Saturday, 18 January 2014

What is hypnosis? 4: Conditioning

Here is part four of our series of posts concentrating on hypnosis. We have taken these posts from Chapter 4 of Ivan and Joe's book, Godhead: The Brain's Big Bang, so if you enjoy reading these posts, please pick up a copy of your own. All references are contained in the book.

Part 1: Why all learning is post-hypnotic 
Part 2: How we internalise knowledge 
Part 3: Hypnosis: psychotherapy’s most powerful tool 

PART FOUR: Conditioning

What kind of experiences would lay down a memory in the brain to be triggered off later – sometimes years later? For an answer to this we have to return to the work the behaviourists did in the early decades of the 20th century. This group conducted a huge range of experiments showing that conditioning plays the most potent role in determining behaviour in all animals – including us. Strangely, their discoveries are largely ignored now and are not for the most part integrated into modern schools of psychotherapy.

Practitioners of cognitive behavioural therapy (CBT), for example, put great emphasis on changing thought patterns when attempting to change behaviour, and only pay lip service to the early discoveries of the behaviourists. They play down the fact that there are conditioned patterns programmed into our amygdala by things that happened to us earlier in life which, when triggered in the present, are immediately pattern-matched back to the earlier experiences. As far as conditioning is concerned in such cases, thought is not an intervening variable because the pattern-matches that trigger disturbing emotional responses are unconscious. The problem for cognitive therapists is that their main technique is to use logic to challenge their clients’ thinking and beliefs, but very often the beliefs are the irrational products of underlying pattern-matches and unless you change the original patterns you are unlikely to bring about significant improvement. We know from discussions with patients and clinical staff that, when people who experience strong neurotic reactions arising from emotionally conditioned behaviours go for CBT, maybe for 12 or more sessions, improvement is often only modest at best.

In the 1970s and 80s CBT became more and more entrenched in the US and the UK, largely because researchers found it to be more efficacious than the drug treatments with which it was mainly compared. This skewed ‘evidence base’ gave it a head start over other forms of therapy, such as interpersonal or solution-focused approaches, that were equally or more effective than CBT but against which it had rarely been compared. As a result of this trend, the discoveries about conditioning were forgotten, and more and more emphasis was put on changing patterns of thought, which is one of the main reasons why in practice CBT is a less successful treatment than it might otherwise be. (And when CBT therapists introduce on an ad hoc basis ‘guided imagery’, ‘mental rehearsal’, or an ancient meditation technique known as ‘mindfulness’ into their procedures, it still remains to be demonstrated that this improves their outcomes. These so-called ‘third-wave’ CBT practitioners have not yet generated evidence that doing this makes them even as effective as their predecessors in CBT.)

One of the important things the early behaviourists discovered was that environmental stimuli programmed the hypnotic store via both the reward and punishment and fight or flight instincts. When similar stimuli were subsequently encountered, they would be pattern-matched to the details previously programmed in and this reactivated the earlier emotional response. This is why people can react strongly to apparently inconsequential details when they have a phobia or have developed PTSD symptoms after a psychologically traumatising event. A lifetime phobia of grass, for example, could arise because someone was beaten up on a lawn as a child and developed an aversion to, say, the colour or smell of grass. This is what learning consists of: attention is focused and existing patterns in the brain are expanded, allowing more scope for richer pattern-matches to be made subsequently. In our earlier writings, we have explained that the mechanism underlying this is the orientation response, the neuronal pathway from the brainstem to the thalamus which, when activated, prepares the brain to receive information from each incoming stimulus by triggering off the REM state in which our basic instincts were originally laid down. This focuses our attention on the stimulus: our pupils enlarge, bloodflow to the brain increases.

We’ve also shown that attention has to be focused in order to programme new patterns into people. This means that, whenever the fight or flight mechanism is triggered, or we get rewarded or punished, the orientation response is activated, which focuses and locks the brain’s attention mechanism on the stimulus long enough for pro- gramming to take place or be reinforced. That process occurs via the REM state and is the common denominator of all conditioning variables, and therefore all learning. We can take this one step further by asking a couple of questions. What is it about reward or punishment or fight or flight that does this? What have these variables got in common that triggers the REM state? We think it is the fact that they intensify the focus of attention by firing the orientation response (the brain mechanism that focuses attention) and releasing the required attention energy. If this is so, it is critically important. Consider the underlying neuronal pathway involved in all addictive behaviour: the motivation pathway fuelled by dopamine. These variables all fire off on that pathway because it intensifies the focus of attention.

Indeed, the underlying mechanism of all reward is attention, whether taking hard drugs or alcohol, eating an enjoyable meal or falling in love. In any intensification of experience, pleasurable or otherwise, the underlying mechanism is the process of focusing and locking attention. This is what intensifies consciousness, for good or bad, pleasure or pain, and conditions in new learning, useful or otherwise.

Attention requires energy however. We all know from our own everyday experience that we have a limited amount of attention energy. At the end of an exhausting day, for example, we all find it difficult to concentrate: we just want to relax, chill out and recharge our batteries. Another illustration of this would be what happens whenever one is buttonholed for any length of time by an attention-seeker. He or she quickly drains you of energy; being in their presence is physically and emotionally exhausting. There comes a point where you have no more attention to give until you’ve rested and built up a reserve of it again. So you ‘switch off’, stop listening to them and concentrate on devising a strategy to escape their presence.

More evidence supporting the idea that we have a limited amount of attention energy comes from research into the connection between dreaming and depression. It was found that when the orientation response (technically called a PGO, or ponto-geniculo-occipital, spike) fires off too intensively while we dream, the balance between recuperative slow-wave sleep and energy-burning REM sleep, in which dreaming takes place, is disturbed, people wake up tired, unable to focus and lacking motivation to do anything. This depressed state is caused by excessive worrying (often unconsciously) about one or more innate emotional needs not being met, which generates a large number of stimulations of the autonomic arousal system. When no action is taken to solve the difficulties being worried about and getting these needs met somehow – which would de-arouse the autonomic nervous system – excessive dreaming is the result. This misuse of imagination is why humans are so vulnerable to becoming depressed. Worrying depletes our store of attention energy. It’s a question of balance: we become de-aroused if we take appropriate action in the environment, and remain aroused if we misuse our imagination by focusing on negative fantasies and worries.

So, it is our capacity to give attention that enables us to focus on the world around us and learn. And when conditioning variables are brought in to play we can sometimes be conditioned with inappropriate patterns that, when they fire off, create unhelpful neurotic responses that prevent us from learning. When we use psychological interventions like the rewind technique to release patients from these neurotic responses – frozen patterns of attention in the amygdala – we are simultaneously releasing more attention capacity in them and opening up their potential to understand reality in greater depth. We have heard hundreds of patients who, after being detraumatised, say things like “I feel liberated,” “I’ve become more intelligent,” or “I have more energy to engage with life again.”

The final post: Learning versus indoctrination

Previous post: Hypnosis: psychotherapy’s most powerful tool

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Read Prof A.V. Ashok's review of Godhead: The Brain's Big Bang

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