There is nothing that we do that cannot  be understood through behaviorism. Nothing. Dr. Pete and Dr. Rubin explain how learning theory is fundamentally woven into all aspects of being human. Whether it is a holiday dinner, career, or romance, we can use behavioral science to learn to improve how we interact with one another and ourselves. Tune in to learn how.

Transcript:

Pete: Well, behaviourism is everything. And this episode Nikki, we're going to talk about how, really there's nothing void of behaviourism, in any experience that we have.

Nikki: Yeah, that's right, because everything that we do is behaviour. And maybe if someone's listening to this going like, "okay, Nikki, that's pretty darn obvious".

Pete: You think you're so smart.

Nikki: Yeah, " you think you're so smart. I'd be like, "yeah, well", you know I like to operationalize things, we got to be really concrete and clear here that everything that we do is behaviour. And I don't think that's something that not only the average [inaudible-0:57] recognizes, but actually, the average clinician doesn't even recognize that sometimes.

Pete: Well, maybe that's one of our episodes about like, the different schools of thought, because we're typically like cognitive behavioural therapists, like we're the cult,

Nikki: Yeah, we like to focus on behavioural science. But I would say, even within cognitive behavioural therapy. I mean, the example I'll give is that there have oftentimes been, like infighting in our community about how do we define behaviour, and sort of like the second wave, the older school CBT therapists will talk about thoughts as their own thing. And it's like, yes, you can have a thought. And that could be like a thing in your mind. Thinking is behaviour, though,

Pete: That's right.

Nikki: Not behaviour we can see. It's a covert behaviour, as I've talked about here before.

Pete: You certainly have, yeah.

Nikki: Thinking is behaviour, imagining is behaviour.

Pete: Yeah,

Nikki: Running is behaviour. Crying is behaviour.

Pete: And one of the things I always struggle with that is like, stop thought, and that's for the second wave. It's like, I don't know, I haven't learned any way of stopping my thoughts.

Nikki: No, we can't know. Because that's a behaviour that's ongoing. That's actually part of our... well, and it's an involuntary behaviour. So like, we could get really detailed here, like, your heart beating, that's behaviour. You don't control that behaviour, but its behaviour. That's something that's happening.

Pete: Well, what I'm wondering is, do you think our thoughts continue after...

Nikki: Oh, actually...

Pete: What?

Nikki: I just realized I backed myself into a corner here, because I'm like, behaviour, but I was talking about you can control behaviour. So actually, I take that back, your heart beating, I would say, is not a behaviour, because it's an involuntary process in the body.

Pete: Oh, I see what you're saying, by [inaudible-2:25] the same way.

Nikki: Yeah, but thoughts, we do have agency, you can choose to think about it.

Pete: Well see, I say we have control over nothing.

Nikki: We'll see. But like, right now, when you just raise up your hand. Pete and I can see each other on zoom here. You chose to do that.

Pete: I did. Right.

Nikki: So that, we have agency over that.

Pete: We can't choose to think or choose not to think,

Nikki: So this is where we're really going to get sticky here.

Pete: Yeah, we're getting sticky.

Nikki: We're getting sticky. We can't choose thoughts that just show up. So that can be involuntary that can...

Pete: You're right, automatic thought we would call that.

Nikki: Automatic thought. An automatic thought or like an intrusive image.

Pete: Intrusive thoughts as well, or images. Yeah.

Nikki: But what happens next, what we do, we control.

Pete: Correct, that's the behaviour.

Nikki: That's the behaviour, so we can start to go like, "I'm going to think about this", I don't know, “sandwich I want to have for lunch", like maybe a tuna sandwich popped into my mind.

Pete: I'm on a diet or something like that.

Nikki: Yeah, sure. Or you don't have any tuna in your house, and you're like, "well, I can't make a tuna sandwich".

Pete: Yeah.

Nikki: So..

Pete: Well, we got in the weeds a little bit. But I think the way I look at especially... Okay, I'll bring it to Buddhism. So thoughts are thoughts, there's no control over them, what you do is you build a relationship with them, they're loud. And so one of the things I talk about is that we can maybe look at the volume of it. And so I could potentially lower the volume of my thoughts, but that I really can't control them. And I actually don't use the word control at all in my treatment. So there's no like... I don't use the word, it's a verb to control. And you might try to, but I don't think it's really that effective. So I think what we do in third wave, especially in Buddhism, is we learn to exist with our thoughts. Our thoughts are very creative. And so they're not always great. And they will kind of... they'll tempt us. If I'm on a diet, and I'm like, "I want a burger", says the vegetarian. Or something that maybe I'm trying to avoid, because I have high cholesterol or something like that.

Nikki: Right

Pete: You're going to be tempted.

Nikki: Yes, totally.

Pete: Thoughts will tempt. And so I think what we're getting here is everything's behaviourism. And, so what I was going to say about the heart is like, I don't know if our thoughts stop when our heart stops. I'm going to just put that out there. Let that sit there.

Nikki: Oh, yeah. I was going to say, I love when we start getting into like the, 'and now we get into consciousness'.

Pete: Now we get into consciousness, yeah.

Nikki: Yes.

Pete: And the philosophy of behaviour.

Nikki: And the philosophy, yeah, we don't know that. And so when we're saying behaviourism and we go, "everything is behaviourism". It's like maybe what's more, again, to be more clear is like everything is behaviour. And then Western behavioural science, we have a well established, well studied scientific framework that helps us understand how behaviours are learned,

Pete: Right

Nikki: And how behaviours are maintained. Meaning why do we continue to do them?

Pete: But before you give us a lesson on,

Nikki: Yeah. Oh, I will.

Pete: I was going to say is I think that referencing back to the cognitive cult, is we have a lot of also random control trials. So in CBT, because we're somewhat manualized, we can look at what we do in a manualized way, when compared to other types of therapies, it might be just more subjective. And in the moment, I think I bring that into my work. But the truth is, what I'm doing is still based on learning theory. And that's just why... that's some of the basis of the cognitive cult language, because we do have the most evidence based empirical studies showing the efficacy of the interventions that you and I talked about here on this on this podcast.

Nikki: Yes, absolutely. And I would say actually, like, just to clarify, historically, there were manuals. But actually in third wave, we've actually, significantly moved away from that. Because as our listeners might guess, humans don't fit well into a box of a manual. And that's often a criticism, rightly so, of cognitive behavioural therapies. And the more modern approaches have really emphasized, again, how do these behavioural science principles, how can they be flexibly applied to complex human beings? That we actually

Pete: Coming back to flexibility.

Nikki: Yeah, coming back to flexibility. And then that's something, as we've talked about in the podcast before, has also been well studied as, the more psychologically flexible someone is, it's highly correlated with psychological well being,

Pete: Yes.

Nikki: And then the inverse is true, the more inflexible someone is psychologically, that's highly correlated with psychopathology.

Pete: Yes. And so I think what we've talked about... And in Buddhism, we look at flexibility around. I mean, this Dalai Lama has looked at some more like neurological pathways, and how actually flexibility can now be sort of seen, with some imaging. We can see changes to certain areas of the brain. So again, I think for listeners, just trying to think about ways to do it. So give us a little rundown of sort of learn and maintain so you talked about behaviourism, in general, Western behavioural science looks at how behaviours are learned and maintained or punished.

Nikki: Yeah,

Pete: As we'll get into the two.

Nikki: Absolutely. So I'll do the first one that I think most people are familiar with, which is, I would say most people have heard of Pavlov's dogs,

Pete: I think so.

Nikki: Which is, Pavlov was a guy who basically found that he was like running some kind of other study. And he found that when these dogs he was studying, when he brought out food, to feed them their breakfast, or dinner or whatever, he rang a bell, and the dogs would salivate. And eventually, he started to notice that the dogs would salivate when they heard the bell, even though the food wasn't there. And so that was the start of this learning theory that's referred to as classical conditioning, which basically means the brain can learn to associate, literally anything, honestly,

Pete: Yes

Nikki: Anything with what are already considered involuntary bodily processes. So like salivation, increased heart rate, even like eye blinking, certain things that we don't choose to do, they're involuntary. But our bodies can learn to have those responses to things that are unrelated. So I always like to share an example of like, when I was a grad student, I was working with like, some very suicidal patients.

Pete: Yeah.

Nikki: I had a certain cell phone ring, that I use to have.

Pete: Oh, yeah.

Nikki: And I would get called on that number.

Pete: This is a good one, yeah

Nikki: Yeah, I would get called on that number by some people that were really suicidal. And my reaction, understandably, would be like, it's involuntary, when somebody you care about is in danger, I was scared. And so I would sweat and my heart would increase.

Pete: Yeah.

Nikki: And so I had to eventually change, when I left that training site, I had to change my cell phone ring, because every time I heard that ring, and to this day, if someone has that ring, my body reacts.

Pete: You remember, yeah. That's a perfect example. And people listening could think about that with smells, maybe it reminds you of like a grandparent, all the senses will trigger certain memories, and both good and bad. And so I think within third wave CBT and Buddhism, we look at just radical acceptance of what is. So again, everything's behaviours, if I work with an injured athlete, people think, "well, it's PT and it's medicine". Well, it's also like mind-set, there's evidence that the behaviour I approach my recovery will impact my prognosis to recovery, there's a big line there. So that's how things are learned. What about maintain,inaudible-9:56].

Nikki: Well I was going to say, what you just shared was a nice segue into like, another part of behaviourism. So classical conditioning is how our brain can be conditioned to learn certain things. There's also a type of behavioural learning theory called operant conditioning. And this is something I would say most people are maybe more familiar with, because it's the kind of behavioural theory used when, as we mentioned in our dogs and well being episode that is used when training animals.

Pete: That's right.

Nikki: And so, you can learn behaviours this way. And it also can maintain certain behaviours by accessing these principles. So these have to do with reinforcement and punishment. And I always get really bummed out because these are sort of like the most widely misunderstood principles. And same thing, not just with the average Joe, but also actual clinicians, I often come across don't understand it as well.

Pete: Yeah.

Nikki: So basically, what reinforcement means is that if a behaviour is reinforced, it means it's more likely to happen again, that's all it means. If a behaviour is punished, it means a behaviour is less likely to happen again, that's all. So it's not good or bad, right or wrong, it's just behaviour is more likely to occur or less likely to occur.

Pete: That's right.

Nikki: So when we talk about positive reinforcement or negative reinforcement, it doesn't mean what most people think it does. It's like they're terribly named, in my opinion. Positive doesn't mean good, and negative doesn't mean bad.

Pete: That's right.

Nikki: Positive in operant conditioning means we add something to the situation. And negative means we take something away. So if I want to train my dog to learn to shake, and I want to positively reinforce him, I'm going to grab a spot and say shake, and then I'm going to give him a cookie, I've added something. And when he gets the cookie, it means he's more likely to give me his paw next time.

Pete: Right.

Nikki: Negative...

Pete: It will take several trials.

Nikki: Learning trials, right. It'll take many trials, he's not that smart. He's not going to learn it in one trial. Negative reinforcement means we take something away. So let's say somebody in my neighbourhood is afraid of dogs.

Pete: Yeah.

Nikki: And every time they walk by me, and my dog Toby's very large. He's like 110 pounds, even though he's a gentle giant, they don't know that.

Pete: They don't know.

Nikki: They feel afraid.

Pete: Yeah.

Nikki: So if they're walking on the same side of the street as me, and they decide, "oh, that's scary,"

Pete: Cross the street.

Nikki: I'm going to cross the street, guess what? Their anxiety goes away.

Pete: Yes.

Nikki: And what does that do? It teaches their brain that more likely, next time they see a dog to avoid. That's what negative reinforcement is.

Pete: Beautiful.

Nikki: Any other examples you would add before I jump into punishment here?

Pete: Go to punishment,

Nikki: Go to punishment?

Pete: Because then we'll go to like, the real life, we'll get more examples.

Nikki: Okay. So punishment, also, I think, wildly misunderstood, because it's colloquially used obviously, as like, 'I'm going to punish someone'. Like, I'm going to do something bad to them. But again, in behaviourism, it just means that a behaviour is less likely to occur. So punishment's not used a lot in therapy, because it doesn't teach new behaviour, it just suppresses behaviour. So here's an example. And I'll use a positive punishment example. So again, positive, remember, we've added something.

Pete: Add it.

Nikki: So if you get a ticket while speeding on the freeway, and if you're in LA, and you're speeding on the 405, and you get a fine,

Pete: The 405...

Nikki: Right, the 405. That's positive punishment, something's been added, you're given a fine, and you're less likely to speed on the 405 going forward. But here's the thing, it doesn't teach you not to speed, you get on the 10 freeway, you might hit 90 miles an hour, no problem. So positive punishment, it has a place, it's not very effective at, honestly, like teaching people newer adaptive behaviours, it just kind of temporarily suppresses the behaviour you don't want. Negative punishment is where we take things away. This is often used with children, like taking stimuli away. So if a kid goes on a timeout, because they've like, thrown all their toys all over. And so you put them...

Pete: Through tantrums.

Nikki: In a boring room in the house, you're removing, negative, taking away. You're taking away the stimuli, the exciting stuff, to hopefully reduce that behaviour of tossing their toys around.

Pete: Yep.

Nikki: So that's my little lesson. Hopefully, that's clear for everybody.

Pete: Well it's probably not. I mean, I know a lot of times... I mean it is, and I appreciate it. But I think when we're just regular human beings in the world, we're not always thinking about these things. And that's why, God bless her, your English major undergraduate dogs, Lola, was not the best behaved, even knowing all these principles. So I think for... yeah,

Nikki: Yeah, knowing them doesn't mean that you execute them perfectly.

Pete: There you go.

Nikki: Which is what you're trying to say, yeah.

Pete: Yeah,

Nikki: And I think that the reason, though I always want to be really clear. And I often share some of this segues with patients.

Pete: Oh, sure.

Nikki: Because I feel like that's the thing, is because everything we do is behaviour, actually really understanding what's happening gives you more opportunity to choose how you respond. So it doesn't mean it's going to go perfectly. We, humans, animals, we're all complex organisms, though, it might help you make choices about what you do next that might work a little bit more effectively than just....

Pete: And that's a way to look at it, is like it's not right or wrong, it's just effective. I find myself using that language a lot too. It's like, 'Can I be effective', 'can I find effective communication', things like that. And so, really, there's nothing, in my opinion, that does not include behaviourism. Everything we do is behaviourism, politics, my job in academia, sports, going to the gym, just my own sort of self care or personal growth, holidays, so we're recording this right after Thanksgiving. And then as we get into the December holiday season for whatever you celebrate, and there's a lot of behaviourism in the holidays.

Nikki: We'll say more about like, why? Because I think maybe, like hearing sort of, so I just kind of gave like the dryer, like concrete info about, what behavioural science is, and then, you know, you're saying like, well, this applies to everything, and I'm sure other people listening, going like, okay, but like, how, like, how does this apply? How does this apply to everything that I do?

Pete: Yeah, so like my nieces having crayons by the couch, which their mother's like, "No crayons by the couch", and I'm just like, "oh, what's the crayon for?" and then just trying to like, either reward them for not colouring on the couch, whereas moms try to grab it away, which is avoidance, and then takes away even the opportunity for them even to mess up. And I'm going to just do some scaffolding of like, 'what's a crayon for', 'here's a piece of paper'. And if you happen to colour on your couch, like you did last time you were here, I'll clean it, and it will come off. Couches are made pretty strong these days.

Nikki: So you're thinking about different things to reinforce,

Pete: Yes,

Nikki: And different things to, and this is another behavioural term, extinguish,

Pete: Extinguish, right.

Nikki: Which extinguish basically means we stop reinforcing something.

Pete: Like I don't want them to draw on the couch.

Nikki: So you're not going to give that attention.

Pete: That's right.

Nikki: You're not going to give that reinforcement.

Pete: I'm not going to be like, "No, no, no, grab it away and get it...", because, yeah,

Nikki: And that's what people get confused about. They think if I say, 'no, no, no'. But what they forget is that that's adding something.

Pete: They don't know it's attention.

Nikki: Its attention, and attention is a very potent reinforce.

Pete: It certainly is, and I think that we see that a lot. And that's where I think I value the foundation of psychology, where it's like attachment theory, birth order, and so that's helpful data. So like, if I have a last born client, and they're like, emotionally dysregulated, and look for attention in their relationship, well, it makes sense, because that's likely how we operated in our family system. You probably had to tantrum at the table to finish your dinner, or things of that nature. And I think I operate that way professionally, so if I have students, in general, or even just professionally for like, state associations, or national associations professional, you don't want to give so much energy and attention and engagement with the outliers. So if you're getting in an argument with someone on a list over email, or in my case, like, if a student is making a lot of noise, I'm not going to engage in a really ineffective way, because that's... Because...

Nikki: Because that's going to make that behaviour the other person's doing more likely to happen.

Pete: That's exactly right.

Nikki: And I think that's what people, again, not that they were supposed to do, like we had to go to a lot of school to learn about this stuff. That's why we're sharing it on a podcast, we want everyone to know. Having this foundational understanding of how behaviour is influenced and shaped is really helpful in deciding, like, 'how do I want to interact with this?'

Pete: Well knowledge is power.

Nikki: Yeah, it is.

Pete: Knowledge is power, and 'how do I want to interact with this', I love that. How do I want to interact with it, because we don't always want to, and we want to really set some healthy, good boundaries around who and how and when we interact. And I think a lot of times, if I do some, like role playing with some clients, I'm like, "Oh, it's sounding too psychological", and I get it because they're like, "That's amazing. Can I write that down and say that to my kid?" or whatever, it's like,

Nikki: Sure, sure

Pete: For sure, you could write it down, but it's like, this just comes with practice.

Nikki: That's right, and I like that you said a few minutes ago, like, it's important that nobody expects that you're going to execute these behavioural interventions in some robotic perfect manner.

Pete: Right,

Nikki: Pete and I say it all the time, we're humans. Like, we're messy, and we live in a messy human world.

Pete: Yeah. And we mess up, which is like, I'm so thankful for that, like messing up because I'm imperfect. And that might also be helpful for people to hear. So one of the things I'll say to clients is like, "yes, this sounded really good in here, and I'm a psychologist with training in this, and as long as you give it a shot, that's already better than nothing".

Nikki: Absolutely, and there's a quote that I often think about, and I share with my students when I'm beginning to train them in the basics of behavioural science, which I believe I hope I'm attributing this correctly. One of my mentors used to say it and I think she said, Marsha Lineman said it,

Pete: Yeah.

Nikki: Who is the creator of dialectical behaviour therapy. And she always says, 'No one is immune to the principles of behaviourism. Not even therapists'.

Pete: Yeah,

Nikki: And the reasons that I said students is because again, we could say not even anybody, not even parents, not even teachers, not even,

Pete: Fill in the blank.

Nikki: Yeah, fill in the blank. Point being that everything we do is behaviour.

Pete: Yeah,

Nikki: Everything everybody else does is behaviour and we're constantly influencing each other and shaping each other. And when we have this knowledge about what Behavioural Sciences works more effectively, and what doesn't work so effectively, we have the opportunity to choose behaviours that might make things go a little bit more smoothly.

Pete: And no one is immune to behaviourism. And so, what I hope that listeners think about with this is, as the holiday season is upon us just think about what is it that you're trying to reinforce, what are you trying to punish? And can you work to at least raise awareness around extinguishing some behaviours without dancing and engaging in the unhealthy activities and communications that we often do.

Pete: This has been When East Meets West. I'm Dr. Pete Economou.

Nikki: And I'm Dr. Nikki Rubin. Be present, be brave.

Pete: This has been When East Meets West all material is based on opinion and educational training of doctors Pete Economou and Nikki Rubin.

Nikki: Content is for informational and educational purposes only.

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