The Psychology Lounge ™ » Psychology

Radical Non-Defensiveness: The Most Important Communication Skill

Andrew Gottlieb, Ph.D. — Wed, 08 Dec 2010 21:04:38 +0000

“Jack and Jill went up the hill
To fetch a pail of water.
Jack fell down and broke his crown
And Jill came tumbling after.
Jack blamed Jill,
Jill blamed Jack,
And each vowed they would
Never come back.”

What is the secret of good couples communication? What one simple skill tremendously improves the ability of couples to discuss difficult subjects?

It is the skill of non-defensive responding. What do I mean by this?

Let me give you an example. Imagine a hypothetical couple Jack and Jill. Jack comes home from work and is tired and hungry. Jill got home from her job one hour before. She’s sitting on the couch reading the paper.

Jack says, “I can’t believe you haven’t started dinner. I’m really hungry! You’re just sitting there relaxing, while I’m starving!”

(If you were Jill, how would you react?)

A typical response that Jill might make would be something like, “You’ve got hands, why don’t you make dinner! Why do you expect me to be your slave!?”

At which point it is likely a good fight would ensue.

The non-defensive response would be something like, “It sounds like you’re really hungry and kind of annoyed that I haven’t started dinner yet. You’re absolutely right, I was really stressed out when I got home from work and I decided to relax for a while rather than start dinner. I can see how you would feel frustrated getting home from work tired and hungry and seeing me just sitting here. Why don’t you sit down and relax and I’ll get us some quick snacks, and then get dinner started.”

Notice the difference. In the first example Jill counterattacks. Jack will counterattack in return and quickly things will escalate into a full fight.

In the non-defensive example Jill acknowledges Jack’s feelings. Then she finds some truth in his statement. Next she validates his feelings. And finally, she proposes a solution.

This is an incredibly powerful skill for reducing conflict and improving communication between people. In this article I will give you some basic theoretical rationale for why non-defensive responding works so well, and then teach you — step-by-step — how respond non-defensively.

First the theory. Human ego is a delicate thing. We spend a lot of our energy defending our sense of self against attacks or criticisms. The problem with this model is that it’s impossible to defend completely against all attacks or criticisms. This is because most of us are very far from perfect — we are quite flawed — and we know it.

The problem is that we don’t accept it. We have this all or nothing model of ourselves which says either we are perfect or we are awful. So when any criticism comes along, it challenges our model of being perfect and we slip into the painful feelings of complete inadequacy.

We don’t like feeling inadequate, so we try to deny or counterattack any criticism. There are so many types of defensive responding that it’s difficult to catalog all of them. But some of the major types of defensive responding are described below. (These are based on John Gottman’s work on communication.)

Major Kinds of Defensiveness

1. Denying responsibility. This involves denying that you’re at fault no matter what your partner accuses you of. If your wife says you hurt her feelings by saying something insensitive, you reply that you didn’t do anything wrong.

2. Making excuses. This is when you acknowledge the mistake, but create a reason for why circumstances outside your control forced you to make the mistake. Classic examples of this are, “traffic made me late,” or “I just forgot to pick up the milk.”

3. Disagreeing with negative mind reading. This is when you disagree with your partner’s interpretation of your internal state or emotion.

Jack: You seemed very frustrated with me tonight.
Jill: That’s not true, I was just tense being at a work party.

4. Cross complaining. This defensive response involves meeting your partner’s complaint or criticism with an immediate complaint of your own. An example would be:

Jill: you never take me out anymore.
Jack: and you never cook me dinner anymore!

5. Rubber man/rubber woman. This is based on the old saying, “I’m rubber, you’re glue. Whatever you say bounces off me and sticks to you.” In this form of defensiveness, you immediately counterattack with a similar criticism.

Jack: You were very mean to me at the party tonight.
Jill: Well you were mean to me yesterday when we visited your mother’s house.

6. Yes-Butting. This is where you start off agreeing, but then end up negating the agreement.

Jack: You said you would put away your work papers off the dining room table.
Jill: Yes I did, but I was waiting for you to clear off your books first.

7. Repeating yourself. This involves repeating the criticism again and again without listening to your partner.

8. Whining. This involves the sound of your voice and the stressing of one syllable at the end of this sentence. For instance, “You always ignore me at parties.”

9. Body language. Typical body language signs of defensiveness are crossing your arms across her chest, shifting side to side, and a false smile.

Ultimately the goal of all defensiveness is to preserve the self. This is a commendable but hopeless goal, since defensiveness triggers elevated levels of criticism from the other person. As Gottman has so elegantly described, the more you defend yourself, the harsher the criticism you receive. That’s because when someone criticizes you they want you to knowledge the validity of their feelings and thoughts. When you respond defensively you are invalidating them, so they escalate the criticism. If you can’t hear them the first time, they say it louder.

This of course leads you to become even more defensive because the criticism is now much harsher. And the two of you are off to the races! The fight escalates, gets personal, and both of you end up feeling damaged.

So what is the solution? How do we get out of this vicious cycle of defensiveness and criticism?

The answer is a radical shift in the way we think about ourselves. Radical non-defensiveness is the answer.

What is radical non-defensiveness? First it requires a shift in our core beliefs about ourselves. Remember that most of us have an all-or-nothing model of our self. We believe, “I must be perfect otherwise I am crap. If anyone points out my imperfections, they are basically saying that I am crap, and I won’t listen and I will counterattack.”

Radical non-defensiveness means that we shift our core belief about ourself to, “I am a flawed human being. I make many mistakes. I can improve on almost anything I do. But even with my flaws I am a worthwhile and valuable person.”

With this radically changed belief about the self, criticism changes as well. Instead of criticism meaning that we are worthless human being, it simply acknowledges the reality of being flawed, and helps us to improve.

If you think about it for a moment, you might realize that radical non-defensiveness is the antidote to perfectionism. Perfectionism beliefs cause much human suffering. When we feel that we need to be perfect in order to be worthwhile we are living in a glass house. The smallest pebble can crack our armor. And that pebble can be any criticism.

The radical non-defensive model is completely the opposite of perfectionism. I don’t need to be perfect to be good and worthwhile. I can shoot for an 85 rather than 100. If I make a mistake, I can acknowledge it and realize that everybody makes mistakes.

Let’s go over — step-by-step — how to respond non-defensively. (Some of this is based on some of David Burns’s work on communication.)

First let’s create another example of criticism. Back to Jack and Jill. They have finished dinner, and Jack retires to his laptop computer, where he spends the next several hours deep in Internet surfing. Jill tries to talk to him about something that happened at work, but he ignores her. Finally, she explodes, “You never listen to me! You are always surfing on your stupid computer! You don’t care about me, and you’d rather watch YouTube videos than listen to my problems. You are an uncaring husband!”

Whew! That’s pretty intense criticism isn’t it? How can Jack respond non-defensively to this?

Let me take you through it step by step.

Step One: Paraphrase back to the person the thoughts and feelings they are expressing to you.

Jack says, “It sounds like you’re really frustrated and angry with me right now, because I was on the computer rather than focusing on you.”

Step Two: Find SOME truth in what they are saying. In this step what you try to do is select whatever reality-based truth there is, and ignore hostile names or labels. You focus on the behavior that you’ve committed rather than the nasty labels.

Jack says, “You are absolutely right. I have been spending way too much time on my computer and not enough time connecting with you.”

Step Three: Validate the emotion paraphrased in Step One, and connect it to the behavior in Step Two. This lets the person know that many people, including you, might feel the same emotion in the same situation.

Jack says, “I can see why you might feel frustrated. If I wanted to talk more with you and you were reading all the time I’d probably feel the same way. It makes perfect sense.”

Step Four: Offer possible solutions. Here there are several options. One option is a genuine apology. This is very powerful. Another option is to suggest discussing the problem in order to find solutions. This option is best when the criticism encompasses a complex problem that can’t easily be resolved. Another option is to simply fix the problem right then and there.

Jack closes his computer and says, “I’m really sorry. I do want to hear what happened at work, why don’t we sit together on the couch and talk about it.”

Step Five: Thank the other person for bringing the problem to your attention. This is probably the most alien step of all for most people. How can you thank someone for criticizing you? If you recall in the radical non-defensiveness model, you acknowledge that you can always improve, and that criticism is often what helps you to improve. So thanking the person for criticizing you is really saying thank you for caring enough about me to help me improve.

Jack says, “Thanks Jill for telling me how you feel. That allows me to be more conscious of being a better husband. Thanks again.”

One typical objection to non-defensive responding is “Won’t the the other person criticize me more if I don’t defend myself?” The truth is actually the opposite. The more you defend yourself the more criticism you receive, and the harsher the criticism becomes. Most criticism is designed to create change or to be listened to, and defensive responding achieves neither.

Another objection is, “What if the criticism is completely unfounded or unjust? How can I respond non-defensively in that case?”

Criticism is rarely completely unfounded. There is almost always SOME truth in most criticism. Even if it just factual truth, you can agree with it. Example:
Jill: You were flirting with that woman Nancy at the party. You’d like to sleep with her.
Jack: You are absolutely right, I was flirting a little. I can see how that would upset you. I don’t want to sleep with her though. What can we do at the next party so I don’t upset you?

Try using this skill at home, at work, with friends, and with family. You will be surprised at how effective it is. I’ve summarized the steps below.

Now I’ve got to go apologize to my sweetie for spending so much time writing this….

Non-Defensive Responding Step by Step
1. Empathy: respond with empathic reflection, “It sounds like you are feeling quite angry at me for forgetting your birthday.” (Use tone matching and empathic body language). Reflect both content and feeling.

2. Find some truth in the statement, and strongly agree. “You are absolutely right. I totally forgot your birthday! What a dope I am!”

3. Validate the emotions reflected in step 1. “I can see why you are angry. I’d be angry in your situation too!”

4. Offer possible solutions, compromise, problem solving, or an apology.
“I blew it, I’m very sorry, and I’d like to make it up to you by taking you away next weekend. How does that sound?”

5. Show appreciation for the person giving you the feedback. “Thanks for letting me know how you feel. Now I can make a point of not forgetting your birthday.”

Dr. Andrew Gottlieb is a clinical psychologist in Palo Alto, California. Dr. Gottlieb specializes in treating anxiety, depression, relationship problems, and other difficulties using evidence-based cognitive behavioral therapy (CBT). CBT is a modern no-drug therapy approach that is targeted, skill-based, and proven effective by many research studies. Visit his website at CambridgeTherapy.com or watch Dr. Gottlieb on YouTube. He can be reached by phone at (650) 324-2666 and email at: Dr. Gottlieb Email.

How Ivan Pavlov Handled a Piece of Steak

Andrew Gottlieb, Ph.D. — Sun, 19 Sep 2010 18:19:02 +0000

Most psychology students recognize the name of Ivan Pavlov, one of the great minds of psychology, who developed the theory of classical conditioning (dogs salivating when he rang a bell). From the Yale Alumni magazine comes this wonderful tidbit of a story:

“In mid-August 1929, the Harvard Medical School hosted the Thirteenth International Physiological Congress, one of the largest gatherings of scientists ever convened in the United States. Pavlov, the doyen of experimental physiology at almost 80 and honored by a Nobel Prize a quarter-century earlier, was the lion of the gathering. His pioneering work on conditioned reflexes had been crucial to understanding brain function, and he was keen to see the Harvard neurosurgeon Harvey Cushing ’91 operate. The preeminent brain surgeon and father of modern neurosurgery as a field, Cushing, two decades younger than Pavlov, was at the top of his game. Performing for Pavlov in a theater at the Peter Bent Brigham Hospital, Cushing removed a large tumor of the left hemisphere from a cancer patient’s brain. The patient later recalled that Cushing introduced him to Pavlov, saying, “You are now shaking hands with the world’s greatest living physiologist.”

Pavlov was captivated by the new electrosurgical knife Cushing used in the operation, and at the end of the procedure, Cushing got a piece of beef so that the elder scientist could try his hand. After making a few incisions, Pavlov inscribed his name into the meat. “I asked him whether he wanted me to eat the meat in the hope of improving my conditional reflexes,” Cushing wrote in his journal, “or whether we could keep it in the museum, the latter we will proceed to do—’Pavlov’s beef-steak.’” A collector of old medical books and of brain tumors, when he died in 1939 Cushing bequeathed both to Yale, where his rare books would become the cornerstone for creating the Medical Historical Library.”

Anyway, I love this story, especially the concept of him eating the steak, to “improve his conditional reflexes!”

Next time I throw a barbecue party I’ll serve the Pavlov-Steak sandwich…

New Study Suggests You Can Reprogram Your Brain in Less Than Five Days!

Andrew Gottlieb, Ph.D. — Sat, 24 Apr 2010 23:16:45 +0000

Many previous studies have shown through the use of neuroimaging that meditation can change the brain. But most of those studies have looked at medium to long-term meditators. Some looked at monks who had meditated for decades, and some looked at new meditators who had meditated daily for 6 to 8 weeks. At least this much meditation practice was thought to be necessary to create measurable changes in the brain.

But a new study at the University of North Carolina at Charlotte suggests that brain changes may happen much more quickly, in as few as four days!

Student volunteers were randomly assigned to either practice mindfulness meditation or listen to the reading of JRR Tolkien’s The Hobbit, for 20 minutes a day, for four days. The groups were tested using behavioral tests of mood, memory, visual attention, attention processing, and vigilance. The meditative practice was a simple mindfulness technique. Participants were told to focus on their breath, and that when thoughts distracted them to notice the thought, and then refocus on the breathing.

What were the results? Both groups improved in mood, but only the meditation group improved in cognitive measures. In one challenging mental task, the meditation group did 10 times better than the reading group. It appeared that meditation improved the ability to sustain attention and vigilance.

This is an exciting study which hopefully will be replicated and expanded with their neuroimaging to see if there are functional or structural brain changes after brief meditation practice.

To summarize, it appears that a brief four-day practice of mindfulness meditation can significantly improve cognitive functioning that is related to attention and vigilance.

How lasting is this effect? Does it wear off in hours, days, etc.? What is the dose response ratio of meditation to cognitive functioning improvement? For instance, would eight days of meditation practice create even more cognitive improvement?

In any case, it’s worth practicing meditation at least briefly to see its effects on your mind and your emotions. Commit to 20 minutes a day for one week, and see what happens for you.

Now I’m off to meditate…

Does Money Buy Happiness? No, And The Answer Of What Does Buy Happiness May Surprise You

Andrew Gottlieb, Ph.D. — Thu, 03 Dec 2009 03:03:12 +0000

It is often said that money can buy happiness, and as I’ve blogged in earlier articles, this is true, but only up to a basic middle class economic status. Above that, money doesn’t seem to add much happiness. (See my posts here and here.)

So what does buy happiness? We have a surprising answer from our friends across the pond, at the University of Warwick in England. A new study published online Nov. 18 in the journal Health Economics, Policy and Law surveyed thousands of people on their levels of happiness and correlated it with external factors such as a pay raise or winning a lottery prize, and compared this to receiving psychotherapy. Astonishingly, even to me, a psychologist, the increase in happiness from a $1329 course of therapy was so large that to equal it people had to get a pay raise of more than $41,542! That’s a ratio of 32 times! That means a dollar spent on therapy boosts happiness 32 times more than the same dollar received in a pay raise or lottery prize.

As the study author Chris Boyce, of the University of Warwick, summarized: “Often the importance of money for improving our well-being and bringing greater happiness is vastly over-valued in our societies. The benefits of having good mental health, on the other hand, are often not fully appreciated and people do not realize the powerful effect that psychological therapy, such as non-directive counseling, can have on improving our well-being.”

Bravo,Chris! Now when patients ask me whether therapy is worth the money, I can confidently say that research suggests it might be one of the best investments you can make in yourself and your own happiness. (And it’s okay to get a raise, as long as you spend it on therapy!)

The only problem I can see with this article being published is that it may lower MY happiness, as I might get busier, perhaps earning more money, but not having time to see my own therapist!

So to answer the original question, does money buy happiness? Money doesn’t buy happiness; it buys psychotherapy, which yields 32 times more happiness than money!

Link to study: http://www.nlm.nih.gov/medlineplus/news/fullstory_92421.html

Why do Most Psychologists Ignore Science Based Therapy? Evidence Based Psychotherapy and the Failure of Practicioners

Andrew Gottlieb, Ph.D. — Sat, 10 Oct 2009 00:16:41 +0000

A new article in Newsweek magazine titled Ignoring the Evidence documents how most psychologists ignore scientific evidence about treatments such as cognitive behavioral therapy which have been proven to be effective.

A two-year study which is going to be published in November in Psychological Science in the Public Interest, found that most psychologists “give more weight to their personal experiences then to science.”

The Newsweek article has a wonderful quote,

“Thanks to clinical trials as rigorous as those for, say, cardiology, we now know that cognitive and cognitive-behavior therapy (teaching patients to think about their thoughts in new, healthier ways and to act on those new ways of thinking) are effective against depression, panic disorder, bulimia nervosa, obsessive-compulsive disorder, and -posttraumatic-stress disorder, with multiple trials showing that these treatments-the tools of psychology-bring more durable benefits with lower relapse rates than drugs, which non-M.D. psychologists cannot prescribe. Studies have also shown that behavioral couples therapy helps alcoholics stay on the wagon, and that family therapy can help schizophrenics function. “

The article documents how most psychologists fail to provide empirically proven treatment approaches and instead use methods which are often ineffective. The truth is there is very little evidence for most of the types of therapy commonly performed in private practices by psychologists and by Masters level therapists. If you are shopping for the most effective types of therapy you need to find a practitioner who is skilled at cognitive behavioral therapy (CBT) which is one of the few psychotherapy approaches that has been proven to work on a variety of problems.

Another interesting article in Newsweek about evidence-based treatment discussed bulimia. Here’s the summary:

“On bulimia (which affects about 1 percent of women) and binge eating disorders (2 to 5 percent), the verdict is more optimistic: psychological treatment can help a lot, and cognitive behavioral therapy (CBT) is the most effective talk therapy. That’s based on 48 studies with 3,054 participants. CBT (typically, 15 to 20 sessions over five months) helps patients understand their patterns of binge eating and purging, recognize and anticipate the triggers for it, and summon the strength to resist them; it stops bingeing in just over one third of patients. Interpersonal therapy produced comparable results, but took months longer; other therapies helped no more than 22 percent of patients. If you or someone you love seeks treatment for bulimia, and is offered something other than CBT first, it’s not unreasonable to ask why. Cynthia Bulik, director of the University of North Carolina Eating Disorders Program, summarized it this way: “Bulimia nervosa is treatable; some treatment is better than no treatment; CBT is associated with the best outcome.”

So the bottom line is this:

1. Most psychologists who don’t practice Cognitive Behavioral Therapy (CBT) are just winging it, using treatments that haven’t been shown to work by scientific studies. It’s as if you went to a regular physician and got treatment with leaches!

2. Many psychologists claim to use CBT but haven’t really trained in the use of CBT, or have taken a weekend workshop. Unless they prescribe weekly homework that involves writing down thoughts, and learning skills to analyze and change your thoughts, then they aren’t really doing CBT, and I recommend you find someone else.

3. If you have an anxiety disorder, depression, bulimia, or obsessive compulsive disorder, and haven’t been offered CBT, then you are not receiving state of the art treatment.

How to Deal with Teenage Depression: A New Study of Adolescent Depression and its Treatment

Andrew Gottlieb, Ph.D. — Tue, 17 Feb 2009 01:09:37 +0000

A new study reported in the Journal of the American Academy of Child and Adolescent Psychiatry found some interesting results of a study of teenage depression and its treatment.

This study of 439 teenage children with major depression, done at the University of Texas Southwestern Medical Center at Dallas tested anti-depressant medication (fluoxetine or Prozac), cognitive behavioral therapy (CBT), and a combination of both (COMB). They found that only 23% of the patients had their depression cured by 12 weeks of therapy. But 9 months of therapy was much more effective, with 60 percent going into remission.

The bad news though is that this means that almost half of the teenagers (40%) were still depressed after 9 months of therapy.

The good news is in terms of relapse. Of those who responded quickly to treatment, two-thirds retained the benefits of treatment over 9 months. The same was true of those who took longer to respond.

Which treatment was better? That is an interesting picture.

It depends at which time point you are looking at. At 12 weeks, the results for percentage fully remitted (cured) of depression were: combined drug and CBT therapy (37%), drug therapy only (23%), and CBT therapy only (16%). The combined therapy was significantly better than the other therapies. But note that overall, only 23% of the teenagers had recovered at 12 weeks, which means that 77% were still suffering!

But at nine months the outcomes look quite different. The combination therapy is still the best, but by less of a margin. The results for remission at at 9 months were: combination, 60%; drug, 55%; cognitive-behavioral therapy, 64%; and overall, 60%. By 24 weeks all the treatments were working well. But a full 40% of the teenagers were still depressed.

So the right answer to the question of which treatment works better is neither. Both drugs and cognitive behavioral therapy were equally effective, over the long term. But the combination of both was worked more quickly. As the researchers said, “choosing just one therapy might delay many teenagers’ recovery by 2 or 3 months.” As the saying goes, candy is dandy, but liquor is quicker, and we might conclude that drugs or CBT are dandy, but combined therapy is quicker.

So what does this mean to parents of depressed teenagers? Here are my takeaway messages:

Don’t expect treatment for depression to work quickly. It may take more than 9 months of weekly treatment before your teenager responds to therapy. This means at least 40 sessions of therapy.
Be patient, and set reasonable expectations for both yourself and for your child. Tell them that therapy will help, but it may take a while. Let support networks such as school counselors or trusted teachers know to be patient.
Although medications and cognitive behavioral therapy were equally effective in the long run, the combination of both tended to work much more quickly. So if you can afford it, and have access to good practitioners who do cognitive behavioral therapy, use both.
Be aware that in other studies, the relapse rate for medication treatment of depression was significantly higher than for cognitive behavioral therapy, once the medications are discontinued. So choosing medications only may increase the risk that your teenager will relapse into depression.
Be aware that much teenage depression can be a reaction to social environments. This includes the family, the school, and peers. Be sure that your teen’s therapist is attuned to family, school, and peer issues. They should meet with the whole family at least several times.
Take teenage depression seriously. It’s not just a phase. Teenage depression, when serious, can greatly increase the risk of suicide. All suspected depression should be evaluated by a professional and treated if present.

SOURCE: Journal of the American Academy of Child and Adolescent Psychiatry, February 2009 . And December 2006 issue too .

The Magic of Behavior Therapy: True Stories

Andrew Gottlieb, Ph.D. — Wed, 29 Oct 2008 19:05:27 +0000

Although I’ve been practicing behaviorally oriented therapy for more than 20 years, I’m still amazed and delighted by its power and effectiveness. Here are four tales of behavior therapy, from both inside and outside my office, with children, adults, and even animals!

Playing with Spiders

I recently had a very satisfying experience in the clinical practice. A client of mine asked me if she could bring her grandchildren to a session, in order to work on their spider phobia. I told her that if they were willing, I’d be happy to work with them. We would be able to make some progress by having the children look at pictures of spiders on my computer. The kids were 10 and 13, let’s call them David and Janet.

She surprised them (and me) by announcing at the beginning of the session that she had actually brought two live spiders in jars. This changed my plans for the session. I told the kids that we would only work with the live spiders if they were comfortable doing so. (It’s not a good idea to spring surprises during desensitization sessions.)

So we started doing what is called desensitization. This is a process where step-by-step, in a gradated way, the client is exposed to the fearful object. We started off by looking at pictures of spiders on the web (pun not intended). I picked less scary pictures at first, and I asked the children to rate their anxiety. Then I asked them to see if they could lower their anxiety numbers. We used a hundred point scale, and when they were able to lower their anxiety from 70 or 80 to 30 or below, we moved on to the next picture.

Eventually they were looking at pictures which were quite scary looking, even for me, and I like spiders!

Next we went on to work with the actual spiders. There were two spiders. One of them was a small daddy long-legs spider, and the other was a relatively small but scary looking spider. I decided to work with the daddy long-legs spider, as it was slower moving, and less scary looking.

First I had them look at the spider in the jar. Next I had them hold the jar. They were able to do this fairly rapidly. The next step was to open the jar, and look into the jar with the spider walking around inside the jar. David and Janet were able to do this without very much anxiety at all.

The next step was harder. It was to allow the spider to walk around on my office floor, and to have them touch the spider. I made this a little bit easier by having them put on surgical gloves. First I modeled the behavior for them. I touched the spider, and then I allowed the spider to walk over my hand.

Now it was their turn. First one, then the other, tentatively touched the spider. At first their anxiety rating was quite high, 70 or 80. Then I had them do this repeatedly, until they were able to do it with relatively low anxiety ratings of about 40.

One of the advantages of working with both of them simultaneously was that they were a bit competitive. Janet was initially a little braver, but David quickly responded to this challenge, and matched her touch for touch.

Once they were comfortable touching the spider with gloves on, it was time to take the gloves off. Once again I modeled for them touching the spider comfortably. In a few minutes, they were able to allow the spider to walk over the back of their hand. After a few minutes more, they were able to have the spider walk up their arm.

By the end of the session they were very comfortable playing with this small spider. They were actually having fun playing with Mr. Daddy Long-Legs. And this was only a 60 minute session!

Once again, I was amazed at the power of simple behavioral tools. Modeling — where the therapist demonstrates a behavior. Gradated exposure — gradually exposing the person to increasingly fearful stimuli. Reinforcement — where the therapist complements and praises the client for successful exposures. Shaping — where the client is reinforced for behaviors that gradually approximate the target behavior.

In less than 60 minutes I was able to take these two brave children from being terrified of spiders to relative comfort with spiders. Given that most people are not comfortable having a spider crawl up their arm, by the end of the session they had actually exceeded the comfort level of the average person.

(I recently got a follow-up report on the kids. According to grandma, David now can pick up dead spiders with his fingers, without using paper, which he could not do before. While his family was recently eating dinner, they noticed a large fly buzzing around. During their meal, the fly got caught in a spider web in the corner of nearby window. After the family had eaten dinner, they inspected the web and found the spider wrapping the fly. They left the web in place, deciding that it was beneficial, and David was comfortable with the arrangement. Janet reported that was able to put her hand on a picture of a big, multi-colored ugly black tarantula in her science textbook, with her mom watching. )

Bridging the Gap

Another opportunity for using the science of behavior therapy arose on a vacation. My partner and I were visiting Vancouver Canada, and one of the attractions there is the Capilano Suspension bridge (www.capbridge.com ). The bridge is a 6 foot wide suspension bridge which is 439 feet long, and 230 feet above a river gorge. It’s like the bridge in Indiana Jones and the Temple of Doom, swaying as you walk across it.

There was only one catch, my partner is very afraid of heights. She hates any situation involving them, and doesn’t even like walking across the Golden Gate Bridge.

But I thought that this might be an opportunity for her to overcome this fear, and offered to do in vivo desensitization with her if she was willing.

So we did. First I had her approach the edge of the bridge, and once again, I had her rate her anxiety using a 100 point scale. Ninety, she said. I then asked her to use breathing and relaxation to lower the anxiety. Before long she was able to stand at the very end of the bridge.

Next I had her advance out a few feet onto the bridge, stay there as long as she needed, and then retreat to solid land. She repeated this several times, until it was more comfortable.

Then I modeled walking partly across the bridge. I went slowly and hesitantly, modeling caution and slowness rather than speed and bravado. A coping model that shows the person overcoming fear is more effective than a perfectly confident model, I have found.

She then walked 10 or so feet across the bridge, and stood on the swaying bridge. Fear spiked and then subsided.

All along, I was giving her a lot of praise and encouragement. Next she managed 15 feet, and then retreated. Then she advanced 20 feet, then 30, then 40, and so on, until she was able to walk all the way across the bridge. Once she had accomplished that success, I had her repeat the process until her comfort level increased. I even invited her to jump up and down on the bridge, to demonstrate her lowered fear levels.

By the end of our visit there, not only was she able to traverse the bridge (which I admit was scary, even for me), but she was also able to traverse another attraction, a catwalk that was built between a number of Douglas Fir trees, which at points is 100 feet off the forest floor. This required more desensitization, but was successful in the end.

By the end of the day my brave partner had successfully overcome a lifelong fear of heights, and experienced some tourist attractions that she never would have enjoyed previously. When I showed her the video of her walking across the bridge, she was amazed at what she had been able to do.

Which is what I truly love about behavioral therapy; the ability to quickly and without lengthy therapy to overcome lifelong fears and expand one’s personal horizons!

Shaping Sandy to Swim

Another technique of behavior therapy is called shaping. What is shaping? Shaping is a technique where you reinforce gradual approximations of that behavior until you achieve the full behavior.

I had an opportunity to utilize shaping last summer when we spent some time at Lake Tahoe. We were renting a house on the beach, and our next-door neighbors had an adorable golden retriever named Sandy. Sandy loved to play on the beach, and her favorite game was fetch. But she wouldn’t go in the water past her ankles, and was afraid to swim. The owner said that she had never been willing to swim, even though they came up to Lake Tahoe regularly. The dog was about three years old.

I was challenged. Could I use behavior therapy to help Sandy overcome her fear of water and start swimming? I knew one thing; that dogs instinctively know how to swim, so it wasn’t a question of skill.

I decided to utilize the technique of shaping. First I made friends with Sandy by playing fetch on the beach. Pretty soon whenever I came out to the beach Sandy would run over with a stick to play.

Next I trained Sandy to follow me with the stick. She would follow me anywhere on the beach. Then I went into the water and encouraged her to follow me a few feet in order to grab the stick. She was willing to come into the water a little bit. I would praise her, and I would play some more with her on the beach.

Next I made it a little bit more difficult. In order to grab the stick she had to follow me into the water a few feet more.

I kept repeating this, each time requiring her to follow me further out into the water. Pretty soon she was following me five or 10 feet out into the water, but she still wasn’t swimming. Her feet were still on the bottom.

Next I used a slightly different technique. This time I had her come out into the water and grab the stick with her mouth. Instead of releasing it, I held on and moved out deeper into the water. Pretty soon her feet were off the bottom and she was swimming. I would then let go and she would swim back to shore, shake off, and play with me some more. The first time I did this she seemed a little perturbed, but quickly got into the game.

Over a couple of training sessions during the same day I continued this process. She got more and more confident, and was willing to swim out to grab the stick.

Finally I had her owner call to her while swimming in the deeper part of the beach. I threw a tennis ball out to the owner, and Sandy much to everyone’s surprise, swam out to the owner, grabbed the tennis ball, and swam back to the beach!

After that, Sandy seemed comfortable swimming in order to fetch a stick or a ball, even when it required her to swim in deeper water. Shaping had allowed her to learn gradually to overcome her fear and be able to swim with comfort.

The owners were amazed, as many times they had tried to coax her into the water. All I did was apply systematic methods of behavior therapy in order to allow Sandy to succeed. I shaped Sandy to swim, and she followed her destiny as a waterdog retriever.

Finding the Right Reinforcer

I want to tell one more story about behavior therapy, this time with dogs.

Although I’m a human therapist, I am very fond of dogs, and if I had an alternate career it would be as a dog trainer.

My friends Marli and Stu have two adorable dogs. They are Papillons, which are small cute toy dogs, who look a little bit like the gremlin "Gizmo" in the movie Gremlins . They have the same floppy ears and big eyes. (But they don’t turn into monsters if you feed them after midnight!)
In an effort to make their lives a bit more convenient, my friends had installed a dog door into their bedroom so that the dogs could go outside without needing help.

The problem was that neither Vinnie, the older dog, nor Bowie, the younger dog, was willing to use the dog door. They were both afraid of it. After weeks and weeks of hoping the dogs would figure out how to use the door, they still had not. Stu and Marli kept putting the dogs through the door, but the dogs never figured out how to use the door on their own.

Enter the confident behavior therapist, who offered to solve this problem. I was very confident that I could use food treats to entice the dogs through the door. Once having learned how to go through the dog door, I felt that they would continue to use it without treats.

I asked my friends not to feed the dogs the day I came over so that the dogs would be hungry and more motivated by food.

To make a long story short, I failed miserably. I was able to coax the dogs through the dog door by physically picking them up and pushing them through the door, but no amount of food treats would entice them to go through the door. They seemed uninterested in food treats. After several hours of trying everything I could think of, I gave up.

This bothered me greatly. Had I lost my behavior therapist powers? Had the technology failed? That night, as I tried to fall asleep, I found myself obsessing a lot about the problem. Just as I was about to fall asleep I realized the solution.

Can you guess what the solution was? I will give you a hint that it had to do with what type of reinforcements I had selected. Let me give you one more hint. Both of these dogs are very attached to my friend Marli. They like Stu, but they are crazy about Marli! They follow her everywhere. When she comes home from work they go nuts wanting to play with her.

The solution was to change the reinforcement. Instead of putting food on the other side of the dog door, I needed to put Love! What I did was to have a Marli call her husband Stu right before she came home. Then he would put the dogs outside. She would come inside the house, and call to the dogs through the dog door. The first time she did this both dogs dove through the dog door as if it wasn’t even there!

The next time she came home she came through the yard, and called to the dogs from the outside. Once again, motivated by love, they were very willing to use the dog door to get outside.

After a few days, they no longer had to use this procedure, as the dogs were happily using the dog door on their own. Behavior therapy had triumphed once again, but it required a more careful behavioral analysis of what these particular dogs found reinforcing. They were more motivated by love than by food.

And that’s a key secret…sometimes the best motivators are subtle, and never forget the power of love to motivate! If reinforcement isn’t working, it’s probably because you are not using the right reinforcement.