This is part of the parent training course: http://www.simplybehaviour.com/parent-training/

Introduction:

John B. Watson (1913) and Ivan Pavlov (1927) were influential figures in the field of psychology, particularly in the areas of behaviourism and learning theory. Watson focused on the study of stimulus-response (S-R) relationships and the influence of environmental factors on behaviour. He conducted the famous Little Albert experiment, demonstrating emotional conditioning through classical conditioning. Watson’s work emphasized observable behaviour and the role of conditioning processes in shaping behaviour. Their work laid the foundation for understanding how behaviour is shaped and learned through environmental stimuli and responses.

Classical conditioning is highly beneficial in shaping emotional responses. 

This conditioning describes how a person creates an emotional behaviour towards specific people or situations. Our behavioural response to a situation produces or reminds older responses as they both are linked. It occurs through a process of association between a neutral stimulus and an unconditioned stimulus (See Figure 1.)

Figure 1. Classical Conditioning (Pavlovian)

Here are the steps involved:

1. Unconditioned Stimulus (UCS): The unconditioned stimulus is a stimulus that naturally triggers an unconditioned response (UCR) without prior learning. For example, in Pavlov’s famous experiment with dogs, the presentation of food was the unconditioned stimulus.
2. Unconditioned Response (UCR): The unconditioned response is the natural and automatic response elicited by the unconditioned stimulus. In Pavlov’s experiment, the dogs salivating in response to the food was the unconditioned response. Remember this is not operant behaviour its a reflexive response such as salivation, blinking etc.
3. Neutral Stimulus (NS): The neutral stimulus does not initially evoke any significant response or reaction. In Pavlov’s experiment, the sound of a metronome or a bell was initially a neutral stimulus.

Conditioning Trials: 

During the conditioning phase, the neutral stimulus (NS) and the unconditioned stimulus (UCS) are repeatedly presented together. For example, the sound of the bell (NS) is presented just before the presentation of food (UCS) in Pavlov’s experiment. 

Conditioned Stimulus (CS): 

After repeated pairing of the neutral stimulus (NS) with the unconditioned stimulus (UCS), the neutral stimulus becomes a conditioned stimulus (CS). The conditioned stimulus now elicits a response similar to the unconditioned response (UCR) even without the presence of the unconditioned stimulus. In Pavlov’s experiment, the sound of the bell became the conditioned stimulus (CS).

Conditioned Response (CR): 

The conditioned response is the learned response that is elicited by the conditioned stimulus. It is similar to the original unconditioned response (UCR). In Pavlov’s experiment, the dogs salivating in response to the sound of the bell, even without the presence of food, was the conditioned response (CR).

It is important to note that the Conditioned Response is not an operant response but becomes part of the story with the way we operate in our environment and the way it is reinforced. 

Figure 2. Emotion, Behaviour & Physiological Elements

Summary:

The process of classical conditioning occurs when the neutral stimulus (NS) is repeatedly paired with the unconditioned stimulus (UCS), leading to the formation of an association between the two. Over time, the conditioned stimulus (CS) alone can elicit the conditioned response (CR) similar to the unconditioned response (UCR). This association between the CS and the CR is the result of learning through repetition and association. Classical conditioning occurs through a process of association between a neutral stimulus and an unconditioned stimulus. Here are the steps involved:

It’s important to note that classical conditioning can also involve other factors such as timing, contingency, and the predictability of the conditioned stimulus, which can influence the strength and persistence of the conditioned response.

Treatment of Emotional Responses

• Counterconditioning and Extinction are the basis of therapeutic approaches used to treat emotional conditions. 
• Counterconditioning involves replacing an anticipated salient outcome with a new outcome of opposite valence. 
• Counterconditioning forms the basis for therapies such as systematic desensitisation or aversion therapy, where undesired responses are inhibited by activating an antagonistic response system. 

Figure 3. Classical Counterconditioning of Fear 

Points to Note:

• Counterconditioning can be contrasted with extinction which as previously discussed as it refers to the process of omitting a previously conditioned stimulus or reinforcement, resulting in a reduction of the learned behaviour. However, extinction is often considered a relatively weak and temporary form of inhibition, as the original learned response can re-emerge in various contexts.
• In situations where there is aversive-to-appetitive conditioning, the introduction of appetitive stimuli might lead subjects to engage with the feared CS for a longer duration, allowing basic extinction processes to operate. 
• Counterconditioning could also affect attentional processes and the level of attention paid to the CS during the second phase of learning.

Counterconditioning in humans first carried out by Mary Cover Jones ( see Figure 2.) in her “Little Peter” experiment called “Little Peter”. In this experiment, Peter, a child who showed fear towards a white rabbit, underwent a process of counterconditioning. The rabbit was gradually introduced in the presence of appetitive stimuli (candy), and over time, Peter’s fear subsided. The experiment demonstrated the potential for counterconditioning to modify behaviour and reduce fear responses. 

How to carry out counterconditioning :

1. Use a salient US that is not available in any other condition but the highest value possible (please lock it away only to be used in this condition otherwise it won’t work)
2. Start from a good safe distance from the object which is eliciting a fear response otherwise you can cause the behaviour to become worse and plus you want to start practicing with the stimuli in this condition
3. Do not restrict or force your learner in any way shape or form – remember non-contingent escape? this is what we can use provide the individual with freedom to escape- let them flow by opting in and out
4. Take your time, do not rush and repeat exposure over time and the lovely high value unconditioned stimulus that you use will come to predict good things. 

Figure 4. Exposure Therapy (Jones 1924)

Reciprocal Inhibition

The approaches that use this kind of approach are often referred to as reciprocal inhibition. These therapies aim to elicit feelings or actions that are incompatible with unwanted reactions. For example, a patient may be encouraged to be in a fully relaxed state before encountering an anxiety-provoking situation. The stimulus eliciting the competing response should be stronger than the stimulus eliciting the unwanted response. This principle highlights the importance of creating incompatible states to effectively inhibit unwanted behaviours. Desensitisation, flooding, prolonged exposure or graduated exposure type therapies are types of counterconditioning therapies which often involve relaxation and the promotion of incompatible states, standard extinction therapies focus on maximising inhibitory or corrective learning during a state of anxiety. 

Figure 5. Contexts of Exposure

Appetitive Research on Counterconditioning/Response Inhibition

• Some studies have found no advantage of counterconditioning over standard extinction (Meulders et al., 2015) but the valence ratings were higher in the counterconditioning condition. 
• Money is limiting as a rewarding outcome because it is a generalised reinforcer and can increase willingness to engage in painful movements suggesting that this reward might reduce avoidance of pain related actions (Claes et al., 2014)
• Kang et al. (2018) found threat expectations were lower compared to extinction and valence ratings were the same.
• Dis et al., 2019 found skin conductance responses for startle responses were not changed but valence ratings were
• Schweckendiek et al. (2013) found no difference in brain activity for disgust pictures paired with money reward. 
• Keller & Dunsmoor (in press) did find a reduced skin response compared to extinction

Aversive Research on Counterconditioning/Response Inhibition

• Replacing the aversive unconditioned stimulus (US) with a neutral stimulus in counterconditioning can effectively reduce fear responses.
• Novelty-facilitated extinction, where a neutral stimulus replaces the aversive US during extinction, leads to less fear relapse compared to standard extinction.
• The presence of a new perceptible outcome in counterconditioning and novelty-facilitated extinction enhances learning through increased prediction error.
• Aversion therapy, which aims to re-associate maladaptive behaviours with negative outcomes, has a controversial history and is used to treat addictive disorders (see Figure 3.).
• Research on appetitive-to-aversive counterconditioning and aversion-based therapies is limited but shows promise for understanding and treating maladaptive behaviors and addictive disorders.
• More research is needed to explore the effectiveness, long-term outcomes, and treatment adherence of aversion-based therapies in real-world settings.

Aversive Conditioning Therapy

Despite limited evidence of its efficacy this approach is still sometimes used in extreme cases of alcohol addiction or drug dependence. This approach is based on classical conditioning theory by associating an unpleasant response with substance use and ultimately creating a negative cognitive and emotional response to the undesirable stimulus (substance use).

Figure 6. Aversion Therapy

Exposure techniques

These are commonly used in therapy to treat an underlying emotional response and to reduce anxiety. The most common one used in ABA is systematic desensitisation and is often combined with an appetitive stimulus. The treatment protocol is not always that clear and so its important to work with a skilled clinician to set this up with your learner. Other techniques include flooding, systematic desensitisation, and graduated exposure (often used in psychology with various names but the underlying process is the same). Here is a summary of each technique, along with their procedures and effectiveness:

Figure 7. Flooding Versus Progressive Exposure

1. Flooding:
   • Procedure: In flooding, the individual is directly and intensively exposed to the feared or anxiety-provoking stimulus or situation for an extended period without the possibility of escape or avoidance.
   • Flooding aims to facilitate extinction by overwhelming the fear response and allowing habituation to occur. It can be highly effective in reducing anxiety and fear, but it may also cause significant distress during the exposure process.
2. Systematic Desensitization:
   • Procedure: Systematic desensitization involves a step-by-step process of gradually exposing the individual to the feared stimulus or situation while practicing relaxation techniques. The exposure starts with the least anxiety-provoking scenario and progresses to more challenging ones.
   • Systematic desensitization aims to replace anxiety responses with relaxation responses through the process of counterconditioning. It has been found to be effective in treating specific phobias and anxiety disorders.
3. Graduated Exposure:
   • Procedure: Graduated exposure, also known as exposure hierarchy or fear hierarchy, involves creating a step-by-step list of feared situations or stimuli based on their level of anxiety or fear. The individual is then gradually exposed to each item on the hierarchy, starting with the least anxiety-provoking and progressing to more challenging ones.
   • Graduated exposure helps individuals confront their fears in a controlled and gradual manner. It has been shown to be effective in reducing anxiety and fear responses, particularly in anxiety disorders and post-traumatic stress disorder (PTSD).
4. Implosion Therapy:
   • Implosion therapy, also known as implosive therapy or flooding in imagination, involves the individual vividly imagining and mentally confronting the most feared and anxiety-provoking scenarios without actual exposure to the stimuli. 
   • The therapist guides the individual through a detailed description of the feared situations, aiming to evoke intense anxiety.
   • Implosion therapy aims to facilitate extinction and habituation by creating intense imaginary exposure. It has shown effectiveness in reducing anxiety and fear responses, particularly in phobias and obsessive-compulsive disorder (OCD).

Figure 8. Systematic Desensitisation

To optimize the effects of response inhibition/counterconditioning and prevent relapse, several strategies can be considered:

1. Enhancing generalisation and reducing contextual renewal: 
   Counterconditioning is more prone to fear renewal than extinction due to increased discrimination between contexts. Gradual extinction techniques, where the extinction trials are reinforced with a diminishing rate of the new outcome, have been shown to reduce fear relapse. A similar approach could be applied to counterconditioning by gradually interweaving trials with the new outcome during extinction. Conducting counterconditioning in multiple contexts can also help prevent fear relapse by enhancing generalization of the new learning across different contexts.
2. Incorporating unexpected rewards within a memory reconsolidation framework:
   Memory reconsolidation refers to the theory that reactivating a long-term memory makes it labile and susceptible to change. Reactivating a fear memory and then pairing it with an unexpected reward during extinction has shown promising results in reducing fear. For example, presenting a positive stimulus, such as chocolate, during fear memory reactivation can diminish the return of fear. This approach can also be applied to aversive memories, where counterconditioning can be performed during the reconsolidation period to alter both appetitive and aversive memories.
3. Considering boundary conditions and procedural differences: 
   The effectiveness of counterconditioning within a memory reconsolidation framework can be influenced by various factors, such as the strength and age of the memory. Not all memories may be equally amenable to reconsolidation-based interventions, and procedural differences across studies can impact the outcomes. Understanding the boundary conditions and optimising the protocols will be crucial for the successful application of counterconditioning in clinical settings.

In summary, optimising counterconditioning techniques and incorporating them within the framework of memory reconsolidation holds promise for preventing the relapse of unwanted thoughts and behaviours. Further research is needed to explore the effectiveness of these strategies and to refine their implementation for clinical applications.

References

Domjan, M. (2018). The Principles of Learning and Behavior. Cengage Learning.

Jones, M. C. (1924). The elimination of children’s fears. Journal of Experimental Psychology, 7(5), 382-390.

Pavlov, I. P. (1927). Conditioned Reflexes. Oxford University Press.

Skinner, B. F. (1953). Science and human behavior. Simon and Schuster.

Todd, J. T., & Morris, E. K. (1994). Modern Perspectives on John B. Watson and Classical Behaviorism. Greenwood Publishing Group.

Woodruff, M. L., & Lotfipour, S. (2017). Classical Conditioning: Pavlovian Learning and Its Applications. International Review of Neurobiology, 136, 261-284.

Watson, J. B. (1913). Psychology as the Behaviorist Views It. Psychological Review, 20(2), 158-177.

Watson, J. B., & Rayner, R. (1920). Conditioned Emotional Reactions. Journal of Experimental Psychology, 3(1), 1-14.