In need of a 250 word response/discussion to each of the following forum posts. Agreement/disagreement/and/or continuing the discussion.
Original forum discussion/topic post is as follows:
Psychosomatic Anxious Reactions
A woman is seeking therapy for psychosomatic anxious reactions that occur as she is pulling into the driveway after work each night. Upon further analysis, you (the therapist) discover that two years previously her husband was experiencing a severe depression that resulted in angry outbursts each evening after she returned home from work. The husband has since recovered from his depression and the angry outbursts have stopped. Identify the US, CS, CR and provide an example of how you would work with the client to extinguish or replace the current CR. Incorporate what you learned in this week’s assigned readings and the video on systematic desensitization in your post.
Forum post #1
In the above scenario, the unconditioned stimulus was the angry outburst made each evening by the woman’s husband. The conditioned stimulus is the act of pulling into the driveway after work each night. The conditioned response is the psychosomatic anxious reactions experienced by the woman.
During Week Two of this course, we learned about the four main learning phenomena. Extinction was among these phenomena. With Extinction, the conditioned response is lost. In order for a response to be lost, a conditioned stimulus must be repeatedly presented without an unconditioned stimulus. In the above scenario, the conditioned stimulus (pulling into the driveway) must be repeatedly presented without the unconditioned stimulus (angry outbursts) for the conditioned response (psychosomatic anxious reactions) to become extinct.
The scenario was unclear regarding certain details about the woman’s psychosomatic anxious reactions that occur as she pulls into the driveway after work each night. It is stated that the angry outbursts occurred two years prior, and due to the husband’s recovery, the outbursts have since stopped. The scenario does not say if the woman has had psychosomatic anxious reactions over the course of the last two years, if the reactions have just begun, or how much time has passed since the woman’s husband has recovered from his depression. Extinction could have occurred over time after the husband’s outbursts discontinued, but could have reappeared with spontaneous recovery. In that case, the woman could continue to pull into the driveway after work each night without being greeted with angry outbursts from her husband in order for the process of extinction to occur once more.
To help the woman, like in the video, I would first have her completely relax and then imagine herself pulling into the driveway. If she felt anxious reactions during that time, I would encourage her to think of all the positive outcomes that happen when she arrives home after work. In order to replace the current conditioned response, I would do one of two things: enlist the help of the woman’s husband, and/or instruct the woman to set a reward out for herself each morning for when she returns home from work. If the husband was willing to help the woman replace her conditioned response to her conditioned stimuli, upon pulling into the driveway after work each night, the husband could meet the woman in the driveway with a positive physical presence. If her husband stands in the driveway as she comes home, and she can see that he is smiling or is in a good mood, her psychosomatic anxious reactions might be replaced with other positive feelings. If he is unable to help her, the woman could set a piece of chocolate or something she enjoys on or near the driveway. This way, she would be receiving a positive reward for pulling into the driveway. She knows that the reward will be there. She will have something positive to look forward to when she pulls into the driveway after work each night.
Forum post #2
This week’s reading and lesson discussion have been very interesting. We studied the four main phenomena of learning, conditioned stimulus (CS) and conditioned responses (CR). In the mentioned scenario/scene the woman showed both. When pulling up to her house the woman the conditioned stimulus of her husband’s past outburst automatically kicks in triggering her conditioned response which in this case would be psychosomatic anxious reactions. Because this had been a repeated process, her conditioned response was embedded, making it harder to forget therefore would need to be replaced by an unconditioned stimuli (US).
If I were the therapist in this scenario, my first mission would be to get down to the root cause of the original problem. I would try to figure out exactly what did her husband do in the midst of his outburst; which may give me the indication to why it cause her such trauma. (I personally believe that the outburst alone is not what caused the significance, however the actions as it relates to the outburst.) I would then ask her questions relating to happy times between her and her husband, which they both enjoyed such as dates, conversations, and walks in the park, massages or other small gestures. I may even go to the extent of involving he husband, who could offer a few gestures upon her drive in from work each evening for a few weeks, just to show that he loves/adores her and that he has gotten better as for as his depression is concerned. This will hopefully trigger joyful emotions causing her to relax little and be at ease. I would do this as an attempt to trigger her conditioned response as it relates to her conditioned stimuli. (Changes something to get something) I would attempt to explain that in order to changes the outcome that maybe her attitude towards the situation would have to change.
The assigned reading for this talked about systematic desensitization, which is a type of behavioral therapy. Because this technique aims to remove the fear response of phobia and substitute a relaxation response to the conditional stimulus overtime. In the video, the (girl) patient tried to overcome her fear of milk. It made her think of cows and farmers milking cows. The therapist tried various relaxation techniques and even attempted to show her pictures, had her envision what it was like to walk through the dairy isle of a grocery store. The patient feared milk so much that she could not stomach it because of her past experience. As time went on, the patient eventually drank the milk and not only loved it but she went on to started milking cows on a farm. The systematic desensitization technique was used to help the patient overcome her fear.
Forum post #3
Based on the scenario presented, I would say that the husband’s angry outbursts are the Unconditioned Stimulus (US), the woman pulling into the driveway I would label as the conditioned stimulus (CS), and the conditioned response (CR) is the psychosomatic anxious reactions. These reactions could affect her mind and body, and symptoms can often include an increased heart rate, nausea, physical shaking, sweating uncontrollably, and various physical pains in the chest and head.
As many of these psychosomatic responses are a response to mental stress and anxiety, but underlying physical and mental health issues may exacerbate them. I would likely want to begin by ensuring the patient had recently been to the doctor for a physical. Once physical issues were ruled out, I would also request her patient history, especially if it included any mental health issues before the two years described in this scenario, and eliminate any comorbid symptoms from my diagnosis. I would also want to ensure if I were to prescribe any medications for anxiety or stress, they would not interact with anything she was currently taking, including any self-medicating through pain killers, narcotics, or alcohol.
Once physical factors had been eliminated, I would likely recommend cognitive behavioral therapy (CBT) or another form of exposure therapy. These are the most effective therapies at eliminating the response that occurs because of learned behavior, especially in the case of a traumatic experience. Since the angry outbursts are no longer occurring, the goal of the therapy would be to eliminate the fear that was associated with the conditioned stimulus, which in this case is the woman pulling into the driveway. The goal of the therapy over time would be to modify the woman’s feelings about returning home until the conditioned response (CR), her physical and mental dread, has been eliminated. Although medication can help with the symptoms, it is not a treatment by itself, since this woman does not have a Generalized Anxiety Disorder (GAD), but rather anxiety as the result of a learned behavior. I would begin treatment by having the woman close her eyes and visualize her return home, describing in detail how the drive itself makes her feel. I would ask her to explain to me why the idea of going home and encountering her husband makes her feel fear or dread. With time, I would help her to understand that she is not responsible for her husband’s former anger, and that she cannot blame herself for his depression. Eventually, together we would help her understand that her home is not a place to fear, and that her husband is not a threat to her safety. Ideally, I would like to include the husband if he is willing. As long as the husband does not continue with angry or passive-aggressive behavior towards his wife, extinction of the conditioned response would eventually occur, and the physical and mental impact of her anxiety would cease.
Over time, proper treatment of psychosomatic responses can also decrease the impact of the physical responses. This would not be true if the woman had anxiety or depression as the result of a chemical imbalance, rather than from a traumatic event.