Imagine that you have an uncle that lives in Australia that you visited as a little kid. And you got your ass kicked by a kangaroo. You very reasonably might become afraid of kangaroos.
But years later when you go back, this gets in the way. Your uncle now has a pet kangaroo, and it's a total sweetheart. But you're stuck with this fear. So you determine to get over it. You spend more time with the kangaroo. Pushing yourself closer and closer, while paying attention to the fact that it's actually playing nice. Eventually you'll get comfortable with the thing and you're not afraid anymore. Yay systematic desensitization.
And in addition to getting attacked by a kangaroo, you developed another fear. On your first visit, you were just not watching where you were going and you ran into his ham radio antenna. When you looked up, you had no idea what you were looking at. It looked like this giant monster which hurt you. For the rest of the trip, you wouldn't go near the monster. That thing was scary. When you were walking around the neighborhood and saw another one, you screamed and demanded everyone turn around.
But when you go back as an adult, things are different. You don't remember exactly what it was you were afraid of, but you remember it being this big scary monster thing. So your uncle takes you out back to show you. And after the big reveal.... it's just funny. It's just like "I was afraid of that!? Haha, that thing doesn't even move!". You don't need to systematically desensitize yourself. It's just a non issue.
And these two situations are fundamentally different. Even at the neurological level. And they behave differently.
Look at fear recovery. You're petting the kangaroo and you aren't afraid of it anymore and everything is great! Then it bares its teeth at you. What do you do? You flip your shit. Fear is back in full force. However, what happens when you bump into the antenna again? Does that fear come back too? No. It's still an antenna. Big difference.
In the kangaroo case, what you learned when becoming unafraid is that the base rate of kangaroo attacks is lower than you thought. That's the reason you don't want to go right up to it - it doesn't feel safe yet, and you have to accumulate statistical trials before you're willing to drop your guard. But you still know that kangaroos can kick your ass, and that it does happen. So of course when it shows signs of aggression, it brings the fear right back. Not only is that one trial a huge update on your base rate estimate, that estimate don't mean shit when you have an aggressive kangaroo in front of you.
And this is what we find when we shock lab rats and do extinction trials. It really looks like we're just learning an inhibition to patch over our still-existing fear response.
But in the antenna case, you're not accumulating statistical data. You just learn in one fell swoop that it's an antenna - not a monster. You're still afraid of monsters, of course. It's just that no amount of bumping into an antenna makes it a monster. You didn't tentatively learn "safe for now", you learned "I was fundamentally wrong to have been afraid in the first place".
And that is the difference between extinction and reconsolidation.
Reconsolidation just sounds way nicer. You get to laugh, and relax. Instantly. Fears don't come back. All good shit. It makes no damn sense to slowly extinct your phobia of butterflies through systematic desensitization. I mean, it'll work, sure. It's way better than nothing, sure. If that's what you know how to do, do it. But like... it's clearly not the right solution. Butterflies never should have been scary in the first place. If you're looking for how to solve butterfly phobias right, look for reconsolidation.
However, extinction has its place. Sure, maybe you could reconsolidate to some extent by learning to put your uncle's nice pet in a different implicit reference class than wild kangaroos, taking into account other factors, etc. However, whenever there's something that really has given you reason to fear it and you can't find a remapping that shows the reasons to be mistaken, it makes sense to keep that fear response inhibited and ready to spring back. If it's not there, then you won't react in time when the kangaroo sits back on its tail preparing to double kick your ass.
How can we do reconsolidation effectively?
ReplyDeleteThanks for the blog, by the way. Hopefully you will continue to update it sporadically
There's basically two steps.
DeleteFirst, you get in touch with the purpose behind the response. Think about what bad stuff could happen if you *didn't* have that response. The Coherence Therapy people like to use sentence completion for this: "If I didn't have a fear of heights _____".
If you're really aching for the fear of heights to be gone, you might want to finish it with "I could finally use the glass elevator at work instead of climbing 20 stories or stairs!" or whatever. And that's fine and true and all, but keep going and see what comes up once you run out of nice things. You'll probably get something like "I might not know to respect heights, and I might fall and hurt myself".
Again, you might have impulses like "but that's stupid! I'm afraid even when I can't possibly fall!". And that may be true, and you don't have to suppress that impulse or anything, so that's fine. Once you're past that though, it's still true that if you magically whisked the fear away without replacing it with anything, you might not notice when you're in danger and get hurt.
This is the end of the first step. At this point you should no longer *want* the fear to just up and leave, since you see the purpose.
The next part is deciding (now that you have full information in mind) what you *do* want to happen. This part can get arbitrarily complicated, because reality is messy and you're dealing with an entire method of dealing with danger due to heights in all possible scenarios (for example).
However, to simplify it we can look at one little piece and decide how to respond in one context. Say the big problem is the glass elevator even though you *know* it's safe. You start looking for *experiences* that confirm or deny the relevance of the fear. This could be memories or it could just be picturing what would happen in various scenarios. For example, I might ask myself "how could I possibly get hurt in the glass elevator?" and start picturing all sorts of scenarios up to including me trying to kick out the glass. In the more complicated cases my simulation engine will return "it breaks and you fall" which I'll have to deal with, but in the simple case it's gonna be a funny image of me trying in vain to hurt myself and the thick glass making me look dumb. Laughter is a good signal that you've got a "juxtaposition experience", to use a CT term.
So you ask yourself "okay, so it's good to be afraid of heights when it's necessary to keep me from hurting myself, but do I need it in the glass elevator?" and the answer is gonna be a humorous and obvious "no". It'll be a felt no, like "no, that's silly! Why would I ever do *that?*", as opposed to the old response of "No! I *shouldn't* be afraid! [but I am anyway!]". So you decide that there is nothing important to do to make sure you don't hurt yourself, so now when you get in that imagined elevator it should just be *boring* - and same when you get in in real life.
In short, "get in touch with the reason for the response, then look for experiential data that contradicts it".
The Coherence Therapy people talk about it quite a bit. In particular, I've found these examples to be pretty informative.
http://www.coherencetherapy.org/discover/examples.htm
With respect to blog updates, I have a ton more posts mostly written and will continue sporadically. I just don't often get around to getting someone to give it a read through and make sure it'll make sense to anyone but me.