Tag Archives: Behaviorism

Mental Illness: Nature or Nurture? #Write31Days

31 Days of Mental Health

Welcome to the seventh installment of the 31 Days of Mental health series. Today, I picked another of the 30 questions from the 30-day awareness challenge: do you believe nature (biology, physiology, etc.) or nurture (your psychosocial environment) causes mental illness? I am very tired, too tired to find the scientific evidence to back my post up with. will share what I do know off the top of my head, but please don’t ask me to cite my sources.

In medicine in general, there used to be a strictly nature-based model of illness and health. This determined that biological and physiological processes in the body caused illness and there was no contribution of psychological or social influences. This model is called the biomedical model and my health psychology book used it to describe the history of views on physical illness.

In mental illness, there have been many schools of thought that laid blame on the environment, in fact. For example, Freud blamed fixations in one’s psychosexual development for mental illnesses. The school of behaviorism also blamed the environment. Watson, the founding father of behaviorism, at one point said that, if given a handful of babies at birth to raise, he’d be sure he could make whatever you wanted the babies to become from them purely by processes of conditioning (behavioral learning).

It is interesting that there is such a distinction between the biomedical views on physical illness and the psychosocial views on mental illness. After all, though religion may say otherwise, scientists usually see the mind as part of the body. At least the brain is and dysfunction in the brain can cause mental disorders.

I currently study healht psychology at university. Health psychology feels illness as resulting from an interplay of biological, psychological and social factors. Again, they usually study physical illness, but I must say I believe the same goes for mental illness.

I remember when I was still diagnosed with dissociative identity disorder reading a scientific article that said in part that the role of psychological trauma in the cause of what is often diagnosed as DID may be less significant than people think. They used the analogy of borderline personality disorder, which they said most people diagnosed with DID truly have. BPD is commonly thought of as a developmental trauma disorder, but research shows that there may be genetic and other biological factors predisposing to its development. Then again, trauma researchers have made it very clear that trauma and other strong environmental factors alter the brain.

I personally tend to believe there is not a single mental illness that is solely caused by nature or nurture. There are illnesses where biology is the main causative factor, such as schizophrenia, and illnesses where psychosocial factors are the main cause, such as post-traumatic stress disorder. However, stress can trigger psychosis in vulnerable people and trauma only causes PTSD in some of its victims, presumably those biologically predisposed to PTSD.

As for my own mental illness, there are biological factors predisposing me to developing mental disorders. Though I don’t have any family members diagnosed with a mental illness, autistic traits run in my family. NOw again I don’t see autism as a mental illness, but autistic people are more vulnerable to mental illnesses than neurotypicals. I also was a preemie, which may’ve caused brain dysfunction. Lastly, though none of my famly members are mentally ill, a difficult temperament tends to run in my family.

As for psychosocial factors, I am a childhood trauma survivor. I also have had high levels of stress in my life, possibly due to the incongruence between my autistic self and the neurotypical environment. It was a stressful event that sent me over the edge, but it was probably biology that predisposed me to vulnerability to stress.

Thoughts on Autism and Behavior Modification

As I said yesterday, autism sucks sometiems. This doesn’t mean it needs to be eradicated. Then again, not eradicating it doesn’t mean not pursuing treatment for its bothersome symptoms. I would pursue treatment for certain symptoms even in an ideal society. For example, I take medication for irritability and anxiety and see no reason not to.

Where it gets trickier is when I’m forced by circumstances to pursue treatment, and others dictate what kind of treatment I get. I may legally be an adult, but I am not in a position to live without supports, which in essence creates a power dynamic in which my staff largely determine whhih of my symptoms get treated and how. Behavior modification is staff’s favorite treatment modality, and even though originally, behaviorists tended to include the environment in their assessments of behaviors, B-mod has largely gone down to ignoring and/or punishing “negative” behaviors and sometimes rewarding “positive” ones.

I put these two between scare quotes because, what is perceived to be a positive or negative behavior, is not always (or rather, is rarely) objective, and even when a behavior is by most perceived to be positive or negative, the way it’s handled may still vary depending on people’s perceptions of what is behind said behavior (which, I might say, the original behaviorists didn’t care about). For example, as long as I’m not acting out aggressively towards others (which icnludes mild verbal aggression), I can exhibit as much self-directed violence as I need to. I assume the idea behind this is that I’m borderline and borderlines need to be responsible for their own behavior and its consequences. I’ve had people seemingly more annoyed at the fact that they had to take care of my physcal wounds than concerned at the fact that I’d inflicted them.

Now we’ve moved past the times when cognitions, emotions etc. didn’t exist. Lay behaviorists (ie. most staff) have taken just what they want out of behaviorism. I remember in 2008 my diagnosing psychologist recommended a functional bheavioral assessment on my meltdowns. This includes close observation of behavior, antecedents and consequences, in order to hopefully find the stimuli that trigger the aggressive response. Now I’ve not yet figured out what I think of this, but I never got to, since such an assessment never took place. The staff introduced seclusion, used it as a threat when I became even slightly irritable, noticed that made my behaviors decrease and decided this was the cure.

Now let me tell you: autistics have as much emotion, cognition and sensation as neurotypicals, we just experience it differently. If you wouldn’t want to be subjected to harsh behaviorism yourself, then don’t subject an autistic to it. If you want to eradicate a behavior, observe its situational context closely and consider how you would respond in this situation. Is the autistic perhaps trying to communicate the same that you would in this situation, only using a different modality? Are they perhaps responding to sensory overload the same you would, only experiencing this overload differently than you would? If so, consider meeting the autistic’s needs beofre you attempt to modify their hehavior. If you want to modify their behavior anyway, consider whether you would want your preferred B-mod method used on yourself. I think everyone who has the power to seclude, restrain or tranquillize another person, needs to have expierenced it themselves first. Lastly, don’t assume that just because the autistic isn’t displaying behavior that annoys you, it means that they’re coping fine.