Escape and Avoidance in Mental Health Disorders (Psychology of Learning)

Chapter nine of the text discusses escape, avoidance, and punishment. These are aspects of behavior reinforcement that can be manipulated, instinctual, or modernized. The introduction of this chapter follows the general understanding of reinforcement. This specific chapter, however, focuses on the termination of an unwanted entity that creates a habit, otherwise known as negative reinforcement. Historically, psychologists have used simple matters to understand this behavioral technique. Most commonly there were experiments done on rats with different aspects of environmental manipulation--shocks, lights, loud noises, food, etc. In a modernized sense, negative reinforcement can be understood through the myopic lens of mental health crises. 

I was diagnosed with generalized anxiety disorder at sixteen years old. This did not come as a shock to anybody around me. I was described as a "cautious child," who was sensitive, hyper-aware of social interactions, and, at times, volatile. I soon began psychopharmacological therapy, with basic levels of medications introduced in small quantities. I also began weekly cognitive therapy, with external assignments such as journaling and meditation. For a sixteen-year-old girl, mental health was at the bottom of the list of priorities. I was a two-sport varsity athlete, honors student, full-time ice cream shop employee, and big sister to two middle-aged children. I also wanted to stay social, reach my fitness and nutritional goals, and chase after delusions of love with a boy who did not know my last name. 

I did not understand the effects of my anxiety until I graduated high school. I thought that the medication was working, so my therapy sessions slowly got shorter. It was evident that I was healed! I did not have anxiety anymore! Woo-hoo! 

I was wrong, obviously. 

It took me until about five years later to break down and reflect on the consequences of my delusions (not about the boy, but about my anxiety). There were two general actions these consequences fell into, both regarding negative reinforcement. 

1. I ate to cope with nightmares. 

   
   

Remember when your mother told you not to believe everything you read on the internet? Well, she was right! I suffered excruciating nightmares shortly after graduating high school. After reflection, it was due to the build-up of overwhelming intrusive thoughts that I could not cope with. I would dream about terrible things happening to my family, friends and even my pets. I could not bring these things to my therapist, seeing as the cycle of anxiety shades experiences from even people who you pay to listen to you! In order to aid in the night-terrors, I did what any teenager would do: I googled “how to get rid of nightmares.” A wiki article suggested that I should eat a snack about an hour before bed in order to reduce nightmares. The article mentioned some variety of anxiety being neutralized by food, due to the primitive nature of fear vs. food. In retrospect, this wiki article meant anxiety during the day, and there is conclusive evidence that suggests that food before bed causes nightmares. However, I was not in the mood for intense research, so I went to the kitchen and ate a bowl of cereal. The nightmares soon began to fade away (by some miracle of hypocritical psychological research) and I made this into a nightly habit. I would come home from practice, take a shower, do my homework and eat a bowl of cereal around 10:30 pm, with a bedtime of 11:30 pm. Eventually I brought this idea to my therapist, who shook his head and giggled at my teenage reasoning. He told me that this behavior was a sort of a self-experimentation. He explained to me that instead of using one behavior to diminish another, I should have handled the issue at the source–talking about it in therapy. This negative reinforcement only worked briefly anyway, and the nightmares escalated once I got to about week three of my bedtime breakfast. Thanks Kellogg! 

The other aspect of my negative reinforcement was an action I used to cope with OCD: another aspect of generalized anxiety that now has an exclusive category in the DSM-5-TR. In obsessive compulsive disorder, there are obsessions and compulsions (duh!). The disorder requires both of these entities for a proper diagnosis. In a standard diagnosis, the patient experiences intrusive obsessions (money, gore, sex) and compulsions which generally terminate the obsession. This became tied to my superstitions after I graduated highschool. I was bullied in middle school, leading to a trifecta of social anxiety, body dysmorphia and hyper-awareness of my thoughts, dialogue and movements. Why wouldn’t I talk about these things with my therapist, you ask? I didn’t want him to be mad at me! This brings us to consequence number two. 

2. I used compulsions to terminate obsessions. 

In order to diminish these obsessions, I began a series of physical compulsions which seemed to make the bad thoughts go away. These physical compulsions were so ritual that many of my friends in college thought I had tourette syndrome. I would tap a certain amount of times, shake my hands, or say certain phrases aloud to rid the bad thoughts. There were three specific actions I used to terminate bad ideas or obsessions. 

1. I tapped my desk in four sets of three (similar to S-S-S in morse code) whenever I said something in class that I thought was embarrassing. 

1. ep: Professor Berg asks “what is the powerhouse of the cell,” and I answer, “chloroplasts.” I start to blush and obsess over saying the wrong answer. I instinctually tap *** *** *** on my desk with my finger to move on from the moment. 

2. I shook my hands in a jazzy way when I began to think about gorey thoughts. These could be anything, but they were usually about fingernails. When I had these thoughts I would shake my hands outward to “get rid” of the thoughts. 

3. If I found myself thinking about how I looked in my clothes, I would begin to obsess over the idea that other people also cared [suddenly, at the exact moment I had]. In order to rid these thoughts, I had to play a series of piano chords on an imaginary keyboard. These chords were C, D, and A. I had to literally play them on my desk to “reset.”

These actions are clear examples of negative reinforcement. I also did other things, which were not necessarily negative punishment, but did act as “preventive measures.” The primary one happened while driving. I punched the roof of my car under every yellow light under the impression that I would crash my car if I didn’t. If I missed a punch or punched the roof after the light turned red, I had to tap the brake two times to “reset.”

To summarize, negative punishment is more than rats in cages. It can be instinctual and mental conclusions which lead a person to do funny things to “erase” even funnier things. The chapter discusses all aspects of escape and avoidance, which can be a boatload of other social experiences. The basic component of this chapter boils down to fear and how animals use actions to cope with fear. This fear is almost always perceived, especially in people who experience mental health disorders. It is important to recognize these actions, compulsions and obsessions, but it is more important to understand why they happen. Understanding the why is the most effective way to break down behavioral components like reinforcement and punishment.