong with him. This provides a confirmatory bias because George is only paying attention to the things that confirm what has already been thought of him.
Behavioral/cognitive perspective--#2
George is diagnosed with an anxiety disorder. According to the Behavior/Cognitive perspective, this abnormal behavior has been learned from somewhere other than himself.
There are signs of classical conditioning with the anxiety George experiences. The unconditioned stimulus of not feeling well and being ill (dating primarily back to his tonsillectomy) is paired with the neutral stimulus of his hospitalization and hearing his mother say he was frail and sickly, and “I hope he lives to see 21.” The unconditioned response is the feeling of anxiety. The UCS becomes the CS, in this case the feeling of illness. The UCR then becomes the CR of anxiety.
Operant conditioning is also apparent in George’s case. George’s behavior of staying home and never leaving home without his mother is positively reinforced by more attention and babying from his mother. The cognitive distortion perpetuated by his mother that George was “too sick to leave home” for college positively reinforced the self-image of his “delicacy”. The positive reinforcement of his need to stay home also increased after his father’s death as he was given the role of “man of the house” who looked after his mother and her sister. This put more pressure on his need to stay home and not venture out on his own.
When George, on rare occasions, would go out on infrequent dates or even attend a therapy session without his mother, his mother would withdraw her special attention from him or even become antagonistic to this therapy, and he would stop going. She even complained that the therapist was “corrupting his morals” when he would date a girl. The events acted as negative reinforcement of his abnormal behavior of staying home to keep receiving this attention from his mother and reinforced his anxiety about leaving home and doing things without his mother. The act of staying home to relieve the anxiety is a negative reinforcer in itself.
The schedules of reinforcement seem to be continuous; as long as George stays home, or does not venture out on his own without his mother, she continually babies him as delicate and nervous. Yet the minute he explores the slightest bit of independence, she withdraws this attention.
There does seem to be stimulus control present. The unwanted behavior occurs when in a setting where his mother is present, and in his home environment. His mother has promoted this behavior since he was young, and actually helped accelerate it when, upon his completion of high school, she convinced him he could not leave for college because of his “nerves” and that he was “too sick to leave home.” This worsened after his father’s death, when he was promoted to “man of the house.”
George may be modeling his behavior from his mother, who was described by her sister as “overprotective and nervous.” George has also been treated as very “delicate” by his mother since he was a baby. There are cognitive components to be taken into consideration also. George experiences thoughts such as, “What if I am really ill?” and “something must be dreadfully wrong with me”[catastrophizing] when he tries to leave the house.
To the biomedical/mental
illness example
To the social
deviance/psychosocial example