Behavioral Self-Help Books (of the 70s)

This was a 1977 compendium of 14 individual chapters written by different authors, including one Todd Risley. This was sponsored by the Banff International Conferences on Behavior Modification, which was apparently ahead of the game, having had their inaugural meeting in 1969.  

The many faces of self-control, or behavior modification changes its focus
Frederick H. Kanfer
Kanfer hypothesizes a two-part model of self-control: the initial, free operant choice (termed decisional self-control); and persistence driven by values (termed protracted self-control). He appears to treat the process as molar (versus molecular), and recognizes the continuing free-operant nature of self-control in a discussion of delay discounting. This chapter is well-done, and it explains how pigeons can be trained to tolerate a delay, while we had to wait until 2014 to learn how gamers can get the same training.

Biofeedback and the self-management of dysregulation disorders
Gary F. Schwartz
Schwartz argues that insufficient or inaccurate feedback can hamper progress, and one solution could be biofeedback, a technology-enabled form of monitoring and feedback. In an interesting digression, he illustrates his point by mentioning commercials for antacids, drugs that combat what could be a natural form of feedback, presaging the current enthusiasm for GLP-1 drugs – which have effectively severed normal systems of environmental feedback (and one theory for why sugar substitutes increase obesity). While we’ve been told that we have better technology than 1977, we are in a bizarre position in which biofeedback has apparently not advanced, just like…wages.

The social context of self-control
Todd R. Risley
Risley ran multiple experiments on school children, finding that you could increase what they say, or change the content of what they say (e.g., teach them to explain that “being polite is good.”) without changing what they actually do. To change what kids do, you have to give feedback on their performance, at least initially; Risley describes how this is true of behavior change in adults – they can’t just say what they want to do without feedback. “Self-control,” then, is a say/do correspondence, and you should do what you say Deborah!

The use of relaxation and cognitive relabeling as coping skills
Marvin R. Goldfried
Unfortunately, this chapter does not detail the actual procedures of behavioral relaxation, but Goldfried notes that his clients often generalize the skill before he is able to engage them in desensitization – and then don’t actually need the desensitization program. In a wild irony, he seems to begrudgingly include “cognitive relabeling” as a skill because critics of relaxation believed that relaxation by itself did not address underlying causes of anxiety. For this sin, Steve 

Hayes will rub his head stubble against Marvin Goldfried’s shins for eternity.

Meditation, self-control, and alcohol use
G. Alan Marlatt and Janice K. Marques
Marlatt & Marques describe a study of college-aged problem drinkers who were assigned to treatment groups including meditation, progressive relaxation, placebo (reading quietly), and no treatment control. The treatment groups and the placebo group all decreased their drinking, increased their feelings of control, and increased their relaxation, with the meditation group showing the largest gains. Most students stopped their assigned practice when the study ended, but the meditation group had the most adherents, so perhaps meditation is more addictive than alcohol.

Behavioral self-control training in the treatment of problem drinkers
William R. Miller
Experiment 1 compared aversive conditioning (self-administered finger shocks while smelling preferred alcoholic beverages), a self-control teaching intervention, and a more intensive and comprehensive self-control intervention, finding that both self-control interventions outperformed aversive conditioning by reducing average number of drinks. In experiment 2, participants were given either an instruction manual, or an instruction manual plus a weekly meeting with a therapist, finding that both conditions reduced drinking in a similar manner. In experiment 3, participants attended 10 weekly 90 minute classes, and drinking was reduced. All of these experiments were designed, in part, to counteract the Alcoholics Anonymous dogma that a person must be completely abstinent from alcohol, but…do we conduct studies to ensure that people can smoke a reasonable amount?

Effects of self-control procedures for insomnia
Richard R. Bootzin
Bootzin has found that any behavioral relaxation method helps slightly with sleep, but more important is stimulus control. The methods are simple: lie down only when sleepy, use the bed only for sleeping, if unable to sleep get up, go to bed and wake up at the same time each day, and do not nap. Despite being squarely gen-X aged, these instructions are mostly the same today, therefore gen-X isn’t all bad.

Parameters of self-monitoring
Richard M. McFall
McFall summarizes the methods, benefits, drawbacks, and research applications of self-monitoring. He includes helpful bullet points on how to improve self-monitoring, including training a person in data collection, ensuring their motivation, a well-designed system, low response-effort, low response-competition, and reinforcement/feedback. These are great tips and I can’t wait to self-manage someone else.

Development and evaluation of weight reduction procedures in a health maintenance organization
Carol Landau Heckerman and James O. Prochaska
Three treatment groups met once every 12 weeks for 90 minutes, and were divided into 3 groups: 

• standard self-control, in which they were given nutrition information plus info on self-monitoring, stimulus control, self-reinforcement, and social reinforcement; 

• self-control plus contingency contracting, which was the same as the first group plus a contract to lose 1 pound per week with a corresponding $2 refund of their deposit (or response cost of $2 for failure); 

• and self-control plus internal control, which was the same as the first group plus information that they could control their behavior through antecedents and consequences, and could replace eating with other behaviors and self-talk. 

All groups lost similar amounts of weight, but did not continue to lose weight after the study ended. Given this fact, the authors recognize that this was not self-control per se, but social control, and perhaps more effective than contingency contracting is judgment. 

Using environmental restriction to initiate long-term behavior change
Peter Suedfeld
The author introduces his work, wherein he tries to induce changes in behavior by giving a brief message after subjects spend 24 hours in a sensory deprivation tank, as something he assumed would not work. An initial experiment found, to his surprise, that sensory deprivation reduced smoking with or without an anti-smoking message. Follow-up studies found that addicted smokers sometimes easily quit after 24 hours in sensory deprivation, which the author believes is because of a lack of environmental cues to smoke (e.g., SDs). The section detailing criticisms of sensory deprivation is longer than the successes, as people seem to think it’s related to “brainwashing” or powerful manipulations of behavior, and in fact Suedfeld has tried to change “sensory deprivation” to the acronym “R.E.S.T.” (still called “isolation tank” on wikipedia).

Development of women’s self-help clinic
Lynn Buhler and Reta McKay
Women in Vancouver in the early 1970s were facing trash medical care, wherein mostly male doctors were dismissive and unhelpful, and formed a self-help medical collective through ads in a feminist magazine. Over the course of a year, some women apprenticed with helpful doctors, and they visited a self-help clinic in Seattle, and became proficient in some basic women’s services, and patched together funding from various grants and donations. An interesting perspective: people can have high motivation to engage in “self-help.”

Self-help group approach to self-management
Richard B. Stuart
A man after my own heart, Stuart notes the impossibility of evaluating self-help books, and the impossibility of a random assignment to a self-help group (self-helpers are, by definition, self-selecting). Nevertheless, in a study of weight loss, Weight Watchers was shown to be superior to treatment at a hospital – and Stuart believes that the hospitals will fail due to pathologizing problems rather than treating them as behavioral problems, moral judgments, a failure to induce motivation, and a lack of community. A similar organization, TOPS, also had success at inducing weight loss, though this is a strange look back at 1977 when there was a popular movement toward weight-loss groups and also obesity continued to grow for 50 years.

Power reversal and self-help: The Vancouver Mental Patients’ Association
Phillips, Hooper, Batten, Dexall, Beamish, Pollak & McCann
Similar to the “women’s self-help clinic,” former mental patients banded together to provide helpful treatment that they did not receive from institutions. Their initial founding in 1970 involved no rules, with a bunch of guys sharing a house, which they quickly had to revise. By 1977 they had purchased a home for another location and reported success with their mission, and appear to still exist. 

Behavioral treatment of obesity: failure to maintain weight loss
Albert J. Stunkard
In lab settings, all manipulations to increase or decrease a rat’s weight – injecting with insulin, force feeding, starvation, free feeding – only temporarily change weight, until circumstances return to baseline and the weight stabilizes. At the time, two human studies, one of undereating and one of overeating, found similar results: when the subjects were free to eat ad libitum, they simply returned to baseline weight. Stunkard then outlines a few successful studies that mostly appear to use basic guidelines developed by Ferster, and reports that behavioral treatment is quite successful – though it is unclear what kind of maintenance is socially significant when it comes to weight loss.

It seems that this book is a compendium of “self-control” methods described by various specialists; for example, there is a chapter from Albert Ellis (on “treatment of a homosexual,” uh…), who is decidedly not a behaviorist (and according to Wikipedia, was an admitted serial sexual criminal? Uh…). 

But there is a chapter from Skinner!

Self-Control
Burrhus F. Skinner
Let’s explore this unique and unexpected work from Skinner – 

Shit! This is like that time I thought I found a new Skinner interview, only to realize the book was all fictional encounters.

Well, anyway – what does Skinner say here about self-management?

Reinforcement and punishment are not quite opposites, otherwise every response that encounters both (he uses drinking alcohol as an example) would simply fall into some middling rate – but this is not the case. 

Some responses are controlling, while some responses are controlled, and one way of controlling responses is through physical action, such as covering your mouth before you laugh out loud. We may make changes so that some responses are less likely (e.g., physically leave money at home to reduce spending) or to make them more likely (e.g., set up a trust fund to induce saving).

Stimuli itself can be avoided (closing curtains to reduce distraction) or presented (wearing glasses to increase vision). Deprivation (not eating before a big meal) or satiation (drinking water before going out for drinks) can be used to control behavior. The writer D.H. Lawrence is quoted as saying that a doctor once told him to forcefully engage in a habit to eliminate it – for example, to bite your nails when you don’t want to.

Emotions can be controlled, either by avoiding them (biting your tongue) or eliciting them (re-reading an insulting letter).

Aversive stimulation can be used, such as setting an alarm clock. 

Drugs (legal and illegal) can be used to alter behaviors.

In terms of self-reinforcement and self-extinction, Skinner believes that it’s not possible and that these processes bear only a superficial resemblance to operant conditioning. Self-punishment he believes to be similar. 

He discusses “doing something else” as a response that must, in fact, be emitted strongly. For example, to “not flinch” is a response (holding still) that must overcome the response “flinch.”

The main point comes in the final paragraphs, under a heading “THE ULTIMATE SOURCE OF CONTROL,” to which he refers to, of course, society. “...little ultimate control remains with the individual.”

Skinner sees this as a positive step forward: nobody is helped when told to “use your willpower.” But to have the behavioral strategies explained to them – essentially to manipulate their environment in advance – there is bound to be more successful application of the controlling behaviors.