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Tension And Anxiety In Deconditioning
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Tension And Anxiety In Deconditioning
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This dissertation has been
microfilmed exactly as received 68— 10,244
MYERHOFF, Howard L ee, 1931-
TENSION AND ANXIETY IN DECONDITIONING.
U n iversity of Southern C alifornia, PfuD., 1968
P sychology, clin ical
University Microfilms, Inc., Ann Arbor, Michigan
TENSION AND ANXIETY IN DECONDITIONING
by
Howard Lee Myerhoff
A Dissertation presented to the
FACULTY OF THE GRADUATE SCHOOL
UNIVERSITY OF SOUTHERN CALIFORNIA
in Partial Fulfillment of the
Requirements for the Degree
DOCTOR OF PHILOSOPHY
(Psychology)
January 1968
U NIV ERSITY O F S O U T H E R N C A L IF O R N IA
T H E G R A D U A T E S C H O O L
U N IV E R S IT Y P A R K
L O S A N G E L E S . C A L IF O R N IA 9 0 0 0 7
This dissertation, written by
........................ H o w a r d . L e e ,M y e r h o f f ..........................
under the direction of his.....Dissertation Com
mittee, and approved by all its members, has
been presented to and accepted by the Graduate
School, in partial fulfillment of requirements
for the degree of
D O C T O R OF P H I L O S O P H Y
.......
Date. J . f t n uar y ; ,1. 9 . 6 . 9 .
DISSERTATION COMMITTEE
Chairman
\o '—•— \ v N
■ ■ \ l ) . ( C ^
D E D I C A T I O N
I would like to dedicate this work to my
wife Barbara. Her love and unwavering
support made my years of graduate work, and
this dissertation, a labor of fun as well
as a growth experience.
ii
ACKNOWLEDGMENTS
I would like to thank Dr. Georgene Seward for being
the first to encourage my interest in psychology and my
pursuit of graduate studies.
I would like to thank Dr. Langdon Langstreth, and
Dr. Douglas De Nike, both members of my guidance committee,
for their careful reading of my proposal and their valuable
suggestions for improving the study.
Special thanks are due to Dr. Norman Tiber,
Dr. William Larson, Dr. Alfred Jacobs, and Dr. Milton
Wolpin for critically reading the study and for being much
more than Dissertation Committee members. The genuine
concern and human warmth provided by them was as important
as their sharp thinking in completing the study success
fully. They were human as well as professional models
for me.
iii
TABLE OF CONTENTS
Page
DEDICATION.............................................. ii
ACKNOWLEDGMENTS ......................................... iii
LIST OF T A B L E S ............................................vii
LIST OF FIGURES......................................... ix
Chapter
I . HISTORY OF THE PROBLEM......................... 1
II. THE PROBLEM..................................... 20
General Statement
Pilot Study
Objectives of the Study
Hypotheses
III. METHOD............................................ 3 2
Design
Subjects
General procedure
independent Variables
IV. RES ULTS.......................................... 40
preliminary Analyses
Tests of Hypotheses
V. DISCUSSION........................................ 71
Theoretical Considerations
Methodological Considerations
iv
Chapter Page
VI . SU MMARY......................................... 86
LIST OF REFERENCES..................................... 92
APPENDIXES
A. Fear Survey Schedule.......................... 99
B. Raw Data for pilot Study of Subjective Fear
Reactions to Fearful Scenes presented under
Conditions of Muscular Tension (T) and No
Muscular Tension (N) 100
C. Description of Research Read to potential
Student volunteers ............................ 103
D. instructions to E-2 for Conducting the
Pre-Treatment criterion Tests A and B . . . • 105
E. Modified Avoidance Scale ..................... Ill
F- Subjective Fear Scale.............................112
G. judgments by 5 Judges as to Whether a Given
Scene presentation Was Administered to an S
from the T or the N Group........................113
H. instructions to judges for Evaluating Scene
presentations for B i a s ..........................115
I. Fear Scenes Read to Subjects in the
Experimental Groups ............................ 117
j. procedure for Administration of Experimental
Treatments........................................119
K. Schedule for Obtaining Tension in the
Tension Group ................................... 121
v
Page
APPENDIXES— Contd.
L. judgments by 7 Judges as to Whether a Given S
Was in an E Group or in the C Group............122
M. instructions to judges Evaluating for Bias
in Post-Treatment Criterion Testing ......... 124
N. instructions to E-2 in Conducting the post-
Treatment Criterion, First Test X then Test
Y ................................................... 128
O. personality, pre-Treatment, and Post-
Treatment Test D a t a.............................. 131
p. Tables of Analyses of Personality Data . . . 134
LIST OF TABLES
Table Page
1. Summary of Pilot Study Data Comparing Fear
while Visualizing Scenes under Conditions
of Muscular Tension (T) and no Muscular
Tension (N) 26
2. Mean Scores on the EPI-Extraversion (EPI-E),
the EPI-Neuroticism (EPI-N), the Taylor
Manifest Anxiety Scale (TMAS), the Fear
Survey Schedule (FSS) , and A g e .............. 41
3. pre-Treatment Avoidance Score Means and
Standard Deviations for N, T, and C Groups
on Tests A and B ............................. 43
4. Summary of Analysis of Variance for Test A and
Test B Avoidance Scores for All Three
Groups......................................... 45
5. Sign Test for Number of Ss in Each Group
Changing Their SF Ratings from Test A to
Test B ......................................... 46
6. Means and Standard Deviations for Subjective
Fear at Test B for All Three Groups .... 48
7. Summary of Analysis of variance for Subjective
Fear Scores in Test B for All Three
Groups......................................... 49
8. Mean SF Scores for the N and T Groups for the
First Scene presentation O n l y ............... 50
vii
Table Page
9. Summary of Analysis of variance of the SF
Scores for the Scene presentations, by
Group (N and T) and by 6 Blocks of 5
Trials each B l o c k ........................... 52
10. Mean SF Scores for the N and T Groups for the
First Block of Five Scenes..................... 55
11. Summary of Analysis of Variance for SF Scores
at Test B and Test X for All Three
Groups......................................... 57
12. Subjective Fear Means for Each Group, for
Test B and Text X ........................... 58
13. Summary of Analysis of variance of SF Change
Scores from Test B to Test X ................ 60
14. Comparison of Mean SF Change Scores for
Groups N, T, and C ............................ 61
15. t-Tests for Differences between the Mean
SF Scores at Test X for All Three Groups . . 63
16. Summary of Analysis of variance for Avoidance
Scores at Pre-Treatment Test B and at
Post-Treatment Test Y, for All Three Groups 66
17. Avoidance Score Means for Each Group for
Test B and Test Y ........................... 67
18. t-Tests for Differences between the Mean
Avoidance Scores at Test Y, for All
Three Groups.................................. 69
viii
LIST OF FIGURES
Figure page
1. Mean Subjective Fear Ratings for 6 Groups
of 5 Trials Each Group, separately for
the N and the T Groups....................... 54
2. Mean SF Scores for Each Trial, by Group . . . 64
3. Mean Avoidance Scores for Each Trial,
by Group........................................ 68
ix
CHAPTER I
HISTORY OF THE PROBLEM
Joseph Wolpe's Reciprocal Inhibition is a major
recent development in psychotherapy. Wolpe presented his
theory of the development and maintenance of neurotic beha
vior and a theory for its treatment in a series of articles
(1952, 1958, 1960). Wolpe characterizes his theory as being
diametrically opposed to the "disease model" (or models),
which conceptualize neurotic behavior as a symptom of an
underlying conflict ("disease”). proponents of the disease
model maintain that if a symptom is modified or removed
without treating the underlying disease process (the con
flict) the symptom will reappear. According to Wolpe, a
neurosis is a learned pattern of behavior, and its unlearn
ing is the cure for the neurosis. "Neurotic behavior is any
persistent habit of unadaptive behavior acquired by learning
in a physiologically normal organism" (Wolpe, 1958, p. 32).
Wolpe's theory of therapy, as he presents it, stems
1
2
directly from his theory of the nature of neurotic behavior,
phobic reactions represent the simplest example of concep
tualizing the neurotic process according to Wolpe, and
phobic symptoms are acquired in the following manner; An
individual encounters a stimulus situation containing some
noxious or aversive element. Neutral stimuli which may be
present acquire, through association, the capacity to elicit
the fear response. These previously neutral stimuli or cues
then become the fear response elicitors, and are called by
Wolpe the Conditioned Fear Stimuli.^ Retreating from the
fear-provoking situation reduces the fear elicited so that
the avoidance behavior is reinforced by the reduction of the
fear. "Reality testing" of the fear situation is unlikely
to occur because approach reactions elicit fear which
triggers the strongly established avoidance response.
The phobic process described by Wolpe is based on
principles derived from studies such as those of Miller
(1948) and Brown and Jacobs (1949). In these studies, fear
(or anxiety) are conceptualized as learned drives, the
" ' ’ Anxiety is defined for the purposes of this study
as the report of subjective fear when there is no objective
evidence of dangerous (painful or damaging) stimuli. Thus,
the report by S that he is experiencing anxiety or fear is
the operation by which anxiety is defined.
3
reduction of which increases the probability of the occur
rence of behavior immediately preceding them. The Brown and
Jacobs study is especially relevant to the Wolpe theory
since they separated quite clearly the reduction in fear
from the reduction in frustration as the effective variable
in reinforcing escape behavior. Wolpe's theory of the
neurosis follows quite closely the two-factor theory of
Mowrer (1960) in which fear is conditioned to previously
neutral stimuli by contiguity of the neutral stimulus with
painful stimuli, and the resulting avoidance behavior is
reinforced by the reduction of fear which follows the
avoidance behavior.
Wolpe, however, derived his treatment from physio
logical theorizing, and from his work with cats (Wolpe,
1952), and from Jones's (1924b) early work with the fear of
small animals in the child Peter. Wolpe reasons that anxiety
and fear are responses which are predominantly mediated by
the sympathetic nervous system. If it were true that it is
impossible to have the simultaneous occurrence of sympathet
ic and parasympathetic responses, then any response which is
predominantly parasympathetic in its function may serve to
reciprocally inhibit the conditioned fear response. Such
reasoning is a plausible explanation of why Peter, in the
4
Jones study, lost his fear of rabbits; the parasympatheti-
cally mediated eating response was occurring at greater
response strength than the sympathetically mediated fear
response. The fear response was therefore prevented from
occurring, and the rabbit gradually came to elicit the same
generally positive feelings in Peter which eating previously
evoked.
Wolpe uses several different supposedly parasympa
thetic responses in his work, including eating, sexual re
sponses, assertive responses, and relaxation. With regard
to relaxation and tension, Wolpe theorizes that fear or
anxiety is always accompanied by a state of tension in the
skeletal muscles. Fear is thought by him to be impossible
while the body is in a state of complete skeletal-muscle
relaxation. As Lazarus and Rachman (1957) put it, "it is
therefore to be taken as axiomatic that relaxation inhibits
anxiety; their concurrent expression is physiologically im
possible" (see Eysenck, 1960, p. 82). Wolpe argues that
since relaxation is a response which is incompatible with
the response of fear, conditioning the response of relaxa
tion (at high levels of response strength) to the anxiety-
arousing stimulus situation (presented at low but increasing
5
intensities) would automatically preclude the fear
2
response. in other words, the conditioned response of re
laxation would "reciprocally inhibit" the reaction of fear
or anxiety.
The treatment referred to as Reciprocal inhibition
consists of instructing the completely relaxed patient to
imagine scenes of fear-arousing situations (which had been
previously obtained from him), arranged in rank order from
most to least fear arousing (called the "fear hierarchy").
The least fearful items on the hierarchy are presented
first, and the later items presented only after the patient
can visualize earlier items without experiencing any anxiety
while he visualizes them. imaginary scenes are presented be
cause of the practical difficulty of simulating the actual
conditioned fear stimulus for most adult fears. A more
theoretically relevant reason for using visualizations is
that the imagined fearful situation presumably elicits a
less intense fear response than the actual or real situa
tion. Very briefly, the Reciprocal inhibition treatment
consists of the following steps;
2
This is Hullran in that the response strength (sEr)
is a function of drive strength, times habit strength
(D x sHr). D is a function of stimulus intensity.
1. Initial interviews to determine the anxiety-
evoking stimulus situations.
2. Training in muscle relaxation (sometimes, but
not necessarily using hypnosis).
3. Construction of a hierarchy of situations from
most to least anxiety arousing, called the
"hierarchy."
4. Presentations of the scenes of the situations in
the hierarchy to the imagination of the com
pletely relaxed patient, starting with the
least anxiety-arousing, and continuing until the
most anxiety-arousing can be visualized by the
patient without his experiencing any reportable
anxiety.
The ability to visualize the most anxiety-arousing scene
with no anxiety generalizes to the real life situations in
a predictable, lawful way (Wolpe, 1960, 1963).
Reciprocal inhibition techniques have been applied
to a large and growing variety of reactions other than
simple phobias. Brady (1966) has used the technique in the
successful treatment of chronic long standing frigidity in
women. Wolpe (1964) has used it in a variety of cases of
"complex" neurosis. Wolpe defined as complex, cases for
which multiple hierarchies had to be constructed, including
cases which were diagnosed as "pervasive anxiety," "free-
floating anxiety," "obsessional states," and other complex
conditions. Lazarus (1963a) also used Reciprocal inhibition
in the treatment of chronic frigidity, but did not use drugs
to increase relaxation, the way Brady (1966) did. Lazarus
in 1961 used the technique in the group treatment of fear of
public speaking, and Geer and Katkin in 1966 used a modifica
tion of Reciprocal Inhibition in a case of insomnia.
A casual statement made by Wolpe in his 1958 book
cautions practitioners and experimenters using Reciprocal
Inhibition against permitting the patient to experience
any anxiety during the presentation of scenes for desensi
tizing .
A stimulus (a scene) that is too strong may actually
increase sensititivity^ and, especially during early
experiments with the method I have occasionally
produced major setbacks in patients by premature
presentation to them of stimuli with high anxiety
potential. (p. 140)
Systematic evidence for Wolpe1s observation is nowhere
elaborated. Yet adherence to the use of a graduated hier
archy of items as well as the emphasis on the maintenance of
^increased sensitivity is defined as an increase in
the strength of the anxiety response to a given scene in the
hierarchy.
8
relaxation is based primarily on reference to the above and
other supposedly theoretical statements made by wolpe.
in other patients there is a perseveration of anxiety,
so that the anxiety produced by a second presentation
summates with that from the first, the repetition
tending thus to have a sensitizing effect rather than
a therapeutic one. (p. 141)
When sensitivity is increased as a result of an
error of this kind (too rapid introduction of a high
anxiety potential scene) . . . scenes are introduced
very cautiously from far down in the hierarchy whose
subject matter produced the setback. (p. 141, foot
note)
It may be inferred from the above statements that the re
sponse strength of relaxation must be raised sufficiently
to overcome (inhibit) the conditioned fear response. A re
cent article by Lazarus (1964) reiterates the same principle
by designating "crucial procedural factors" in Reciprocal
inhibition as the prevention of undue anxiety.
It is actually advisable to conclude by presenting
several neutral scenes in order to prevent the desen
sitization process per se from assuming anxiety-
generating properties. The hierarchy can then be
"diluted" so that desensitization can recommence
at a less noxious starting point. (p. 68, emphasis
added)
An interesting historical note is found in Jones's (1924a)
article on the elimination of childhood fears. Jones, in
stressing the caution needed in their method of treatment
(which would be called by Wolpe’s group "in vivo"
9
deconditioning), says that "a careless manipulator could
readily produce the reverse result, attaching a fear reac
tion to the sight of food" (p. 389).
Without supporting evidence, the position that re
laxation is essential during Reciprocal Inhibition, and that
damage (i.e., increased sensitization) results if relaxation
is allowed to be dissipated by large "doses" of anxiety
(experienced during the scene presentations) has become part
of the "clinical lore" of behavior therapists who use
Reciprocal Inhibition, as well as researchers in the field.
The theoretical reasoning implied in these admonitions is
that relaxation must be a response which occurs at suffi
cient strength that the lowest scene on the hierarchy will
not elicit reportable anxiety.
Bugelski’s 1956 review of the literature on extinc
tion leads him to a position supporting what was later to
become the cornerstone of Wolpe's theory of treatment.
Bugelski concluded after reviewing the animal literature on
extinction as of 1955, that none of the studies he reviewed
systematically ruled out the possibility that an unobserved
response (i.e., one inhibitory to the response being ex
tinguished) was being learned as extinction was taking
place. The Hilgard and Marquis (1935) study of eyeblink
10
conditioning in dogs, one of the only studies which he re
viewed in which observations were made of other responses
occurring during extinction, showed that the learning curve
for the acquisition of the new response was almost precisely
the reciprocal of the extinction curve for the response
being extinguished. Such evidence to support the proposi
tion that the basis for the disappearance of a response is
the acquisition of a different, incompatible response, also
supports Wolpe's Reciprocal inhibition model.
in this review of the current literature, it would
appear that the issue of the role of relaxation in condi
tioning therapy and the validation of the theory of treat
ment were almost settled. When it is assumed that anxiety
is predominantly sympathetically mediated, and when it is
assumed that any response which is predominantly parasym-
pathetically mediated will be reciprocally inhibitory to the
anxiety response, then it may be predicted that, under re
laxation, the anxiety response will not occur strongly
enough to override the relaxation response which will then
become conditioned to the previously fear-arousing stimuli.
It appears that the treatment stems directly and predictably
from the theory.
Several recently reported studies raise questions
11
regarding the theoretical formulations used by Wolpe in de
riving his therapeutic procedures. An article by Davison
(1965) demonstrated by reference to studies of total curare
paralysis that the subjective experience of fear or anxiety
may be totally independent of skeletal muscular or motor
responses. Davison reports that human subjects have expe
rienced extreme subjective fear when totally paralyzed by
curare. It does not necessarily follow that if anxiety can
occur without muscular tension, relaxation therefore cannot
inhibit anxiety. But the fact that anxiety can occur under
total curare paralysis brings into question the "axiomatic"
relationship between anxiety and relaxation which Lazarus
and Rachman indicated.
Cautela (1966), in treating what appear to be the
most difficult kinds of patients for desensitization
therapy, pervasive anxiety cases, used a variation on
Wolpe's procedure of having the patient signal at the
slightest experience of anxiety during a scene visualiza
tion. Cautela tells his patients to visualize a scene on
the hierarchy, and to signal by raising a finger when it can
be viewed without anxiety. Cautela waits fifteen seconds
before terminating a scene if no signal is forthcoming,
which means that his subjects endure anxiety for fifteen
12
seconds. This fifteen second delay is longer than the usual
length of time Wolpe allows his patients to visualize a
scene, though Wolpe will rarely allow a visualization to
last 15 seconds. Cautela's excellent results raise serious
questions regarding the predicted dire result of allowing
subjects to experience anxiety during treatment. Cooke
(1966) used two treatment groups, one of which received
the usual Reciprocal inhibition treatment. The other group
received Direct Treatment in which the actual fear stimulus
was used rather than the imagined fear stimulus. He found
that there was "much less than complete relaxation" in the
Direct Treatment group, and. much less in that group than in
the imaginal Treatment (Reciprocal Inhibition) group. The
Direct Treatment group also experienced more anxiety than
the imaginal Treatment group. Yet the decrease in subjec
tive fear was greater with the Direct Treatment than with
the Imaginal Treatment.
The procedures used in Reciprocal inhibition involve
extinction in that unwanted behavior (anxiety and avoidance)
is reduced or eliminated. since the Wolpe conceptualization
requires the conditioning of a new response (i.e., relaxa
tion) to replace the anxiety and avoidance, a question has
been raised regarding the relative contribution of
13
extinction and Reciprocal inhibition in Wolpe's method of
reducing the maladaptive behavior. As mentioned above,
Bugelski's 1956 review of the animal literature to that
date revealed no studies which he felt systematically
ruled out Reciprocal Inhibition as the mechanism functioning
in extinction studies. Since Bugelski's review, Lomont in
1965 brought up the question with respect to Wolpe's tech
nique. In this theoretical article, the author indicates
that not much work has been done which unequivocally shows
that Reciprocal Inhibition rather than extinction is the
mechanism responsible for therapeutic changes. Gale,
Sturmfels, and Gale (1966) tried to evaluate the relative
effectiveness of extinction and RI using a conditioned emo
tional response in rats, which they then treated in two
groups, J£i for one group and extinction for the other.
Their results support RI as superior to extinction in elim
inating the conditioned emotional response. However, their
results are highly suspect in that their measure of the
strength of the conditioned emotional response was weight
of boli defecated during nonpunished (extinction) trials.
Their data show that the extinction group defecated more
during the extinction trials than did the RI group. But
the extinction group included one subject which never did
14
completely extinguish* and continued defecating during the
entire extinction process* thereby inflating the cumulative
record for that group.
In a study by Rachman (1965) he evaluated separately
the effects on avoidance behavior and subjective fear of
relaxation alone (R), desensitization without relaxation
(D)* and relaxation and desensitization (Reciprocal inhibi
tion) , R + D. He found no changes occurred in the R group
or the D group which differentiated them from no-treatment
controls. He had only three subjects in each group.
According to Wolpe (1958) and Lazarus (1964) the group (D)
which received the hierarchy without relaxation to inhibit
the anxiety should have gotten worse* and should have expe
rienced an increase in subjective fear to items on the
hierarchy. Rather than getting worse, the subjects in the
D group indicated at the post-treatment test a consistent
though nonsignificant decrease in subjective fear. In
another study* Rachman (1966a) found that RI was superior
to the ”flooding"techniques used by Wolpin and Raines
(1966). Again* the important point in this study was that
contrary to theoretical expectations* "flooding" the
patients (presenting scenes "at the top of the hierarchy")
did not result in increasing sensitivity to the conditioned
15
fear stimulus.
Wolpin and pearsal (1965) obtained dramatic results
with a snake phobic patient by presenting all twenty steps
of the hierarchy in one session after seven sessions of re
laxation training and talk. This patient indeed experienced
several periods of anxiety, and at one point was returned to
two items lower down on the hierarchy during which she had
not indicated anxiety. On this second presentation, she in
dicated much anxiety. A fifteen minute break was taken, and
the hierarchy recommenced, and continued until it was
finished during one session. immediately thereafter the
patient returned to the testing room and picked up and
"fondled" two small snakes which at pre-treatment testing
had caused her considerable anxiety and fear. Wolpin
followed this study by another (Wolpin and Raines, 1966)
in which three groups of two snake-phobic Ss in each group
were used. Group I had a twenty step hierarchy, with no
instructions about relaxation. Group II was also presented
with a twenty step hierarchy, but was instructed to tense
up certain muscles and maintain this tension during the
visualization of the scenes. Group III was presented with
images at the top of the hierarchy, and with no instructions
regarding relaxation or tension. All subjects handled the
16
snakes at the post-treatment testing. All the subjects but
one handled the snake at six-week follow up. Wolpin and
Raines utilized the early portion of each session to talk
with Ss about personal problems. Since five of the six Ss
were patients, this kind of personal talk is a possible
source of improvement in all groups. But since the number
of treatment sessions (four) was small and different experi
menters conducted the treatment and the criterion testing,
it hardly seems possible that either suggestion, "trust in
the therapist," "Hello-goodbye" or "halo" effects alone were
responsible. Lazarus (1961) and Paul and Shannon (1966)
have used control groups receiving personal attention of
various kinds and no improvement has been found in these
groups.
Stampfl (1961), Stampfl and Levis (1965) and Hogan
(1966) have devised and studied "implosive therapy," which
Stampfl calls "a learning theory derived, psychodynamic
therapeutic technique." A prime prerequisite of implosion
is that the patient be able to experience anxiety during the
presentation to his imagination of violent elaborations of
scenes which for Wolpe and his followers would be far
above the "top of the hierarchy." The therapist in fact
gauges which parts of the scene cause visible increases in
17
anxiety manifestations, and elaborates on those which
appear to cause the maximum of anxiety. Hogan, in a theo
retical paper (1966) in which he presents several case his
tories, and Stampfl (1965) and Stampfl and Levis (1965),
elaborate a theory of neurosis strikingly similar to that
evolved by Wolpe. Neurotic behaviors are learned responses
4
to the internal, response produced stimulus cue of anxiety
which is aroused in a dynamically significant situation.
The response is neurotic because there is no longer objec
tive possibility of experiencing punishment or pain. The
implosive technique derives from classical extinction in
which the conditioned stimulus (or the acquired drive stim
ulus) is presented repeatedly without being followed by the
originally feared punishing or painful consequences, while
the patient is forced to experience both the conditioned
stimulus and the conditioned fear response (anxiety) fully.
Due to the reinforcement history of the patient, this may
take a long time, and so Stampfl and Hogan present their
scenes for twenty minutes or more, with the requirement that
anxiety must be experienced at maximum strength during scene
4
This aspect of Stampf1's theorizing seems to use
Guthrie's concept of response-produced cues more than
Wolpe's theorizing. Nonetheless, Stampfl's view of the
genesis of neurotic behavior is essentially the same two-
factor theory used by Wolpe.
presentations in order for it to extinguish when there is
no "primary reinforcement" forthcoming (i.e., no pain or
objective danger). The results which the implosive thera
pists report is impressive. Kirchner and Hogan in 1966 de
monstrated the independence of the technique from any
therapist variable through the use of a tape recorded pre
sentation of the implosion scene. Since the subjects were
student volunteers, the more private and "objectionable"
(i.e., the dynamically derived) material had to be deleted
from the implosive scenes. The authors found that the group
receiving recorded implosion scenes showed significantly
greater reduction in avoidance behavior and fear ratings (at
post-treatment criterion testing) than did the control group
which listened to recorded music and were instructed to
allow their imaginations to roam freely. Eleven of the six
teen experimental subjects indicated that the tapes were
"extremely effective in eliciting anxiety" (p. 104). The
study was designed to eliminate "therapist" effects by hav
ing the implosion scenes taped. For Wolpe, there are more
difficulties presented by Stampfl and his students. Lomont
(1965) comes to the conclusion that classical extinction
rather than reciprocal inhibition is the explanatory concept
most adequately accounting for the Wolpe results.
19
in the studies by Stampfl and his group, it is most
difficult to see what it might be (from Wolpe's viewpoint)
which is reciprocally inhibiting the anxiety response of
the patient. It is obvious that anxiety is being increased.
The implosive therapists are getting results which support
their theory of neurosis from a treatment which is supposed
ly derived from their theory of neurosis. The fact that
beneficial results occur with two opposing treatments
derived from the same theory is not new in the history of
psychotherapy. However, the claims made by both groups to
a scientifically derived treatment may be somewhat more
wishful than factual.
CHAPTER II
THE PROBLEM
General Statement
No one has systematically studied exactly what does
happen to the subjective experience of fear when an individ
ual subject is told to visualize a feared item under a
variety of conditions. The theoretical derivation of Ri
would be strengthened if it could be demonstrated that an
anxiety-facilitating response occurring during scene
visualization resulted in an increase of fear and avoidance
behavior. Wolpe's position would be weakened and alterna
tives must be sought if improvement of phobic behavior
occurred after Ss visualized scenes while performing a re
sponse which is not inhibitory to anxiety.
There are some theoretical and empirical reasons to
support the idea that muscular tension might be such an
anxiety-facilitating response. Wolpe (1958) points out
that muscular tension always accompanies fear and anxiety.
20
21
Davison (1965) has seriously questioned this conclusion.
Even if Wolpe were right, the reverse is not necessarily
true that anxiety and fear always accompany muscular ten
sion. But it seems likely, if tension and anxiety co-occur
as ubiquitously as Wolpe claims, that anxiety would become
a response cord itioned to the stimuli produced by muscular
tension, especially among those in whom there is likely to
be a high frequency of contiguous cocurrences of tension and
anxiety, such as neurotic individuals.
Gellhorn and Loofbourow (1963) find physiological
evidence that there is a feedback system between the skele
tal musculature and the reticular activating system.
Afferent impulses (from reacting muscles) serve as
a positive feedback, augmenting the reticular activ
ity which was responsible for initiating the activity
in the first place. (p. 267)
These authors also cite research studies using dogs which
show that if the brain stem is cut just below the medulla
oblongata, the cortex shows asynchronized EEG potentials
indicating a state of alertness. This state is not markedly
altered even though,the visual, auditory, vestibular, vagal,
and olfactory impulses are eliminated by section. If the
fifth nerve (which carries proprioceptive impulses) is cut
bilaterally, cortical synchrony of EEG potentials results,
22
a state that is interpreted by the authors as being quite
similar to that obtained during sleep, the most complete
relaxation.
In one study Wolpin (1966a) gathered direct evidence
which strongly supports the conclusion that muscular tension
in human Ss increases the anxiety which is experienced while
imagining a scene. Wolpin presented eight scenes to the
imagination of thirty-six nonphobic volunteer subjects under
all three of the experimental conditions, relaxation, normal
state, and muscular tension, counterbalancing the order of
presentation. The Ss then rated the scenes on a series of
dimensions, one of which was fear, defined by the response
to the item "How frightening was the scene?" Responses to
the question were rated from 0 (not frightening) to 7
(maximum fear) by the S. It was found that fear was sig
nificantly greater (p = .01) under tension than under re
laxation, and significantly greater (p = .05) under tension
than under natural conditions. The generality of the find
ings is increased because the scenes used by Wolpin in this
study were not derived from fears of the subjects. However,
the findings may not be strictly applicable to scenes which
would be derived from actual fears reported by Ss, the case
in the clinical application of Rl.
23
Pilot Study
A pilot study was conducted by the author in order
to determine whether Ss instructed to imagine fear scenes
derived from their own reported fears would report more
subjective fear when in a state of muscular tension than
they would when not so instructed. Eleven Ss were selected
from among a group of psychiatric aides in a state hospital
who had indicated fear of both spiders and snakes. The
instrument used was a Fear Survey Schedule (FSS) modified
from one used and validated by Lanyon and Manosevitz (1966),
which had been earlier developed by Geer (1965). The
modified FSS is shown in Appendix A. Ss who checked MUCH
or VERY MUCH fear of both snakes and spiders were selected.
Scenes describing proximity to snakes and spiders were
written out and then read verbatim to Ss, controlling for
order of presentation. The scenes were read to Ss in the
context of no instructions about body states and with Ss
instructed to maintain a state of muscular tension. in the
tension condition, Ss were instructed to tense up specific
muscle groups which were highly visible to E during the
trials. The muscle groups followed wolpin's (1966a) pro
cedure of having Ss clench fists, lift toes but not heels
24
in the air, beetle the brows, clench the teeth, and squeeze
eyes shut. Each scene was presented for 35 seconds (mean
time = 35 seconds, range from 30 to 40 seconds). Each S was
asked how vivid and clear the scene was following the pre
sentation. All scenes were reported quite clear and vivid.
The Ss were then required to rate the amount of fear they
had experienced immediately following each presentation.
The two fear scenes for each fear were presented in
counterbalanced order for the first six Ss. That is, each S
received one scene first under one condition, followed by
the same scene under the other condition. Then for the
second fear, the conditions of presentation were reversed.
The scale for subjective fear ranged from 0 (absence of
fear), to 20 (maximum fear), and the data resulting from this
study are presented in Appendix B. The data were analyzed
using the Wilcoxon Matched-pairs Signed Ranks Test (Siegel,
1955),and are summarized in Table 1. The amount of fear re
ported by the first six Ss was not significantly related to
the order of presentation. Comparing the order of presenta
tion to these Ss of only the first of the two fear scenes,
the resulting T is +10, which with N = 6 is not significant.
The next five Ss were presented the scenes in fixed order,
first the N condition, then the T condition. Comparing all
25
eleven Ss on the first vs. the second presentation of the
first fear scene only yielded a T of +31.5. For N = 11,
this is not significant. Therefore, there was no signifi
cant difference between the first and the second presenta
tion of one fear scene; order of presentation does not make
a difference in the degree of fear reported. The second
fear of each S was analyzed the same way. Presentation 1
vs. presentation 2 of this second fear yielded a T of +33,
which for N = 11 is not significant. That means that for
the second fear, that order of presentation does not result
in significant differences in fear. Using again only the
first of the fear scenes presented to Ss, the amount of fear
under the two conditions, natural and tension were compared,
and this comparison yielded a T of -12. For N = 11, this is
significant at less than the .05 level. The second fear
scene of each S was analyzed the same way, comparing the two
conditions. This yielded a T of -11, which for N = 11 is
significant at less than the .025 level. This means that for
both of the fear scenes, fear was significantly greater
under conditions of tension than the same scenes were under
natural conditions. Therefore it may be safely concluded on
the basis of this pilot data, supported by the data of
Wolpin (1966a), that there is more subjective fear reported
TABLE 1
SUMMARY OF PILOT STUDY DATA COMPARING FEAR WHILE VISUALIZING SCENES UNDER
CONDITIONS OF MUSCULAR TENSION (T) AND NO MUSCULAR TENSION (N)
Wilcoxon Matched-Pairs signed Ranks Test
Comparisons
r T N p
presentation 1 vs. 2 for fear scene
(first 6 subjects only)
1
+10 6 NS
Presentation 1 vs. 2 for fear scene
(all Ss)
1
+ 31.5 11 NS
Presentation 1 vs. 2 for fear scene
(all ss)
2
±33 11 NS
Condition T vs. N for fear scene 1
(all Ss) -12 11
a
.05, one tailed
Condition T vs. N for fear scene 2
(all Ss) -11 11 .025, one taileda
Both of these comparisons are in the predicted direction, with the T scenes
resulting in more fear than the N scenes.
to
cn
27
when scenes are visualized under conditions of muscular
tension than there is under conditions in which no muscular
tension is induced.
Earlier it was pointed out that Wolpe derived his
notion that relaxation, assertion, sex and eating were
responses which would reciprocally inhibit anxiety due to
their supposed parasympathetic mediation. However, in his
1958 book, Wolpe states:
But it would be a mistake to assume that unless an
emotional response constellation manifests parasym
pathetic dominance it is incapable of inhibiting
anxiety. Just as, in the motor sphere, to walk and
to jump are mutually antagonistic, although they
may utilize many muscle elements in common, an emo
tional response that utilizes many elements in
common with anxiety may be antagonistic to the
total anxiety response. (p. 73)
The reasoning by analogy leads Wolpe into more difficulty,
in a recent (1966) personal communication with him he indi
cated that even muscular tension, which as Gellhorn and
Loofbourow indicate is sympathetically discharged, could
be inhibitory to anxiety. Such confusion of positions can
only be clarified by finding out exactly what the effect of
tension is during the presentation of fear-arousing scenes
to subjects.
28
Objectives of the Study
The study to be reported intends to mount an attack
on the question of how muscular tension affects the subjec
tive fear associated with visualizing fearful scenes, the
avoidance of feared stimulus objects, and the subjective
fear reactions to those objects. According to the theoreti
cal position of Wolpe, supported by the work of Gellhorn
and Loofbourow, the response-competition model of Rl leads
to the expectation of an increase in subjective fear for
subjects experiencing muscular tension during the visualiza
tion of fear-arousing scenes. Subjects experiencing muscu
lar tension should report an increase in anxiety during
treatment and should therefore experience an increase in
avoidance behavior at post-treatment tests since the avoid
ance behavior is motivated by the level of anxiety according
to Wolpe. In addition, such sensitization should lead to
increases in subjective fear responses to the feared stim
ulus at post-treatment over pre-treatment tests.
According to the position taken by Wolpin and
Raines (1966) and Wolpin and Pearsal (1965), Ss in whom
tension has been induced should not differ from Ss in whom
tension has not been induced in subjective fear of the
29
stimulus or in avoidance behavior after the treatment.
Their theoretical position would agree with Wolpe in pre
dicting an increase in subjective fear during the visualiza
tion of fear scenes under conditions of muscular tension.
If Davison's (1965) work has applicability to the present
study* then it might be predicted from his position that
since there is no definite relationship between anxiety and
muscular tension* there should be no difference between
those subjects visualizing scenes under tension and those
visualizing scenes without tension. Bugelski's (1956)
position of RI being behind every extinction process would
predict that any activity* even tensing of the muscles*
could reciprocally inhibit anxiety. Bugelski's position
would not only predict a more rapid decrease in anxiety
during the visualization of the scenes* but would also lead
to the conclusion that since anxiety motivates the avoidance
behavior, there would be less tendency for the group receiv
ing the scenes under tension to avoid the feared stimulus
after the treatment.
Hypotheses
The hypotheses derive from the Reciprocal Inhibition
treatment model of Wolpe. Since the inhibition of anxiety
30
responses by classes of responses incompatible with anxiety
is the purported agent which causes the dissipation of the
anxiety; and since the avoidance response is motivated by
the anxiety; and since the visualization of anxiety-
arousing scenes while in a state of muscular tension has
been demonstrated to increase rather than inhibit the
intensity of anxiety responses; then it should follow that
anxiety and avoidance responses will not be dissipated (and
may be increased) by a series of trials in which Ss in a
state of muscular tension imagine themselves approaching
feared objects, and it should also follow that both anxiety
and avoidance will remain at a higher level than in Ss in
whom muscular tension, and therefore anxiety, has not been
thus increased.
Therefore it is predicted that:
1. Ss visualizing feared scenes under conditions
of induced muscular tension (T condition) will
report more subjective fear during those visual
izations than Ss visualizing the scenes without
muscular tension (N condition).
2. Ss visualizing feared scenes under the T condi
tion will become more "sensitized" to the
scenes than Ss in the N condition, and will
therefore report more increase in subjective
fear from the first to the last of the series
of such visualizations than Ss in the N
condition.
Both groups visualizing feared scenes will re
port more subjective fear to the actual feared
stimulus on post-treatment than on pre-treatment
tests, the T group more than the N group.
The group visualizing feared scenes under the
T condition will report more subjective fear at
the post-treatment test than the group visualiz
ing the scenes under the N condition.
Both groups visualizing feared scenes will in
crease in avoidance behavior when the actual
feared stimulus is presented to them at post
treatment as compared with pre-treatment tests,
the T group more than the N group.
The group visualizing feared scenes under T
conditions will avoid the feared object more at
post-treatment than will the group visualizing
feared scenes under the N condition.
CHAPTER III
METHOD
Design
Twenty-five Ss were assigned to each of the three
groups. One group was a no-treatment control (C) which re
ceived all the pre-treatment and post-treatment tests just
as the two experimental groups, but without the experimental
treatment. The experimental groups both received ten visu
alizations per session for three sessions. The standardized
scenes were presented for visualization by being read to
them by the experimenter. The T group received their scenes
while in a state of induced muscular tension, and the N
group received their scenes without such instructions. Ex
pectations of the subjects were controlled for by not tell
ing any S into which group he had been put, all believing
they were in a treatment group, even the controls. All Ss
received the pre- and post-treatment tests, and the experi
mental Ss gave subjective fear estimates following each
32
33
scene.
Subjects
Seventy-five students enrolled in introductory
psychology classes who had fears of small animals such as
rats, mice, snakes, and spiders, were recruited as Ss. The
students were drawn from a pool of volunteers in the Experi
mental Participation program which was part of a course re
quirement. Subjects were read the statement appearing in
Appendix C, and then administered the Fear Survey Schedule
(FSS) which appears in Appendix A. Ss reporting MUCH or
VERY MUCH fear of rats, mice, snakes or spiders on the FSS
were asked to volunteer as Ss. pilot work reported earlier
indicated that a high proportion of such Ss have a marked
avoidance to the animals.
The 75 individuals who became Ss were the result of
criterion testing of 84 original volunteers. Of the 9 Ss
dropped, 6 were dropped because they picked up the animal
during criterion testing (pre-treatment testing) in spite
of having indicated fear of the animal. They said such
things as "I did not know that you meant harmless," or
"Since he was in a cage and could not jump out, I decided to
try to handle him." Three other Ss were lost because they
34
changed more than two avoidance score points from the first
to the second pre-treatment testing, which was defined in
advance as representing a significant decrease in avoidance
behavior due simply to the testing procedure. These three
Ss changed from avoidance scores 6 to 2, 5 to 2 , and 7 to 4
on the first and second pre-treatment testing respectively.
General procedure
All Ss who volunteered were met individually by the
author (E-l), who then asked them to step into a room with
E-2, an assistant who prepared and carried out all the tests
conducted in the study, in accordance with the excellent
suggestions made by Breger and McGaugh (1965). Ss were re
assured that they could leave any time they wished without
penalty, and would not have to do anything they did not want
to do or could not do. S was asked by E-2 to approach the
feared animal which was exhibited, moving in a glass-fronted
cage. E-2 was instructed to see to it that, in every test,
the animal was moving. Pilot tests revealed that movement
of feared animals increased fear. The procedure used by
E-2 is shown in Appendix D, and he read these instructions
verbatim. When S would go no closer, he was assigned the
appropriate Avoidance Score (AS) and asked to step back and
35
make a rating of his fear at the closest approach point.
The AS was assigned according to the scale shown in Appendix
E, and is a modification of that used by Lang and Lazovik
(1963).
After the first AS was assigned (test A) each S was
asked to go over the Subjective Fear Scale with E-2. He ex
plained that the amount of Subjective Fear (SF) they had at
the point where they would go no closer would automatically
be set at the middle of the SF scale, which is shown in
Appendix F. This means that for all Ss, the amount of Sub
jective Fear they had at test A was 16, no matter what their
AS was at test A. immediately following test A, the proce
dure was repeated, but this time after the appropriate AS
was assigned, Ss were asked to judge whether the fear they
had at that closest point was the same, more, or less than
they had at test A. This was the Subjective Fear for test
B. If S did not pick up the animal on either test A or
test B, and did not change more than 2 AS units from A to
B, he was asked to fill out the Eysenck Personality
Inventory (EPI), and the Taylor Manifest Anxiety Scale
(TMAS). After the scoring of the EPI, Ss were assigned to
one of the three groups by use of a table of random numbers.
Ss assigned to the control group were asked to
36
return in two days making their testing schedule consistent
with the two experimental groups. All Ss had pre-treatment
testing, one day between, then post-treatment testing. The
control group received no treatment, but were not informed
that they were control subjects. The two experimental
groups received the treatment of visualizing themselves
approaching and handling the feared animal. They were pre
sented with the same scene to visualize ten times in succes
sion during each of three treatment sessions for a total of
thirty scene visualizations. The sessions were held on
successive days with the first session on the same day as
and following the pre-treatment testing; the last session
was on the same day as and preceded the post-treatment
testing.
Each visualization lasted approximately 60 seconds.
The mean time per scene reading was 60 seconds, but the
timing ranged from 55 to 65 seconds, with no scene lasting
less than 55 seconds and no scene taking longer than 65
seconds. The scenes were read verbatim to the subjects in
a soundproof room, from typed scenes which were appropriate
to the particular fear of a given S.^ Appendix I shows the
The scenes were read to Ss in both groups by the
author. To insure uniformity of presentation, tapes were
37
scenes as the E-l read them to each S. Each S made a rating
of the subjective fear he felt during the most frightening
part of the visualization, after each presentation. This
was done by comparing the amount of fear the S felt during
the current visualization with the amount of fear experi
enced during the prior one, and with the amount of fear ex
perienced during test B of the pre-treatment testing. At
the start of the first experimental session, each S was read
the instructions appearing in Appendix J, which gave experi
mental Ss some practice in imagining a nearly neutral scene
(coming into the building and up to the experimental room)
and instructions about the new use of the same Subjective
Fear Scale which they used during the pre-treatment testing.
Another purpose served by these instructions was to control
for the expectations of Ss. They were told that E did not
know what would happen to their subjective fear experiences,
and that one theory predicted that it would increase, one
theory predicted that it would decrease, and a third theory
predicted that it might either fluctuate or remain the same.
made of the presentations to the first 6 Ss in the T and the
first 6 Ss in the N group, and submitted to judges to deter
mine if any bias could be detected. The results are pre
sented in Appendix G, and indicate that no judge could de
tect to which group an S belonged. The instructions to the
judges appear in Appendix H.
38
Independent Variables
While the N group was given no instructions or sug
gestions concerning their response or their bodily state,
the T group was given instructions in tensing certain muscle
groups which were found by Wolpin and Raines (1966) to be
easily and reliably observed, easy to tense, and to result
in differences in response to non-fearful scenes (Wolpin,
1966a). The instructions given for the induction of
muscle tension, which are shown in Appendix K, included in
structions for maintaining the tension after the scene has
been completed and the eyes opened. This insured that
muscle relaxation following the completion of the scene did
not become contiguous with the cessation of the scene. It
was felt that this could be a source of possible confounding
of the results by conditioning the response of relaxation to
the cues of cessation of the scenes which inescapably accom
pany the opening of the eyes. Ss were instructed to assume
muscle tension immediately preceding the presentation of the
scene, and only had to be told once to "tense up" after the
initial instructions. For each of the thirty visualiza
tions, the T subjects were reminded to hold the tension for
at least five seconds after their eyes were opened until E
39
told them to relax.
After the third session of ten visualizations, Ss
were asked again to go to the testing room where E-2 admin-
2
istered the two post-treatment tests, X and Y. Test X was
to measure changes in SF scores at the point at which S re
fused to approach the fear stimulus any closer at test B.
Test Y was to determine any changes in AS from test B, and
S was asked to approach again, as closely as possible to the
feared stimulus, yielding an AS score and a SF score. The
instructions which E-2 read verbatim to Ss for post
treatment tests X and Y appear in Appendix N.
2
Due to an oversight in the carrying out of the
methodology, the data sheets of the C group differed from
the data sheets of the two experimental groups (which were
identical). Therefore, the taped post-testing of 17 Ss were
submitted to 7 judges in an effort to detect any bias in the
administration of the post-treatment tests. None of the
judges could detect differences in the treatment of the con
trol group. The data for this are presented in Appendix L
and the instructions to the judges in Appendix M.
CHAPTER IV
RESULTS
preliminary Analyses
Personality variables
A preliminary analysis of selected data was per
formed to insure that there were no initial personality
differences between the three groups which might account
for or affect differences after treatment. The raw data
for the three groups on the criterion testing, both pre-
and post-treatment, and control measures is presented in
Appendix O. Table 2 presents a summary of the personality
data for the three groups. The analyses performed to obtain
the reported F-ratios are presented in Appendix P. Also
presented in that appendix is the distribution of sex by
groups which yielded a nonsignificant chi-square of 0.088.
It may be seen that the groups did not differ significantly
on any of the personality measures. Nor did the total
sample (N = 75) differ significantly from norm groups on
40
TABLE 2
MEAN SCORES ON THE EPI-EXTRAVERSION (EPI-E), THE EPI-NEUROTICISM (EPI-N),
THE TAYLOR MANIFEST ANXIETY SCALE (TMAS), THE FEAR SURVEY SCHEDULE {FSS), AND AGE
Measure
Natural
Group
Tension Control
F-Ratio
P
EPI-E 14.0 12.6 13. 3 0.792 NS
EPI-N 10.5 11.3 9.4 1.214 NS
TMAS 17.9 16.1 19.1 0.736 NS
FSS 38.1 37.8 36.2 0.421 NS
Age 19.0 18.4 18.8 1.659 NS
42
the EPI-E or the EPI-N scales. These data are also pre
sented in Appendix P. The t-test for the difference between
the sample and the norm group on the EPI-E scale was 0.152.
For the difference between the sample and the norm group on
the EPI-N scale, t was 1.603, and neither of these is sig
nificant. Therefore, the sample was not significantly dif
ferent from the population of American College under
graduates comprising the norm group for the EPI. Thus far
the preliminary analysis has focused on personality vari
ables which might have differentiated the three groups and
affected the outcome measures. The second part of the
preliminary analysis is the presentation of the initial
measures of the dependent variables.
Dependent variables:
Pre-treatment measures
The scores presented in Table 3 represent the means
and standard deviations of Avoidance scores for all three
groups on test A and test B, before treatment. A Type I
Analysis of variance for repeated measures (Lindquist, 1953)
was performed to determine whether there had been a signifi
cant reduction in AS from test A to test B, and whether
there were any differences between the groups in their AS 1s
either on test A or on test B. Table 4 shows the summary of
TABLE 3
PRE-TREATMENT AVOIDANCE SCORE MEANS AND STANDARD DEVIATIONS FOR
N, Tj AND C GROUPS ON TESTS A AND B
Tests
B
Group
M SD M SD
N 4.20 2.02 3.96 2.03
T 4.32 1.93 3.96 1.73
C 3.92 1.98 3.88 1.94
44
that analysis.
The summary of the analysis indicates that F ratio
for the between tests effects is 3.462 and nonsignificant.
The F ratio between groups is 0.107 and also nonsignificant.
The F ratio for the interaction was 1.456, also nonsignif
icant. This shows that the three groups did not differ on
their As's on either test A or test B, and that there was
no significant change for any group from test A to test B.
It was determined that for the most stringent test
of the hypothesis concerning changes in AS from pre- and
post-treatment that the AS's of test B would be used for
the pre-treatment AS measures because of a slight tendency
for the AS's to decrease from test A to test B. All groups
were equated at test A for SF scores by setting all SF at
the midpoint of the SF scale for the amount of fear each S
had at test A when he would not approach the feared animal
any closer.
Since subjective fear was equated for all Ss on
test A, analysis of variance like that performed on the AS's
for test A and B was inappropriate. But a sign test was
employed to determine whether a significant number of Ss re
duced their SF scores on test B from the equated "16" SF
score assigned at test A. These data are shown in Table 5.
TABLE 4
SUMMARY OF ANALYSIS OF VARIANCE FOR TEST A AND TEST B AVOIDANCE SCORES FOR
ALL THREE GROUPS
Source df SS MS F
P
Between subjects 74 535.53 7.236
Between groups 2 2.58 0.790 0.107 NS
Error, between 72 533.95 7.414
Within groups 75 14.25 0.190
Tests 1 0.63 0.630 3.462 NS
Tests, X groups 2 0.53 0.265 1.456 NS
Error, within 72 13.07 0.182
Total 148 549.78
L n
46
TABLE 5
SIGN TEST FOR NUMBER OF SS IN EACH GROUP CHANGING
THEIR SF RATINGS FROM TEST A TO TEST B
a b
Group x N
P
N -7 23 . 047
T -5 21 .013
C -3 21 . 001
Number of Ss showing an increase in SF
N = Number of non-tied comparisons
47
This analysis indicates that for all three groups
there were significant numbers of Ss who changed their SF
ratings from test A to test B. But since Ss were all equat
ed on test A, no parametric test for the significant of the
amount of change in each group could be performed. However,
the SF scores for test B were subjected to analysis of vari
ance to determine if there were any differences between the
groups in SF then. The means and SDs for SF on test B are
presented in Table 6. The summary of the analysis of vari
ance is presented in Table 7. The nonsignificant F ratio
of 0.412 indicates that there was no difference between any
of the three groups in SF scores on test B.
The final pre-treatment measure to be reported is
the comparison of SF scores for the two experimental groups
on the first scene presentation. Table 8 shows that even
though the SF scores for the first scene presentation were
lower for the N than for the T group, the difference was not
significant, with a t equal to 1.471. A one-tailed test was
used because of the prediction resulting from the pilot
data.
48
TABLE 6
MEANS AND STANDARD DEVIATIONS FOR SUBJECTIVE
FOR ALL THREE GROUPS
FEAR AT TEST B
Group M SD
N
T
C
14. 1
14. 9
13. 7
4. 22
3. 11
2. 79
TABLE 7
SUMMARY OF ANALYSIS OF VARIANCE FOR SUBJECTIVE FEAR SCORES IN TEST B
FOR ALL THREE GROUPS
Source df SS MS F
P
Between groups 2 8.88 4.44
Within groups 72 755.84 10.776 0.412 NS
Total 74 784.72
50
TABLE 8
MEAN SF SCORES FOR THE N AND T GROUPS FOR THE
FIRST SCENE PRESENTATION ONLY
Group
N T
t
-p
Mean per S,
1st scene 14.5 17.4 1.471 .05 < p < .10,
one tailed test
51
Tests of Hypotheses
The first hypothesis was that subjects visualizing
feared scenes under conditions of induced muscular tension
(T group) will report more subject fear during these visual
izations than Ss visualizing the scenes without muscular
tension (N group). This hypothesis was tested by the main
Groups effects in the Type I analysis of variance of the SF
scores for the thirty scene presentations. The scores for
SF for the thirty presentations were collapsed into six
scores by summing the SF scores for the first five presenta
tions, for the second five presentations, for the third
five presentations, and so on. For this first hypothesis,
the overall amount of fear was considered. The operation
by which the overall amount of fear during the visualiza
tions is defined is the summing of the SF scores for all
thirty scenes. Table 9 shows the summary of the analysis of
variance for those data. The Between Groups effect is sig
nificant beyond the .025 level with an F ratio of 7.057.
The tension group reports significantly more fear than the
natural group. The mean of the sums of fear ratings for all
thirty trials for the N group was 236.6 and for the T group
it was 370.2. The difference yields a t of 3.075 which is
TABLE 9
SUMMARY OF ANALYSIS OF VARIANCE OF THE SF SCORES FOR THE SCENE PRESENTATIONS,
BY GROUP (N AND T) AND BY 6 BLOCKS OF 5 TRIALS EACH BLOCK
Source df SS MS F
P
Between subjects 49 288,089.8 4,655.1
Between groups 1 36,926.5 36,926.5 7.057 .025
Error, between 48 251,172.3 5,232.8
Within subjects 250 135,907.0
Trials (blocks) 5 18,344.7 3,668.9 12.530 .005
Trials X groups 5 47,288.2 9,457.6 32.301 .005
Error, within 240 70,274.1 292.8
Total 299 364,005.8
< _ n
to
53
significant beyond the .005 level.
The second hypothesis was that subjects visualizing
feared scenes under the T condition will become more "sensi
tized" to the scenes than Ss in the N condition, and will
therefore report more increase in subjective fear from the
first to the last of the series of such visualizations than
Ss in the N condition. The F ratio for the trials by groups
interaction effect (shown in Table 9) is 32.301, and is
well beyond the .005 level. The mean SF score for each
group for each of the six blocks of five trials each is
shown in Figure 1.
We may conclude that Ss visualizing the feared
scenes under the N condition did decrease more in subjective
fear from the first to the last scenes in the series than
did Ss in the T condition. The hypothesis that Ss would
become "sensitized" and show increases in subjective fear
as the treatment progressed was not only not supported by
any increase in SF scores to the series of presentations,
but there was a significant decrease for both groups. Ref
erence to Table 8 shows that for the first scene presenta
tion there was not yet a significant difference between the
groups. Table 10 shows the mean SF scores per subject in
each group for the first block of five trials only.
54
ft
3
O
0
ft
3
O
U
o
5 - 1
CD i — I
ft ( 0
•H
c u
(0 Eh
< D I
2 m
85
80
75
70
65
60
55
50
45
40
35
30
25
20
15
10
5
0
i—I (0
rtj -H
•H U
U Eh
E h I
in
H
,G
O
r t l
G W
f O
0) G
X -H
&
17
16
15
14
13
12
11
10
21-25 26-30 16-20 11-15 6-10 1-5
Session 2 Session 3 Session 1
Six Groups of 5 Trials Each Group
Fig. 1.— Mean Subjective Fear ratings for 6
groups of 5 trials each group, separately for the N and
for the T groups
55
TABLE 10
MEAN SF SCORES FOR THE N AND T GROUPS FOR THE
FIRST BLOCK OF FIVE SCENES
Group
N T
t
P
Mean SF
first
per S,
block 67.5 80.4 3.539 .005, one tailed
The t test for the difference between the means presented is
3.539, which is significant beyond the .005 level, which in
dicates that the difference between the groups in the amount
of fear shown as the presentations progressed already ap
peared in the first block of five presentations. The data
presented in the summary appearing in Table 9 indicates that
for both groups combined, there was a significantly decreas
ing change in SF scores over the six blocks. The F ratio
between groups was 12.530, and was significant beyond the
.005 level. Reference to Figure 1 indicates that both
groups decreased their SF scores over the six blocks.
The third hypothesis was that both groups visualizing
feared scenes will report more subjective fear to the actual
56
feared stimulus on post-treatment than on pre-treatment
tests, the T group more than the N group. This hypothesis
was tested by subjecting the SF scores at test B and at test
X to a Type I analysis of variance. The summary is present
ed in Table 11. The third hypothesis is tested in the
interaction effects between Tests and Groups. Table 13
shows the six mean subjective fear scores which are involved
in the interaction effects presented in Table 11, for which
the F of 18.693 is significant beyond the .005 level. It
may be seen that in both the N and the T groups, there was a
highly significant decrease in the subjective fear reported
when the S is the same distance from the feared stimulus as
he was at test B. The N group mean changed frcp 14.08 at
pre-treatment test B to 7.52 at post-treatment test X yield
ing a t of 4.846 which is significant beyond the .005 level.
For the N group the change was from 14.92 on the pre
treatment test B to 5.62 on post-treatment test X, yielding
a t of 8.760 which is also significant well beyond the .005
level. For the C group the change is from 14.56 to 13.68, a
slight but nonsignificant decrease. Thus, the third hypoth
esis that the group visualizing the feared scenes under the
T condition should show more subjective fear to the actual
feared stimulus on post-treatment than on pre-treatment
TABLE 11
SUMMARY OF ANALYSIS OF VARIANCE FOR
ALL THREE
SF SCORES AT TEST
GROUPS
B AND TEST X FOR
Source df SS MS F p
Between subjects 74 1,645.83 21.957
Between groups 2 433.97 216.98 12.297 .005
Error, between 72 1,211.86 16.831
Within subjects 375 2,479.50
Tests (B and X) 1 1,164.74 1,164.74 96.908 .005
Tests X groups 2 449.34 224.67 18.693 .005
Error, within 72 865.42 12.019
Total 149 4,125.33
ui
'j
TABLE 12
SUBJECTIVE FEAR MEANS FOR EACH GROUP, FOR TEST B AND TEXT X
Group Test B Test X t
P
N 14.08 7.52 4.846 .005
T 14.92 5.62 8.760 .005
C 14. 56 13.68 1.280 NS
in
00
59
tests was not supported. Not only was it not supported,
but the T group showed a greater decrease in SF from test B
to test X than did the N group, contrary to expectations.
The N group changed an average of 5.40 units on the SF
scale, while the T group changed a mean of 9.28 units, and
the C group changed 0.88 units. An analysis of variance
for the change scores was performed, and the summary is
presented in Table 13. The F ratio of 19.342 is significant
well beyond the .005 level, and led to the t tests shown
in Table 14. All groups changed in the direction of less
fear at post- than at pre-treatment testing. it may be
seen from the t tests for the differences between the change
scores of the N and T groups that the t of 1.847 is signif
icant beyond the .05 level in the direction opposite to
that predicted by hypothesis 3.
The fourth hypothesis, that the group visualizing
the feared scenes under the T condition will report more
subjective fear at the post-treatment test than the group
visualizing the scenes under the N condition was tested by
comparing the SF scores for the N and the T groups at test
X. These data were presented in Table 12 which shows that
at test X, the mean SF score for the N group was 7.52. For
the T group the mean SF score at test X was 5.62, and for
TABLE 13
SUMMARY OF ANALYSIS OF VARIANCE OF SF CHANGE SCORES FROM
TEST B TO TEST X
Source df SS MS F
P
Between groups 2 911.04 455.52 19.342 .005
Within groups (error) 72 1,695.68 23.551
Total 74 2,606.72
c r >
o
TABLE 14
COMPARISON OF MEAN SF CHANGE SCORES FOR GROUPS N, T, AND C
Comparison t
P
N vs. T 1.847 .05
N vs. C 4.432 .005
T vs. C 7.126 .005
62
the C group the mean was 13.68. Table 15 shows the t tests
for the differences between these means. The t for the mean
of the N group (7.52) vs. the T group (5.62) is 1.397, which
approaches significance between the .05 and the .10 level of
confidence, but is in the opposite direction to that which
was predicted by the hypothesis. That is, the T group tends
to report less subjective fear when presented with the
feared object after treatment than the N group reports.
Figure 2 shows graphically the course of changes in SF
scores from pre-treatment test A and B to post-treatment
tests X and Y. It may be observed that while both groups
decrease in SF at post-treatment testing, the control group
does not. It may also be seen that although the T group is
a little higher in SF at test B (not a significant differ
ence, see Tables 6 and 7), this group falls lower than the
N group at test x and remains lower at test Y.
The fifth hypothesis, that both groups visualizing
feared scenes will increase in avoidance behavior when the
actual feared stimulus is presented to them at post
treatment tests as compared with pre-treatment tests (the T
group more than the N group), was evaluated by the analysis
of variance summarized in Table 16. The three groups are
compared on test B and test Y for avoidance scores by means
63
TABLE 15
t TESTS FOR DIFFERENCES BETWEEN THE MEAN SF SCORES
AT TEST X FOR ALL THREE GROUPS
Comparison t
P
N vs. T
N vs. C
Tvs. C
1. 397
5 . 176
7 . 864
NS . 05 < p < .10
. 005
. 005
64
Mean
SF
Scores
16
15
14
13
12
11
10
9
8
7
6
5
Y A B X
Pre-Tests Post-Tests
Trials
= Tension O = Natural A = control
Fig. 2.— Mean SF scores for each trial, by group.
All groups automatically equated at SF = 16, trial A.
65
of the Tests by Groups interaction term, which with the
F ratio of 6.163 is significant at the .025 level. Table 17
shows the mean avoidance scores for each group for test B
and test Y. It is clear from these data that the T group
showed a significant decrease rather than the predicted
increase in avoidance behavior from pre- to post-treatment
testing, as did the N group also. The fifth hypothesis of
an increase in avoidance behavior for the T group is not
only supported, but the decrease is highly significant.
Figure 3 shows the course of the avoidance scores for all
three groups. It may be noticed that both the N and T
groups avoid the feared stimulus less after treatment, while
the C group does not.
The sixth hypothesis, that the group visualizing
feared scenes under the T condition will avoid the feared
object more at post-treatment than will the group visualiz
ing feared scenes under the N condition was tested by com
paring the mean avoidance scores for the two groups at test
Y. This is the test in which Ss were urged to approach the
feared stimulus as closely as possible after treatment.
Table 17 shows the avoidance score means for all three
groups at test Y, and Table 18 shows the t tests for differ
ences between each pair of means.
TABLE 16
SUMMARY OF ANALYSIS OF VARIANCE FOR AVOIDANCE SCORES AT
AND AT POST-TREATMENT TEST Y FOR ALL THREE
PRE-TREATMENT
GROUPS
TEST B
Source df SS MS F
P
Between subjects 74 423.64
Between groups 2 9.16 4.58 0.796 NS
Error, between 72 414.18 5.752
Within subjects 75 216.50
Tests (B vs. Y) 1 70.72 70.72 40.926 .005
Tests X groups 2 10.65 6.163 .025
Error, within 72 124.48 1.728
Total 149 640.14
cn
C T i
TABLE 17
AVOIDANCE SCORE MEANS FOR EACH GROUP FOR TEST B AND TEST Y
Group Test B Test Y t
P
N 3.96 1.92 4.249 .005
T 3.96 2.20 3.510 .005
C 3.68 3.36 0.579 NS
a\
68
Mean
Avoidance
Scores
5
4
3
2
1
Y X B A
pre-Tests Post-Tests
Trials
X = Tension O = Natural A = Control
Fig. 3.— Mean Avoidance Scores for each trial, by
group. All groups taken to AS B = AS X for SF-X score.
TABLE 18
t TESTS FOR DIFFERENCES BETWEEN THE MEAN AVOIDANCE SCORES AT TEST Y
FOR ALL THREE GROUPS
Comparison t
P
N vs. T 0.649 NS
N vs. C 3.008 .005
T vs. C 2.132 .01
c r >
70
It is clear from this that the t test for the dif
ference between the N and the T groups' avoidance scores at
test Y are not significantly different, yielding a t equal
to 0.649. The difference between the two experimental
groups and the control group are both significant, and ref
erence to Table 17 reveals that there is a nonsignificant
change in AS for the C group. Therefore, it is concluded
that the sixth hypothesis, that the group visualizing
feared scenes under T conditions should show more avoidance
behavior on post-treatment test than the group visualizing
feared scenes under N conditions, is not supported.
CHAPTER V
DISCUSSION
Theoretical Considerations
The hypotheses which were supported in this study
were those that relate to the relative increase in anxiety
during the treatment which Wolpe's theoretical position
would predict. That is, there was greater fear response to
the scenes visualized under tension conditions than under
conditions of no tension. Also, the decrease in subjective
fear response to each scene was greater in the no tension
group than in the tension group over the series of scene
presentations. All the other hypotheses were not supported,
and in several cases showed significant changes opposite to
the direction predicted by the hypotheses. The tension
group decreased in subjective fear over the thirty visual
izations just as the no tension group did. The tension
group showed less subjective fear at post-treatment testing
than they did at pre-treatment testing. The tension group
72
showed significantly less subjective fear than the no
tension group at post-treatment testing, and showed greater
mean change in subjective fear from pre- to post-treatment
testing than the no tension group did. The tension group
reduced its avoidance behavior from pre-treatment to post
treatment testing as did the no tension group, and there was
no significant difference between the avoidance behavior of
the two groups at test Y.
The problem presented by these data is that while
Wolpe's model is accurate in its prediction of greater fear
to scenes visualized under tension conditions, he is not
able to predict even with the relatively greater fear in
this group that they nonetheless decrease their subjective
fear and avoidance behavior when confronted with the fear
stimulus. It might be argued that anxiety under the experi
mental conditions was not high enough to lead to the sensi
tization predicted by the Wolpe model. It might also be
argued that the subjects selected are not those likely to
come to a clinic for help, and therefore are probably not
as anxious or fearful to begin with as clinic patients
might be. Several measures of initial anxiety level are
available in this study, both general anxiety and specific
anxiety. The TMAS and the EPI neuroticism instruments have
73
been used in research to assess level of general anxiety.
In addition, the Fear Survey schedule gives a more limited
and specific measure of the level of fear to common harmless
stimuli, and the avoidance tests A and B give both subjec
tive fear and avoidance measures of actual fear to very
specific stimuli. The seventy-five Ss volunteering for this
study showed a wide range of scores on these instruments,
limited at the lower end by requiring all volunteers to have
fears of the small animals indicated on the FSS, and refus
ing to pick up the feared animals at the pre-treatment
tests. in spite of this limit on the low end of the anxiety
range, inspection of Appendix 0, the raw data of the crite
rion testing, reveals that neither experimental group con
tained a single S who showed more avoidance behavior at
post-treatment testing than he did at pre-treatment testing,
as revealed by a negative B-Y score. In addition, reference
to the subjective fear column of the same Appendix indicates
that in the N group there were only two Ss who increased
their subjective fear to the feared stimulus (as indicated
by negative B-X scores) and only one S in the T group who
increased subjective fear. in the C group, one S increased
avoidance behavior and eight Ss increased subjective fear
scores from pre-treatment test B to post-treatment test X.
74
If the hypothesis of sensitization were to be supported it
would be expected that some Ss who had indications of high
anxiety would show increasing fear or avoidance behavior at
post-treatment testing. On the contrary, what is definitely
happening is that Ss are showing reductions in subjective
fear as well as avoidance behavior regardless of differences
in either pre-experimental anxiety or treatment-induced
anxiety. The few Ss who report increases in subjective fear
are not extremely high on any of the pre-test measures of
fear or anxiety.
Stampf1's model might predict that Ss in the tension
condition should show greater decrease in avoidance behavior
than Ss in the no tension condition since they experienced
more anxiety during scene visualizations. The mean avoid
ance scores for the T group at test Y was greater than the
mean avoidance score for the N group (see Table 17), but the
difference between the groups is not significant. The re
sult is different for the Subjective Fear scores. Here,
the t group showed a significantly greater decrease from
pre- to post-treatment testing, and almost significantly
less Subjective Fear at post-testing than did the N group.
This result would be consistent with Stampf1's theory of
treatment in that the T group did indicate significantly
75
more anxiety during the scene visualizations than the N
group did. Hogan and Kirchner (1967) make a very clear
statement of precisely what the therapeutic agent is in
Implosion treatment; "The greater the nonreinforced
anxiety experienced, the greater the extinction of the
fear" (p. 106). Of course this statement of the basic
assumption of Stampfl treatment means that Wolpe should not
get decreases in fear and avoidance behavior, since his
treatment revolves around preventing any but the most barely
reportable minimum of fear. As London (1964) puts it, "The
importance of Wolpe's work rests in anything but the finali
ty of the learning principles from which it was deduced.
Desensitization does not have to be explained at all in
terms of reciprocal inhibition . . ." (p. 91). However,
since the evidence of the effectiveness of desensitization
is accepted, and since the claim made by its users is that
it is a scientifically derived treatment procedure, then
there is some obligation to discover what the variables are
which do in fact account for the success of the treatment.
The present study does shed limited light on at least one
aspect of the Stampfl treatment, as mentioned, in that more
anxiety during treatment led to less fear to the feared
stimulus.
76
One possible explanation for the results of this
study, and also for the general observation that far less
time is required for the Stampfl than for the Wolpe model
of treatment might lie in a "relief-from-stress" model.
This kind of model might state that, because of the greater
fear experienced during the Stampfl treatment, the post
testing of Ss or patients treated in this way would show
the effects of relief in that the post-testing is quite
similar to the pre-testing, but not similar at all to the
terrifying scenes which the imploded patient has been asked
to visualize. As Stampfl himself put it in his 1965 paper
when discussing the implosion of an obsessive-compulsive
regarding his fear of dirt, "When you have wallowed in a
filled cesspool (the content of the scene), it is relatively
easy to grasp a slightly dirty doorknob." Rather than ex
tinction, which would allow for no way of predicting the re
sults which Wolpe achieves, such a relief model would simply
imply that the less anxiety experienced during the visualiza
tions, the less the degree of relief experienced during
the criterion testing. This allows Wolpe to claim that his
method worked for an entirely different reason than
Stampfl's treatment works, without denying theoretical
grounds for either theorist. In addition, the hypothesis
77
that the greater the anxiety during the treatment, the
greater the decrease of fear during the criterion testing,
is quite open to experimental exploration.
Though Stampfl and Wolpe both talk about the use of
a hierarchy (Wolpe, 1958; Hogan, 1966) they use the hier
archy in different ways, and refer to different operations.
Hogan refers to a qualitative hierarchy in which a general
ized spread is hypothesized. Implosion of the most intense
aspect of this qualitative hierarchy precludes the treat
ment of less intense items on the hierarchy. In the Wolpe
system, the hierarchy is one of quantity, if that term may
be used somewhat loosely. The items on the hierarchy are
strictly limited to qualitatively similar items (i.e., on
one dimension of fear), and if other fears are treated, they
are done so on separate hierarchies. This means that a pre
diction could be made about the degree of fear which indi
viduals undergoing both types of treatment might have to
fear stimuli on two different kinds of gradients. in the
Wolpe treatment, there would be no generalization from one
fear to another fear, since Wolpe claims that his treatment
is specific for each fear and the gradient or hierarchy
used is one of intensity of that one fear. In the Stampfl
treatment, it would be expected that less intense fears on
a qualitative gradient of similarity, would show decreased
ability to arouse anxiety to the degree that they were
similar to the fear being imploded. Another prediction
which might be made in what London (1964) calls an engineer
ing type study (comparing the relative effectiveness of
Wolpe and Stampfl procedures), would be that Stampfl proce
dures would be much faster than the Wolpe procedures: faster
in that it would take fewer sessions to reach a criterion of
change in approach behavior or subjective fear than it would
take to reach the same criterion using Wolpe1s procedure.
If efficiency is measured in terms of the time actually
visualizing the feared scenes, then it might be predicted
that, for a given fear, the Wolpe procedure would take less
time actually visualizing than the stampfl procedure. This
is because of the brief scenes used by Wolpe, and the fact
that the Stampfl procedure brings into the scene material
which may only be peripherally related to the actual fear.
However, in an "efficiency" study, overall time would be the
variable of interest. in the Stampfl treatment, no new
learning is postulated, such as in the Wolpe system, where
the new response of relaxation must gain in response
strength sufficiently to become dominant in the habit family
hierarchy. If the agent for reduction of anxiety in the
79
Wolpe system is the inhibitory action of a new response,
then the difference in time might be accounted for as the
time required to build up sufficient habit strength in the
new response so that it occurs regularly when the fear stim
ulus is presented. Bugelski (1956) claims that for any re
sponse to be learned, some other response must of necessity
be unlearned because organisms are rarely if ever "not re
sponding." If Bugelski might say that in implosion some
new response must be learned to the old fear stimulus, then
the rapidity of the Stampfl treatment could still be
accounted for by postulating that it is a matter of indif
ference to the implosive therapist what new response is
learned. For the reciprocal inhibition therapist, the re
sponse to be learned must be one which is inhibitory to the
response of anxiety, thereby requiring the pre-training of
the patient in the new response (the relaxation training).
This set of statements about Wolpe's method could be tested
by using an anxiety inhibiting response other than relaxa
tion, which has the potential for independently measurable
variations of response strength.
The prediction of more rapid reduction of subjective
fear and avoidance behavior by the Stampfl than the Wolpe
method has already received some support from several pilot
projects undertaken at Camarillo State Hospital by the
author and Dr. Milton Wolpin, and by a full scale comparison
of the two methods by Curt Barret (1967) in an as yet un
completed dissertation at the University of Kentucky.'*'
Using the Stampfl method as directed by Stampfl himself, and
the Wolpe method as learned from tapes of therapy sessions
loaned him by Arnold Lazarus, Barret found that subjects
responded by more rapid reduction of fear when imploded than
they did when reciprocally inhibited. Wolpin and Myerhoff
found that with as few as four short sessions, not even full
implosion scenes, approach behavior could be changed, and
subjective fear reduced rapidly. Both Barret and Wolpin and
Myerhoff observed overt signs of fear and discomfort in
their subjects, though Wolpin and Myerhoff did not suggest,
emphasize, or even talk about the response of the subject
during the scene presentation. Emphasis was on the activity
of the stimulus animal and the active participation by the
subject. These subjects were extremely frightened at pre
test, and were observed at pre-test by independent observers
to confirm the actual degree of judged fear. Many of the Ss
^personal communication from Curt Barret, Camarillo
State Hospital, Camarillo, California, August 25, 1967.
81
ran screaming from the room at pre-test, and one S struck
the experimenter with her purse. Yet all the Ss in this
pilot group approached and held the feared animal at post
test, or performed the feared activity at post-test. This
material is cited anecdotally to emphasize the point that
contrary to Wolpe's predictions, reductions in fear and
avoidance behavior accompany scene visualizations regardless
of the presence of large "doses" of anxiety.
Part of the problem presented by the disparity in
the predictions and results from Stampfl and Wolpe lies in
the parochialism shown by the two groups. writers using
Wolpe's model do not cite Stampf11s work, and the reverse is
also true. Neither group is making any effort to subsume
the data which the other group is rapidly accumulating.
This discrepancy between theory and practice in psychothera
py is not new to the field, and within behavior therapy it
must be noted that Herzberg in 1941, and Jones in 1924
(1924a, b) have used behavior therapy techniques which would
fall into the Wolpe model, neither author basing his suc
cessful treatment technique on a theoretical model truly
compatible with Wolpe or Stampfl. True, Jones insured that
little Peter continued eating while the feared rabbit was
brought closer, but there is evidence at every step that
82
Peter experienced fear while undergoing the treatment. How
ever, the closeness of Jones’s reasoning to Wolpe’s is indi
cated by her caution that the feared stimulus not be intro
duced too quickly lest the fear-inhibiting eating activity
become fear arousing. Nothing in Herzberg's thinking indi
cates adherence to a theoretical model similar to Wolpe or
Stampfl, and his sessions with his patient are very similar
to individual sessions reported by behavior therapists who
talk to patients about everything when they are not actually
deconditioning. His treatment, similar to an "in vivo”
treatment plan, worked for him in a variety of cases. So
too did Jacobson (1938) achieve some success with his
treatment of relaxation alone, adhering to a different
theoretical model.
The implications of these speculations is that more
research needs to be done on the variables responsible for
therapeutic change under a variety of conditions. At the
same time, continued research into the theoretical predic-
tims made by existing models is required to clarify precise
ly where it is that theory and practice are isomorphic.
Only then will a truly rational treatment be evolved.
Until then, we are still in the phase of trial and error in
treatment, though the models being proposed currently are
83
preeminently suited to empirical testing. This is a stride
forward which is momentous in itself.
Methodological Considerations
The use of the experimental assistant, E-2, was in
tended to meet the serious criticism leveled by Breger and
McGaugh (1965) that studies which used the same E to do the
treatment and administer the criterion testing might be
seriously biasing their results due to feelings which Ss
might have toward E. In this study, not only was a separate
E used for the criterion testing, but the Ss were told that
E-l (the author, who administered the experimental treat
ment) would not see the individual results of the criterion
testing.
It might be argued that the scenes could have been
presented in taped form as was done by Kirchner and Hogan
(1966) in their study of the therapist variable in implosion
therapy. The reason for not following the tape format was
that the scenes presented were too short. Grossberg (1966)
demonstrated neatly that the physiological (GSR) response to
fear scenes was elicited not when the material was being
described by E, but while S was in the process of imagining
the material, a matter of some seconds after the reading
84
of the scenes. In this study, it was essential to monitor
fear frequently, and thus to have comparatively short scenes
which were nonetheless long enough to permit the S to expe
rience reportable anxiety. To do this, it was found that in
the pilot study E could vary the timing of his presentation
by small amounts, and allow for individual variation in the
timing required for Ss to actually visualize clearly what
was being described.
Since the material to be visualized was drawn from
relatively recent experiences of the S, not much time was
required for Ss to completely visualize each part of the
scene. In addition, Ss in pilot studies reported that if
they had managed to achieve the visualization of a scene,
visualization would begin to change uncontrollably if no
new material were added, or no change in the scene was sug
gested by E. This led early in the pilot work to the expe
rience that when Ss were presented with a scene, and left
to visualize the scene without comment from E, they reported
a great deal of individual variation in form, content, move
ment, and setting of the scene. To control for this, and
permit the assumption that each S visualized each part of
the scene as presented, it was felt to be essential that E
read the material, allowing variations in the timing of the
presentation to insure relative uniformity. The E checked
this by frequently asking as the scene was being read, "is
that clear?", "Do you see that clearly?", "Do you have that
part?", at the close of each numbered statement in the
protocol (see Appendix I). As the presentations progressed,
Ss reported that it was easier and easier to see each part
of the presentation clearly and distinctly.
CHAPTER VI
SUMMARY
This study examined the relationships between the
amount of fear reported while imagining fearful scenes under
two conditions, and the effects of such a procedure on both
fear and avoidance of the actual fear stimulus. The hypoth—
eses were derived from Joseph Wolpe's theory of the treat
ment of phobic disorders by the use of Reciprocal
Inhibition.
The theory states that muscular tension accompanies
subjective experiences of fear, and that fear and a state
of muscular relaxation are mutually exclusive. The treat
ment of phobic reactions by reciprocal inhibition requires,
according to Wolpe, that a new response become conditioned
to the stimulus which is seen as triggering the fear and
thus the phobic avoidance behavior. The new response,
according to the theory, must be one which is mutually in
compatible with the fear response, and relaxation is seen as
86
such a response. The theory also states that if anxiety
is experienced while the reciprocal inhibition process is
occurring, then "sensitization" rather than "desensitiza—
tion" will result. That is, the patient will experience an
increase in fear to the originally feared stimulus rather
than a decrease in fear.
Seventy-five subjects, students in introductory
psychology classes at the University of Southern California,
were selected on the basis of self-reports of irrational
fears of small animals on a Fear Survey Schedule. To insure
that these Ss were actually fearful, they were administered
pre-treatment criterion tests to determine just how closely
they would approach the feared animal. Ss were equated on
subjective fear by use of a Subjective Fear Scale, and by
telling each S that the amount of fear he had at the point
where he would go no closer was at the middle of the scale.
A second pre-treatment criterion test was administered to
control for rapid deconditioning of the avoidance behavior
as a result of the testing procedure. Ss were then admin
istered the Taylor Manifest Anxiety Scale, and the Eysenck
Personality Inventory in order to control for conditionabil-
ity. Ss were then assigned to one of two experimental
groups or to a no-treatment control group. Both
88
experimental groups visualized thirty presentations of fear
scenes involving approach and handling of the feared ani
mals .
One group visualized the scenes with instructions
designed to induce muscular tension while the other experi
mental group did not receive such instructions. Ss were
asked to evaluate their degree of subjective fear on the
Subjective Fear Scale following each presentation of a
scene. All the scenes were read verbatim by E, and a "qual
ity control" procedure avoided any detectible bias. After
both experimental groups had visualized the scene thirty
times in three sessions, all three groups were given post
treatment criterion testing. These tests were devised in
such a way as to permit separate evaluations of changes in
subjective fear and changes in avoidance behavior.
The results offer limited support to one aspect of
Wolpe's theory of treatment regarding the effects of tension
on anxiety only in a relative way. Ss did in fact experi
ence more anxiety when they visualized feared scenes under
conditions of tension than when they visualized the same
scenes without tension. Wolpe predicts that Ss experiencing
anxiety during the visualization of fearful scenes should
show an increasing amount of fear to the scenes as one
89
result of "sensitization." Not only did this not happen,
but the tension group as well as the no tension group ex
perienced significant reductions in reported fear responses
to the scenes. Wolpe predicts that with high levels of fear
experienced during visualizations, Ss should also experience
an increase in fear to the actual fear stimulus, with a re
sulting increase in avoidance behavior. In this study the
results were opposite to those predicted by theory. Both
groups experienced significant reductions in subjective fear
to the actual fear stimulus, and in addition, both groups ex
perienced significant reductions in avoidance behavior as
well. In fact, the group visualizing the scenes under ten
sion conditions experienced significantly less subjective
fear to the actual fear stimulus at post-treatment testing
than did the no tension group, a result predicted by
Stampfl's theory of implosive therapy. The groups did not
differ in avoidance behavior at post-treatment testing.
One conclusion drawn from this study was that al
though Wolpe had devised an effective method for treating
phobic behavior, and had devised a clear and testable
theory of the development and maintenance of such phobic
behavior, the treatment is not effective because of its
theoretical derivation. The implication of this is that
research is required to discover the variables accounting
for the effective treatment of phobic behavior using two
widely disparate treatments exemplified by Wolpe at one
extreme and Stampfl at the other. A model was put forward
that subsumed the data from both Wolpe and Stampfl, and
allowed testable statements to be made.
LIST O F
R E F E R E N C E S
91
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A P P E N D I X E S
98
APPENDIX A
FEAR SURVEY SCHEDULE
NAME : AGE :______MALE :______FEMALE :______
(please print)
This questionnaire contains a list of some of the many
things and situations that can make people uncomfortable,
fearful, or anxious. Please check, in the appropriate
column to the right of each statement, the amount of fear or
anxiety that each produces in you. If you are not sure,
make a guess. please answer every item.
Many thanks for your cooperation.
[Weights ( added after completion)]
1 2 3 4 5
DEGREE OF FEAR OR ANXIETY
NONE
A
LITTLE
A FAIR
AMOUNT
MUCH
VERY
MUCH
1. Crawling insects
2. Fire
3. Mice
4. Going up in an
airplane
5. Lizards
6. High places on land
7. Being in a small,
closed room
8. Rats
9. Seeing nude men
10. Seeing nude women
11. The dark
12. Snakes
13. The unknown
14. Frogs
15. Surgical operations
16. Spiders
99
APPENDIX B
RAW DATA FOR PILOT STUDY OF SUBJECTIVE FEAR REACTIONS TO FEARFUL SCENES PRESENTED
UNDER CONDITIONS OF MUSCULAR TENSION (T) AND NO MUSCULAR TENSION (N)
presentation
Subject
Number
Fear Condition Scores for Difference Difference
Scene
Order
Fear Order
1 2
Conditions
T N
Scores
(T) - (N)
Scores
(1) “ (2)
1 1 Snake T N 11 5 +6 +6
2 Spider N T 9 6 + 3 -3
2 1 Sp N T 4 2 +2 -2
2 Sn T N
3 5 -2 -2
3 1 Sn T N 9 6 +3 +3
2 Sp N T 9 5 +4 -4
4 1 Sp N T 10 6 +4 +5
2 Sn T N 17 12 + 5 +5
5 1 Sn N T 15 13 + 2 -2
2
Sp
T N 18 17 + 1 +1
6 1 Sp T N 14 15 -1 -1
2 Sn N T 15 13 +2 + 2
H
O
o
APPENDIX B— Continued
Subject
Number
Fear
Scene
Order
Fear
presentation
Condition
Order
1 2
Scores for
Conditions
T N
Difference
Scores
(T) - (N)
Difference
Scores
(1) - (2)
The remaining subjects received the T and N conditions in the same order, N then T.
7 1 Spider N T 14 16 -2 +2
2 Snake N T 11 7 +4 +4
8 1 Sn N T 11 8 + 3 -3
2 Sp N T 8 6 + 2 -2
9 1 Sp N T 7 1 +6 -6
2 Sn N T 18 15 +3 -3
10 1 Sn N T 11 14 -3 +3
2 Sp N T 6 9 -3 +3
11 1 Sp N T
4 6 -2 + 2
2 Sn N T 3 2 + 1 -1
H
O
APPENDIX B— Continued
WILCOXON MATCHED-PAIRS SIGNED--RANKS TEST
Comparisons T N
P
Presentation 1
scene 1 (1st
vs. 2 for fear
6 Ss only) + 10 6 NS
Presentation 1
scene 1 (all
vs.
Ss)
2 for fear
+31.5 11 NS
Presentation 1
scene 2 (all
vs.
Ss)
2 for fear
+33 11 NS
Condition T vs.
fear scene 1
N for
-12 11 Less than .05,
in predicted
one tail,
direction
Condition T vs.
fear scene 2
N for
-11 11 Equal to .025,
in predicted
one tail,
direction
APPENDIX C
DESCRIPTION OF RESEARCH WHICH IS READ TO
POTENTIAL STUDENT VOLUNTEERS
The purpose of this study is to evaluate the effect of
various experimental conditions on the fearfulness of cer
tain stimuli. The hypotheses and experimental conditions
are relevant variables in Behavior Therapy. There is no
"hidden agenda" in this study, you will not be lied to or
misled in any way. All questions about the experimental
experience will be answered after the completion of the
experimental tasks.
I want to stress that since we are asking for subjects who
have fears, no one will be forced to do anything he does not
want to do or is afraid of doing. No one will be treated
discourteously or disrespectfully or will be asked to do
anything embarrassing or humiliating.
in pursuit of this goal, I will hand back the Fear Survey
Schedules which you have completed. On those surveys which
have fears relevant to this study I have indicated that you
are "eligible" to be a subject in the study. I am going to
pass around a sign-up sheet so that you may sign up
privately.
A word about the study is in order to clarify anything that
sounds like "treatment." This is an "analogue" study. That
is, no "treatment" of any kind is given for the fears indi
cated. Therefore, no subject may expect to get rid of his
fears through the experimental procedure. Some people may,
and some people may not experience beneficial changes as a
result of any of the procedures, but this is part of what
we are measuring in the study. We are NOT treating the
fears, only studying some of the variables in the proce
dures. Therefore, your "payoff" consists in (1) getting
103
APPENDIX C— Continued
credit for participating in an experiment, and (2) whatever
feeling you may gain from helping me advance the study of
the variables in the behavioral treatment of fears.
It should also be stressed that most people in our society
have some of the fears on the Fear Survey Schedule, and that
no abnormal condition affects those who may have one or more
of the fears listed in the schedule.
APPENDIX D
INSTRUCTIONS TO E-2 FOR CONDUCTING THE PRE-TREATMENT
CRITERION TESTS A AND B
Instructions for Test A:
The point of these procedures is to insure that all Ss have
precisely the same experience in being urged to approach the
feared animal as closely as possible, so that we do not have
differences between subjects or groups which arise from dif
ferences in the way they are administered the criterion
tests.
1) As S steps into the room, stop him at the door, and
point to the cage across the room, and say:
"You indicated by the items you checked on the
Fear Survey that you are afraid of ________. We
have here a harmless ________ in that cage. You
can see it through the front of the cage. I
would like you to approach as closely as you
can. "
E insures that for each subject in each test, the
animal is visibly moving in the cage.
2) As S moves closer, wait until he reaches his closest
point, wait 15 seconds, then say:
"I assure you that the ________ is harmless and
that it will not jump out of the cage. May I
urge you to approach as close as you can."
105
106
APPENDIX D— Continued
3) As long as S moves to the next closest avoidance score
point within 15 seconds, request again that he move yet
closer, step by step, until he either refuses to move
any closer (by saying "NO") or remains where he is for
15 seconds. If S retreats from a closer to a more dis
tant point, but was at the closer point for 15 seconds,
his avoidance score is taken as the closer point. If
he retreats before the 15 second criterion waiting
period, then ask him to again approach as closely as
possible and go through all the steps again.
4) Begin timing after each "standard urging" request. If S
asks any questions about the procedure, or the fear
stimulus ("How do I know he can't jump out?") just
ignore it and continue the timing. After the SF scale
has been administered (see below) you may refer any
further questions to E-l, the author.
5) Do not engage in any conversation with S except that
outlined in these instructions. Make each statement as
nearly verbatim as possible to insure maximum uniformity
of approach with each S. The point is to get each S to
move as closely as possible using the same amount of
urging.
6) immediately following the closest approach point, give
the SF scale.
Immediately following the first pre-test (after getting the
avoidance score or the point where S will go no closer to
the stimulus) show him the Subjective Fear scale and say:
"Let me explain how we work this scale, which goes
from absence of fear here at the bottom, to maximum
fear here at the top. Here is a line on the scale
which indicates its midpoint. The amount of fear
you just experienced when you approached as closely
as you could, will fall here at the midpoint of the
scale. please try to keep vividly in mind just how
107
APPENDIX D— Continued
intense the fear was which is indicated by this mid
line .
"There are several steps in using the scale. When I
ask you to make the next rating, please think of the
amount of fear you just experienced and indicate
whether the current amount of fear is the same, more
than, or less than that indicated by the mid-line.
The next step is for you to estimate how much more
fear, or how much less fear, you are currently expe
riencing than you did a moment before. Is that
clear?
"The labels to the left of the scale tell how far
from the original fear you judge the current amount
of fear to be. For example, if you feel slightly
more fear currently than you did during the first
test, you would mark this line here [INDICATE]. If
you feel somewhat less fear currently than you did
during the first test, you would mark this line here
[INDICATE]. if it is the same currently as it was
during the first test, then you would mark it here,
[INDICATE]. The bottom line indicates complete ab
sence of fear, and the top line is the most fear you
could experience with ________s.
"The labels are only guides. You may use any point
between these that are labelled. Please keep in
mind that we are trying to find out how much fear
you have during these tests. It may be more, it may
be less or it may be the same as it was during the
first test."
108
APPENDIX D— Continued
Instructions for Test B:
This follows the administration of Test A, and the explana
tion of the SF scale to S. This test is complicated by the
fact that different instructions are applicable depending
upon where the subject was at Test A, and where he moves to
at Test Bj In general, the point is to enable each S to
come from the point where he was at Test A to as close as he
can at Test B, using the standard urging, and nothing else.
The avoidance score for Test B is that point where S will
move no closer after 15 seconds or refuses to move any
closer. Following each movement, S is asked in standardized
fashion to come to the next avoidance score point, just as
he was during the A Test.
1) If S starts from an avoidance score point of 2 (touching
animal), bring him back to the cage, ask him to touch
the animal again, then say:
"Now will you please pick it up."
If S says no, or does not do it within 15 seconds, his
avoidance score is 2. If S picks up the animal, he is
eliminated as a subject for the study, just as in
test A.
If S does not pick it up, ask him to step back, and
say:
"Will you please step back here and indicate on
the Fear Scale how much fear you had just now
compared to how much fear you had just a moment
ago during the first test. This is how much
fear you had then, we put it automatically at
the middle of the scale."
109
APPENDIX D— Continued
2) If S starts from an avoidance score point of 3 (placing
hand on floor of cage) bring him back to the cage, ask
him to place his hand on the floor of the cage, then ask
him to move to the next closer AS point:
"Now will you place touch it."
If S touches it within 15 seconds, ask him;
"Now will you please pick it up."
If S refuses to touch it, or does not do anything for 15
seconds, his avoidance score is 3. if he touches it,
but refuses to pick it up, his avoidance score is 2.
If he picks it up, he is eliminated as a subject for
the study, just as in test A.
3) If S starts from an avoidance score of 4 (touching the
outside of the cage), ask him to come to the next
avoidance score point:
"Will you please put your hand on the floor of
the cage."
proceed as above, asking S to come to each successively
closer avoidance score point, giving the appropriate AS
when S refuses to go any further, or refuses to respond
within 15 seconds. He is asked to move to the next
closer point after being at a given point for 15
seconds.
4) if S is at some AS point where he is not in contact with
the cage, begin the standard urging by asking him:
"Will you please come as close as you possibly
can. "
110
APPENDIX D— Continued
5) When an AS point has been scored for test B, again get
a Subjective Fear rating as indicated above in para
graph (1) .
After the SF rating is made for Test B, S is taken to the
room where he will complete the EPI and TMAS, before being
sent in for assignment to one of the 3 groups.
APPENDIX E
Score
1
2
3
4
5
6
7
8
9
10
MODIFIED AVOIDANCE SCALE**
Behavior
1. Holding (lifting)________.
2 . Touching________.
3. Places hand on floor of cage, top open, _____
inside.
4. Touches outside of cage, top open, ________
inside, S looking down.
5. Stands over open cage looking down on ________
6. Stands within two feet of the open cage with
________ inside and visible.
7. Stands four feet from cage, ________ visible
inside.
8. Stands six feet from cage, ________ visible
inside.
9. Stands eight feet from cage, ________ visible
inside.
10. Stands in doorway of room in which ________ is
visible in its cage.
ain every criterion test, the animal is moving.
Ill
APPENDIX F
SUBJECTIVE FEAR SCALE
NAME: M F CONDITION: T N C SESSION: 1 2 3
A B 1 2 34 5 6 7 8 9 10 XY
rami ur
bLlbnlL* Lcibb rEAK
A B 1 2 3 4 5 6 7 8 9 10 XY
112
APPENDIX G
JUDGMENTS BY 5 JUDGES AS TO WHETHER A GIVEN SCENE
PRESENTATION WAS TO AN S FROM THE
T OR THE N GROUP
Judges
Ss Group
1 2 3 4 5
1 N-l T N T T N
2 N—2 N T N T T
3 N-3 N T T T N
4 N-4 T T N N T
5 N-5 N N T T T
6 N-6 N T N N T
7 T-l T T N T N
8 T-2 T T N N N
9 T-3 T N T N T
10 T-4 N N T T N
11 T-5 N N T N N
12 T-6 T N N N T
Correct 8 4 6 4 4 26
Incorrect
Total
4 8 6 8 8 34
60
Chi-square
(each judge) 1. 33 1.33 0 1.33 1. 33
p for each
chi-square
Overall Chi-
NS
square
NS
is 4.
NS
345, p
NS
is NS
NS
The order of presentation to each judge was randomized.
The taped scene presentations were chosen by a roll of dice,
and were the fourth scene presented in the first session.
The first and last of the 10 scenes presented during this
113
APPENDIX G--Continued
session were eliminated from choice. if Chi-square is cal
culated on the basis of a chance guess of 6 correct and 6
incorrect as the expected frequencies, the Chi-square is
5.336, which is not significant. The results of this judg
ment are that no judge could distinguish which group a given
S belonged to by listening to the scene read to him. Nor
was there any overall ability to distinguish the subjects
taking all judges together.
The fourth scene of the first session was placed on its
own individual tape reel so that the order of presentation
could be individualized for each judge.
APPENDIX H
INSTRUCTIONS TO JUDGES FOR' EVALUATING
SCENE PRESENTATIONS FOR BIAS
The tapes you are being asked to judge are record
ings of the presentations of feared scenes to subjects (Ss)
in research evaluating behavior therapy. The Ss have been
asked to imagine the scenes which you will hear being de
scribed to them by the experimenter (E). Following the
reading of each scene, the S is asked to rate the degree
of fear he feels in response to the imagined scene. The
scenes are related to fears of small animals which was the
basis for selecting the Ss.
The purpose of this phase of the research is to de
termine whether one group of Ss is being read the fear
scenes in a manner different from a second group. There are
12 taped scene presentations, 6 from one group and 6 from
the second group. The first group was read the scenes while
in a state of induced muscular tension (the T group), while
the second group was read the same scenes without the induc
tion of the tension (the N group). Since there is the pos
sibility that the E might inadvertently read the scenes
differently to the members of the two groups, and thereby
bias the results, your task is to help decide whether bias
ing has actually occurred.
The factor which is suspected of biasing the fear
ratings made by the Ss is subtle or overt cues which E may
give which might induce an increase of fear in the T group,
or a decrease of fear in the N group. You are asked to
listen for differences in tone of voice, warmth, urging,
or reassurance which occurs more in one S than in other Ss.
Those Ss which seem to be getting more urging, or cues to be
less afraid would be the N group. Ss who appear to be urged
to more fear by E would be Ss in the T group. The data
115
116
APPENDIX H— Continued
sheets which you have been given have places to enter your
judgments as N or T.
The order of listening to the tapes has been random
ized for each judge, and this order is given to you on the
data sheet. You are to listen to all 12 tapes through once
in the given order. Each tape is approximately one minute
in length. Then you are asked to listen to them again and
make your judgments. if you feel that the E is in some way
biasing the S to be more afraid, then you would judge the S
to be in the T group. If you feel that the E is biasing the
S to be less afraid, then you would judge the to be in the
N group.
Remember that your data sheet should indicate 6 N
and 6 T subjects.
APPENDIX I
FEAR SCENES READ TO SUBJECTS IN THE
EXPERIMENTAL GROUPS
SPIDER
1. Picture yourself going over to the cage with the top
open. You can clearly see the spider moving around
inside the cage. Do you see that clearly?
2. y o u reach inside the cage, put both hands around the
spider, hold him, lift him out. He doesn't bite.
3. As you hold him you can feel his full weight.
4. y o u can feel the hair of his skin and feel his feet
as he moves in your hands.
5. Feel yourself stroke him across his back as he walks
over your hands and arms very vividly, very clearly.
6. As you hold him, you can see his legs move and feel
the hair of his body.
7. Picture yourself very vividly as you hold him in your
hands and play with him.
SNAKE
1. Picture yourself going over to the cage with the top
open. You can clearly see the snake moving around
inside the cage. Do you see that clearly?
117
118
APPENDIX I— Continued
2. You reach inside the cage, put both hands around the
snake, hold him, lift him out. He doesn't bite.
3. As you hold him you can feel his full weight.
4. You can feel the scales of his skin and feel his
muscles as he moves in your hands.
5. Feel yourself stroke him across his back as he crawls
over your hands and arms, very vividly, very clearly.
6. As you hold him, you can see his head move and feel
the scales of his body.
7. Picture yourself very vividly as you hold him in your
hands and play with him.
RAT
1. Picture yourself going over to the cage with the top
open. You can clearly see the rat moving around inside
the cage. Do you see that clearly?
2 . y o u reach inside the cage, put both hands around the
rat, hold him, lift him out. He doesn't bite.
3. As you hold him you can feel his full weight.
4. You can feel the hair of his skin and feel his feet as
he moves in your hands.
5. Feel yourself stroke him across his back as he walks
over your hands and arms, very vividly, very clearly.
6. As you hold him, you can see his legs move and feel the
hair of his body.
7. Picture yourself very vividly as you hold him in your
hands and play with him.
APPENDIX J
PROCEDURE FOR ADMINISTRATION OF EXPERIMENTAL TREATMENTS
Following the administration of the pre-criterion tests, and
the EPI and TMAS, give the following instructions:
"I am going to ask you to visualize a scene involving
the ________ which you just saw a few minutes ago.
You will not be asked to look at the ________ again
during the visualizations, until we have the post
test, after the last time you are asked to visualize
the scene. I will read you some material which I
will ask you to imagine as clearly as possible. In
order to acquaint you with the procedure I am going
to ask you to practice imagining the scenes you saw
and felt as you came up here just now. [The entrance
to the building is described and the ascent of the
stairs and the hallway leading up to the experimental
room.]
"Close your eyes and imagine yourself entering
Founders Hall through the doors downstairs. Clearly
picture the red tile floors of the entryway, and
feel yourself walk toward the stairs. They are con
crete, and the stairway has yellow walls and aluminum
bannisters. Picture yourself as you climb the stairs,
and see the high window at each landing through which
you can see a bit of sky, perhaps a tree top or roof
top. You reach the third floor and turn toward room
318.
"Could you visualize that clearly and distinctly?
Were you really "IN" the picture? [If the answer to
either of these questions is "no," repeat the para
graph above.]
119
120
APPENDIX J— Continued
"Here is the scale which you just used during the
pre-test. We are going to use it in a slightly
different way from now on. I will present you with
a scene which you will visualize. The scene lasts
for about a minute, and will be presented ten times
during each of the three sessions we will have.
After each presentation, I will ask you which part of
the scene was most fear-provoking for you, and then
ask you to compare the degree of fear with the amount
of fear you experienced during the pre-tests. I
will also ask you to compare each succeeding scene
with the one just finished. This way we will be
able to be as precise as possible in measuring your
own individual subjective feeling of fear as we go
through this procedure. Please keep in mind that
we are trying to determine what happens to a person's
fear during these procedures. We do not know. One
theory predicts that fear will increase, another
theory predicts that it will decrease, a third theory
predicts that it will not change, and yet a fourth
predicts that it will fluctuate.
"You can be most helpful if you will try to be as
honest and conscientious as possible about each
rating.
"Do you have any questions before we begin? Please
remember that these scenes are only scenes, there
are no live animals in this part of the study, and
that you will not be required to perform the acts
detailed in the scenes at any time."
For N subjects, begin scenes here.
For T subjects, read tension instructions here.
APPENDIX K
SCHEDULE FOR OBTAINING TENSION
IN THE TENSION GROUP
Read this to each subject in the Tension condition.
"I am going to ask you to tense some of your
muscles. sit squarely in your chair with your legs
together, feet flat on the floor, heels and toes
together. Now raise your toes as high as you can
off the floor while keeping your heels on the floor.
Now clench your fists tightly. Now hunch up your
shoulders. Now grit your teeth by clenching your
jaws together. Close your eyes tightly. At the
end of each visualization I will ask you first to
open your eyes. Then I will wait about 5 seconds,
and then ask you to relax. Please maintain the
tension as you open your eyes until I have asked you
to relax. is all that clear?"
Read the first visualization to S at this point.
121
APPENDIX L
JUDGMENTS BY 7 JUDGES AS TO WHETHER A GIVEN S WAS IN
AN E GROUP OR IN THE C GROUP
s Group Key
1 2
Judges3
3 4 5 6 7
10 N E C C E E C C C
11 T E c E C E E E E
12 T E c E C E E E E
13 T E E C E C E C E
14
N E C E C c C E E
15 N E E E E E E C C
16 T E E C E E E E E
17 C C C C E C E E E
18 C C E E E E E C C
19 N E E C E E E E C
20 C C E E C C C E E
21 C c E E E E E C C
22 T E E C E E C E E
23 T E E E E C E E E
24 C C C E C E C E E
25 C C E E c C C E E
26 N E E E E E E C C
Correct 9 7 11 11 11 9 9 67
Incorrect 8 10 6 6 6 8 8 52
Total 119
Chi-square
each judge .06 .53 1.47 1.47 1.47 . 06 .06
P
each judge NS NS NS NS NS NS NS
Overall Chi-square is 3.270, and non-significant
The order of presentation to each judge was randomized,
The randomization was by use of a table of random numbers.
None of the individual judges could differentiate between
122
123
APPENDIX 1>— Continued
E and C group Ss by listening to these tapes of the outcome
measures, since none of the judges achieved a significant
Chi-square. In addition, the overall Chi-square of 3.270
is not significant. No differences could be detected by
listening to the tapes. The tape for each test was put on
an individual tape reel, and numbered so that the order
could be individualized for each judge.
APPENDIX M
INSTRUCTIONS TO JUDGES EVALUATING FOR BIAS IN
POST-TREATMENT CRITERION TESTING
The tapes you are being asked to judge are recordings of the
post-criterion testing of a research project evaluating be
havior therapy procedures. The project used 3 groups of
subjects, 25 in each group. Two experimental and one con
trol group of Ss were used who had demonstrated on a pre
test that they had fears of small animals (rats, snakes,
spiders) . The test was designed to evaluate the effective
ness of the treatment procedures by assigning a pre- and
post- score for how near an S would come to the feared
animal. Changes in this "Avoidance Score" were the depen
dent variable in evaluating the treatment.
An assistant (E-2) was used to administer the tests, and
controls were used to prevent E-2 from knowing which Ss were
in which groups. It was hoped that this design feature
would prevent unintentional bias by E-2. However a flaw in
the procedure allowed the E-2 to know which Ss were in the
control group, although he could not differentiate the two
experimental groups. The E-2 had a set procedure for urging
the Ss to approach the feared animal. This consisted of a
standardized request for S to move from his original avoid
ance score point (his closest approach point on the pre
test) to the next closest avoidance score point. The
avoidance score points which are relevant to the tapes you
will hear are:
Avoidance Score
(AS)
6 Standing no closer than 2 feet from the cage
containing the animal
124
125
APPENDIX M— Continued
Avoidance Score
(AS)
5 Standing next to the cage, looking down on the
animal through the open top
4 Touching the outside of the cage
3 Touching the floor of the cage
2 Touching the animal
1 Lifting up the animal in the hands
On these tapes, each S is asked to come to the nearest AS
point which he came to during the pre-test. Then he is
asked to step back and use a fear scale to evaluate his fear
while at that point, by comparing his fear at that point
with the fear at the same point during the pre-test.
He is then asked again to go to that AS point, and then
given the "Standard urging" to move to the next closer AS
point. The "Standard Urging" is terminated in 3 ways:
a) When S refuses to move to the next closer AS point
within 15 seconds.
b) When S says that he will not move to the next closer
point.
c) When S moves closer at each request, urging is ter
minated when he lifts up the animal— an AS of 1.
Following the termination of this test, he is again asked to
step back and evaluate his subjective fear using the same
fear scale as before, but this time for the amount of fear
he had at his closest approach point.
Because the Ss of both experimental (E) groups made greater
changes in their avoidance scores than did the control (C)
group, this part of the study is designed to determine if
there was any subtle or overt increase in approach-urging
used with the E groups over the C group which might account
for the greater change in Avoidance Scores for the E groups.
126
APPENDIX M— Continued
Both E groups are combined for this part of the study
because there was no significant difference between them on
changes in Avoidance Score.
The E-2 was told that all the tests would probably be re
corded, and was not informed that these 17 Ss were taped.
Each tape is about 2 minutes in length— some slightly
shorter, some slightly longer. Your task is to help deter
mine whether there is systematic bias in urging the E more
than the C group to approach the feared animal. The proce
dure which you are to follow is outlined below.
The order of listening to the tapes is randomized for each
judge by going into a table of random numbers, and this
order is given to you on the separate data sheet. You are
to listen to all of the tapes through once in the given
order, before making your judgments. Then you are asked to
listen to each tape again, in order. On the basis of the
information given above about the possibility of uninten
tional increased pressure for approach in the E group, you
are asked to judge whether a given criterion test was admin
istered to an E or C subject. Two possible factors might
introduce confusion into the judging process, and are now
brought to your attention;
a) Some recorded C subjects did finally hold the
animal, and some recorded E subjects did finally
hold the animal.
b) Some Ss in both groups who were further from the
animal on the pre-test made improvements of several
Avoidance score points.
Therefore, do not confuse the number of steps an S goes
through with increased urging, and do not confuse finally
holding the animal with increased urging. you are asked to
try to detect any difference in manner of approach, warmth
of attitude, coldness of attitude, subtle suggestion in the
procedure, and on THAT basis, decide whether a given S is a
C or E subject.
127
APPENDIX M— Continued
Remember please that there are SIX (6) Control subjects and
there are ELEVEN (11) Experimental subjects. That means
that on the data sheet, your judgments should add up to
6 C and 11 E .
APPENDIX N
INSTRUCTIONS FOR E-2 IN CONDUCTING THE POST-CRITERION TESTS,
FIRST TEST X THEN TEST Y
Make these statements as nearly verbatim as possible.
TEST X :
"Hello rfirst name! You recall that during the
pre-criterion testing you came this [demonstrate]
close. [Here indicate the avoidance score point
which S made during test B. If his avoidance score
was 3, say "You put your hand on the bottom of the
cage." If the avoidance score was 2, say "You
touched it." If it is other than 2 or 3, say "Would
you please step up to that point again."]
After he has been at that point for 15 seconds, say:
"Now please step back here and indicate on the fear
scale how much fear you had just now compared to how
much fear you had the first time you came this close.
This is how much fear you indicated during the second
part of the pre-testing, and you should indicate how
much fear you had just now at the same point."
At no point in any of the testing is there to be any conver
sation between E-2 and any subject. The S has been in
structed not to talk to the E-2 about anything until the
testing is over and E-2 should refuse any conversation
politely but firmly until after the criterion testing is
over.
128
129
APPENDIX N— Continued
TEST Y :
This is complicated by the fact that different instructions
are applicably depending upon where the subject is at test
X , and where he moves to at test Y. in general, the poin t
is to enable each S to come from the point where he was at
test X to as close as he can at test Y, using the standard
urging, and nothing else. The avoidance score for test Y
is that point where S will move no closer after 15 seconds
or refuses to move any closer. Following each movement, S
is asked in standardized fashion to come to the next avoid
ance score point just as he was during test A and test B.
Therefore, each S will receive the standard urging, modified
only by the needs of the particular avoidance score point
at which he starts (his avoidance score point at test B,
which is where we want to check his subjective fear at
test X).
1) If S starts from an avoidance score point of 2 (touching
animal), bring him back to the cage, ask him to touch
the animal again, then say:
"Now will you please pick it up."
If S says no, or does not do it within 15 seconds, his
avoidance score is 2. If S picks up the animal, and
holds it for 15 seconds, his avoidance score is 1.
After either of these events, say: "Will you please
step back here again and indicate on the fear scale
how much fear you just had compared to how much you
had a few minutes ago during the first post-test,
which you can see right here [indicate SF rating at
X] . "
2) if S starts from an avoidance score point of 3 (placing
hand on floor of cage) bring him back to the cage, ask
him to place his hand on the floor of the cage, then ask
him to move to the next AS point;
"Now will you please touch it."
130
APPENDIX N— Continued
If S touches it within 15 seconds, ask him:
"Now will you please pick it up."
If S refuses to touch it, or does not do anything for
15 seconds, his avoidance score is 3. If he touches it,
but refuses to pick it up, his avoidance score is 2.
If he picks it up for 15 seconds, his avoidance score is
1.
3) If S starts from an avoidance score of 4 (touching the
outside of the cage), again, ask him to come to the
next avoidance score point:
"Will you please put your hand on the floor of
the cage."
proceed as above, asking S to come to each successively
closer avoidance score point, giving the appropriate AS
when s refuses to go any further, or refuses to respond
within 15 seconds. He is asked to move to the next
closer point after being at a given point for 15
seconds.
4) if S is at some AS point where he is not in contact with
the cage, begin the standard urging by asking him;
"Please come as close as you possibly can."
Under all testing, the stimulus animal is to be moving
visibly.
After the Y tests, ask all Ss if they have any questions.
APPENDIX 0
PERSONALITY, PRE-TREATMENT AND POST-TREATMENT TEST DATA
NATURAL GROUP
s# Sex Age
FSS TMAS
AS-B,
EPI-E EPI-N AS-A AS-K AS-Y
AS
B-Y SF-B SF-X SF-Y
SF
B-X
SF
B-Y
1 M 20 45 17 14 10 2 2 1 1 6 2 2 2 4
2 M 19 30 17 9 12 3 2 1 1 20 10 15 10 5
3 M 20 27 12 11 8 4 4 3 1 13 10 9 3 4
4 M 18 52 26 3 16 4 4 1 3 20 0 0 20 20
5 M 21 23 27 13 15 5 4 1 3 8 8 5 0 3
6 M 19 36 13 6 9 3 3 1 15 8 5 7 10
7 M 18 26 12 15 10 4 4 1 3 14 0 4 14 10
8 M 20 31 10 20 15 3 3 1 2 10 13 16 -3 -6
9 F 18 32 26 14 18 3 3 1 2 12 12 13 0 -1
10 F 19 36 21 8 17 4 4 2 17 8 5 7 12
11 F 19 51 19 7 5 3 3 1 2 12 0 2 12 10
12 F 18 38 9 17 6 3 2 2 0 10 8 2 2 8
13 F 19 48 10 12 10 4 4 3 1 12 11 4 1 a
14 F 19 34 5 18 6 10 10 4 6 16 15 17 1 -1
15 F 20 30 24 21 11 10 10 3 7 16 10 11 6 5
16 F 19 26 10 14 4 4 4 1 3 9 0 5 9 4
17 F 18 48 16 20 13 2 2 1 1 12 4 2 8 10
18 F 18 55 9 18 10 2 2 1 1 20 10 10 10 10
19 F 20 43 10 14 12 3 3 2 1 20 8 20 12 0
20 F 19 50 30 17 18 3 3 2 1 8 4 0 4 8
21 F 18 42 36 15 3 4 4 3 1 20 4 8 16 12
22 F 18 46 8 20 5 6 6 6 0 20 22 24 -2 -4
23 F 20 31 32 14 10 5 4 1 3 15 5 8 10 7
24 F 20 38 28 15 9 6 5 2 3 13 8 10 5 3
25 M 19 34 20 16 10 5 4 2 2 14 8 9 6 5
M 19.04 38.08 17.88 14.04 10.48 4.20 3.96 1.92 2.04 14.08 7.52 8.24 6.40 5.84
SD 7.94 4.70 4.32 2.02 2.03 1.20 4.22 5.12 6.25
131
SF
B-Y
10
12
-1
12
24
7
19
4
9
6
12
8
10
14
0
-7
-2
7
3
7
9
8
7
8
7
7.'
l.«
APPENDIX 0—Continued
TENSION GROUP
Age
FSS TMAS EPI-E EPI-N AS-A
AS-B,
AS-X AS-Y
AS
B-Y SF-B SF-X SF-Y
SF
B-X
19 28 12 11 10 3 3 1 2 12 2 2 10
18 32 14 8 9 2 2 1 1 12 0 0 12
18 29 16 9 13 3 3 3 1 14 0 15 14
19 36 14 15 13 2 2 1 1 16 8 4 8
19 31 7 14 6 2 2 1 0 24 8 0 16
18 32 26 11 18 2 2 2 1 12 8 5 4
19 31 22 11 15 5 5 2 3 20 0 1 20
18 40 11 16 14 2 2 1 1 12 4 8 8
18 43 25 13 17 3 2 1 1 12 8 3 4
18 33 22 12 13 6 5 2 3 10 4 4 6
17 35 24 15 16 6 6 6 4 15 5 3 10
17 50 14 11 9 4 4 1 0 16 8 8 8
18 37 20 9 12 7 7 4 4 16 8 6 8
18 42 5 17 8 4 4 1 3 18 0 4 18
18 37 10 12 8 3 3 1 1 20 12 20 8
20 58 28 8 17 7 6 2 4 13 11 20 2
17 45 19 3 7 4 4 4 0 12 14 14 -2
18 40 11 21 11 6 5 1 3 15 4 8 11
18 42 19 15 13 5 4 3 3 15 10 12 5
20 51 5 14 14 3 3 1 2 17 0 10 17
18 35 21 16 9 5 4 3 2 14 5 5 9
20 31 33 12 6 4 3 3 1 ■ 12 8 4 4
18 37 8 8 1 5 4 1 3 15 0 8 15
19 34 6 14 6 5 5 1 0 16 4 8 12
20 37 10 19 10 10 9 8 1 15 10 8 5
18.40 37.84 16.08 12.56 11.32 4.32 3.96 2.20 1.76 14.92 5.64 7.20 9.28
7.76 3.95 3.79 1.93 1.73 1.51 3.11 4.16 5.34
APPENDIX 0— Continued
CONTROL GROUP
S# Sex Age
FSS TMAS
AS-B,
EPI-E EPI-N AS-A AS-X AS-Y
AS
B-Y SF-B SF-X SF-Y
SF
B-X
SF
B-Y
1 M 17 37 11 12 6 6 6 6 0 16 14 14 2 2
2 M 18 34 26 13 6 4 4 4 0 12 11 12 1 0
3 M 20 30 17 13 3 4 4 3 1 16 6 24 10 -8
4 M 19 43 7 9 10 3 2 1 1 13 15 16 -2 -3
5 M 18 29 9 9 4 2 2 1 1 16 8 4 8 12
6 F 23 32 12 5 20 2 2 2 0 10 10 12 0 -2
7 F 19 36 34 15 18 6 5 6 -1 17 14 20 3 -3
8 F 18 45 26 7 15 2 2 2 0 12 14 12 -2 0
9 F 16 45 11 14 4 4 3 3 0 12 10 12 2 0
10 F 19 49 36 11 19 2 2 2 0 16 14 13 2 3
11 F 17 45 12 9 10 4 3 3 0 14 14 14 0 0
12 F 19 32 35 16 1 3 3 2 1 13 15 16 -2 -3
13 F 18 37 16 13 11 4 4 3 1 14 17 14 -3 0
14 F 18 46 15 14 13 3 3 2 1 14 13 28 1 -14
15 K 18 28 16 17 7 2 2 2 0 15 16 15 -1 0
16 F 19 45 19 10 12 3 3 2 1 15 16 24 -1 -9
17 M 22 27 12 12 9 2 2 2 0 15 15 20 0 -5
18 M 23 32 9 15 6 4 4 4 0 17 18 20 -1 -3
19 F 19 40 24 18 11 7 7 7 0 14 12 11 2 3
20 M 17 25 8 15 10 3 3 2 1 15 15 20 0 -5
21 M 18 37 29 21 4 5 4 3 1 15 14 14 1 1
22 F 19 34 5 18 14 8 8 8 0 19 17 16 2 3
23 M 19 33 31 19 10 2 2 2 0 14 13 12 1 2
24 M 18 22 32 14 3 8 8 8 0 15 15 13 0 2
25 F 18 41 25 14 8 5 4 4 0 15 16 12 -1 3
M 18.76 36.16 19.08 13.32 9.36 3.92 3.68 3.36 0.32 14.56 13.68 15.52 0.88
SD 9.82 3.82 5.06 1.98 1.88 2.79 5.03
133
APPENDIX P
TABLES OF ANALYSES OF PERSONALITY DATA
TABLE P-l
SUMMARY OF ANALYSIS OF VARIANCE BY GROUPS FOR
EPI EXTRAVERSION SCORES
Source df SS MS F
P
Between groups 3-1 = 2 27 . 39 13.69 0.792 NS
Within groups 75-3 = 72 1,244.56 17 . 29
Total 75-1 = 74 1,271.95
TABLE P-2
SUMMARY OF ANALYSIS OF VARIANCE
EPI NEUROTICISM SCORES
BY GROUPS FOR
Source df SS MS F
P
Between groups 3-1 = 2 48. 35 24.17 1.214 NS
Within groups 75-3 = 72 1,433.44 19.91
Total 75-1 = 74 1,481.79
134
135
APPENDIX P— Continued
TABLE P-3
SUMMARY OF ANALYSIS OF VARIANCE BY GROUPS FOR TMAS SCORES
Source df SS MS F
P
Between groups 3-1 = 2 114.00 57 .00 0. 736 NS
Within groups 75-3 = 72 5 , 574.32 77.42
Total 75-1 = 74 5,688.32
TABLE P-4
SUMMARY OF ANALYSIS OF VARIANCE BY GROUPS FOR
FEAR SURVEY SCHEDULE SCORES
Source df SS MS F
P
Between groups 3-1 = 2 54.72 27 . 36 0.421 NS
Within groups 75-3 = 72 4,681.56 65. 02
Total 75-1 = 74 4,736.28
TABLE P-5
SUMMARY OF ANALYSIS OF VARIANCE BY GROUPS FOR AGE
Source df SS MS F
P
Between groups 3-1 = 2 5.05 2.52 1.659 NS
Within groups 75-3 = 72 109.62 1. 52
Total 75-1 = 74 114.67
136
APPENDIX P— Continued
TABLE P-6
SEX DISTRIBUTION IN THE 3 GROUPS
N T C
Male 9 9 12 30
Female 16 16 13 45
25 25 25 25
Chi-square is 0.0877 and non-significant.
TABLE P-7
MEANS ON THE EPI-E AND THE EPI-N SCALES FOR
AND THE COLLEGE NORM GROUP (N =
THE STUDY SAMPLE
1,003)
Sample Norm t
P
EPI-E 13. 3 13.1 0.152 NS
EPI-N 10.4 10.9 1.603 NS
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Asset Metadata
Creator
Myerhoff, Howard Lee
(author)
Core Title
Tension And Anxiety In Deconditioning
Degree
Doctor of Philosophy
Degree Program
Psychology
Publisher
University of Southern California
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University of Southern California. Libraries
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Tag
OAI-PMH Harvest,Psychology, clinical
Language
English
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Digitized by ProQuest
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Advisor
Jacobs, Alfred (
committee chair
), Larson, William R. (
committee member
), Tiber, Norman (
committee member
), Wolpin, Milton (
committee member
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