Matthew D. Jacofsky, Psy.D., Melanie T. Santos, Psy.D., Sony Khemlani-Patel, Ph.D. & Fugen Neziroglu, Ph.D. of the Bio Behavioral Institute, edited by C.E. Zupanick, Psy.D. and Mark Dombeck, Ph.D.
The principles of operant conditioning have taught us to recognize how certain coping techniques can reward, and therefore continue anxiety disorders. Two similar coping strategies for dealing with anxiety symptoms are called avoidance and escape. For more information about coping strategies, please review this section.
As the name implies, avoidance refers to behaviors that attempt to prevent exposure to a fear-provoking stimulus. Escape means to quickly exit a fear-provoking situation. These coping strategies are considered maladaptive because they ultimately serve to maintain the disorder and decrease functioning. Operant conditioning enables us to understand the powerful impact of these two coping strategies. Both coping strategies are highly reinforcing because they remove or diminish the unpleasant symptoms. Unfortunately, they do nothing to prevent the symptoms from re-occurring again and again in the future.
In 1947, O. Hobart Mowrer proposed his two-factor theory of avoidance learning to explain the development and maintenance of phobias. Mowrer's two-factor theory combined the learning principles of classical and operant conditioning. Based upon the principles of classical conditioning, it was assumed that phobias develop as a result of a paired association between a neutral stimulus and feared stimulus. However, classical learning theory could not explain the continuation of avoidance and escape behaviors. These behaviors often led to further distress and interference in a person's life such as: 1) the avoidance of pleasurable activities; 2) the inability to engage in daily activities and responsibilities; and 3) the inability to maintain interpersonal relationships.
The second stage of Mowrer's model attempted to explain why people felt so compelled to avoid anxiety-provoking stimuli; or failing that, escape from the stimuli. The answer comes from Skinner's theory of operant conditioning and the environmental rewards produced by these coping strategies. Mowrer proposed that the avoidance of (or escape from) anxiety-provoking stimuli resulted in the removal of unpleasant emotions. Thus, avoidance becomes a reward and reinforces (increases) the behavior of avoidance. For example, an individual with social anxiety will feel a significant decrease in anxiety once s/he decides to avoid attending a large social event. This avoidance results in the removal of the unpleasant anxiety symptoms thereby reinforcing avoidance behavior. As such, it becomes the person's preferred method of coping with future social events. Similarly, suppose this same person attempted to go to a party, despite his/her reservations, and experienced a panic attack while there. If this person immediately exited the party, the panic will subside, and the behavior of escape will be rewarded by the swift reduction in panic symptoms. Avoidance and escape are called negative reinforcement. The removal of unpleasant symptoms (negative) leads to an increase in that behavior (reinforcement).
The therapeutic implication of operant conditioning and its relationship to avoidance learning was extremely important. When maladaptive copying strategies that serve to maintain an anxiety disorder are discontinued, these maladaptive behaviors become extinct. The research has demonstrated this to be correct. This understanding formed the foundation for effective treatments.