Background to my interest in teaching children with autism

PSYCHOTHERAPY BEYOND THE FRINGE, continued
This doesn’t sound like it would do anything, does it? The way it works is fairly simple. The purpose is to train anxiety reduction to a voluntary (verbal) cue (in this case, ‘Be Calm’). Most anxiety is ‘anticipatory’ anxiety – that is, it anticipates discomfort. To learn how to reduce such anxiety, it has first to be aroused in a controlled fashion, and then reduced quickly and on demand. There are lots of ways of making a person anxious, but very few of them allow the anxiety to be reduced quickly and on demand. The electrical shock stimulus provides a way to create mild pain which can quickly be relieved as soon as the shock stimulus is turned off. But we don’t want pain; we want anxiety to be aroused and relieved. So the instructions ask the person not to experience pain, but to give the verbal cue (‘Be Calm’) at that moment when he or she expects that the level of stimulation is just about to become uncomfortable – that is, when discomfort is anticipated.
So, every time the person feels anticipatory anxiety, and then gives the verbal (‘Be Calm’) cue, the body discovers (from the many practice trials) that it feels a reduction in its discomfort or anxiety. After a while, every time the person gives and/or hears the ‘Be Calm’ signal, whether or not attached to the shock stimulus, the body reacts by reducing its anxiety. Apparently, it learns that the cue signals that the anticipated discomfort is about to be reduced.
The method conditions or trains anxiety-relief. That, in turn, provides a means by which the person can calm him or herself down at any time during the day, and also provides a means for the nurse to create non-chemical calmness in her patients twice a day during the regular anxiety-relief conditioning sessions.
This programme was an important one on the Unit. A quick glance at each patient’s recorded ‘voltage tolerance’ levels for the day provided Felicity with a simple and quick way of monitoring how each one was doing. If the ‘voltage tolerance’ (the point on the voltage scale at which the patient gave the ‘Be Calm’ signals) was unusually low, he knew the patient was probably feeling pretty depressed – she was apparently particularly sensitive to any felt discomfort, which is a major indicator of depression. If the ‘voltage tolerance’ was unusually high, he knew the patient was feeling particularly defensive, emotionally rather ‘cold’, and thus less vulnerable to discomfort. If the ‘voltage tolerance’ was increasing across the twenty runs of a session, he knew that the anxiety-relief response was conditioned and was working. That is, apparently, each ‘Be Calm’ signal was calming the patient down before the next electrical stimulation, so that she would be less uncomfortable for it and thus able to accept more voltage. Once this was established, anybody could help the patient to settle down by asking her to give the ‘Be Calm’ cue even though she was not attached to the equipment. The procedure reduced distress and arousal in each of the patients, and tended to prevent disruptive actions and interactions within the group due to distress.
Having told you this long story, what follows is bound to be a bit anti-climactic. You see, the usual anxiety-relief conditioning procedure was used in an altered way for both Susan and Shirley. Moreover, we are not going to start by talking about either one of them. Be that as it may, let’s pretend for a little while that the foregoing presentation of the anxiety-relief conditioning method might have been relevant to something, such as the next story.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s