Almost every psychologist I saw to help my own daughter suggested I that I institute a behavior modification program at home to change her “behavior.” As a psychology intern working in a school, I was very familiar with behavior modification programs, and I had a feeling from the beginning that this was not going to work. I knew because of how my own reactivity to sounds worked.
A behavior modification plan is based on the principle that a reward will bring about or increase a desired behavior, and/or that a loss of a privilege associated with an undesired behavior will decrease or extinguish it. Another common strategy used to extinguish behavior is to ignore it.
Can I just say… DISASTER.
Behavior modification plans by nature imply that the child is in control and has at least some ability to direct her own behavior, and will do so if the reward is captivating enough. Eventually, according to this idea, the “reward” eventually becomes intrinsic. That is, a child will first modify his behavior in order to receive the designated reward (e.g. a new toy). However, eventually the child exhibits the desired behavior simply because he or she is “rewarded” by the positive reinforcement of others and due to the feelings of self-esteem and self-efficacy he has developed in modifying his or her behavior.
There is nothing worse that setting your child up for failure. Ultimately that is exactly what happened. My child wanted the rewards we were offering up very badly. However a young child who cannot self-soothe because auditory stimuli is setting off their nervous system cannot possibly succeed in this method.
I wondered how it was possible that psychologists didn’t know this. What kind of field had a gotten myself into? I often wondered this as I looked at all the sticker-charts posted around the elementary school where I was interning. This was working for these children? I asked teachers in the school and many of them swore by behavior modification. Am I a terrible mother? Should I even be a psychologist? Something in my gut told me that there was a big piece missing in my training.
Simply put, when dealing with a disorder that is driven by incoming stimuli (auditory specifically), therapies that rely solely on techniques that reflect a “mind over matter” approach are counter-productive. Sensation is a physiological experience and while it involves a variety of phenomena, it’s not a top/down process that starts with cognition or behavior.Want to learn more? Join a Workshop with Dr. Jennifer Brout or Duke CMER at Misophonia Education.