Re: What’s the Deal With Inkblot Tests? i 4/1 would like to hear your explanation of “functional behavior analysis” … someday has come, grandpa! Enjoy reading IronShrink.com. – Head Like a Sponge
Inkblots and functional behavior analysis (FBA) are both used to assess psychological difficulties, but that’s where the similarity ends. There are at least three big differences.
First, whereas inkblots purport to uncover unseen processes inside the noggin, FBA relies only on what we can see and measure. Second, inkblots look at a person in isolation, while FBA examines a person in relation to the environment. Finally, few assessment techniques involve testing the answer to see if you’re right. FBA, like my high school algebra teacher, requires it.
You seem like the type of person, Sponge, who would demand an example.
Sally (a fictitious character based on true events) suffered from seizures for which there was no medical explanation. She and others around her noticed that the seizures seemed to occur during times of stress, especially after she received bad news or experienced unpleasant interactions with friends or family. For example, learning that she had been turned down for a job might have led to a spate of seizures.
Since her physicians couldn’t find the problem, Sally participated in a battery of psychological tests in the hopes of finding the source of her seizures. The primary tool was a Rorschach (inkblot) test.
The results of that Rorschach test suggested several psychological deficits, including impulsiveness, excessive concern about her physical safety, difficulty managing stress, and a tendency to express anxiety through bodily symptoms – for example, through seizures. There were other Rorschach findings, but most of them were unflattering and unrelated, so we’ll set them aside.
While the Rorschach offered a bit more insight than I’m reporting here, there were unnecessary shortcomings to using that approach with Sally. Foremost, it did not capture any of Sally’s strengths. The blots never bothered to notice that she was charismatic and cheerful around others, she had a good sense of humor (a wonderful coping skill), and she had a strong, analytical mind.
The Rorschach test also failed to provide new information about Sally. She acknowledged at the outset that she had difficulty with relationships, didn’t manage anxiety well, and that this might have been related to her seizures. The Rorschach only offered corroboration and elaboration.
Finally, while the Rorschach appeared to confirm her symptoms, it didn’t tell us what to do about them. Sally wasn’t putting herself through these tests for fun; she needed answers. The Rorschach produced some potentially useful information, but there is a more direct approach to problems like these. Let’s look at the same situation using FBA.
Easy as ABC
Functional behavior analysis begins with these three questions:
- What is the target behavior that the person wants to increase or decrease? (Decrease in number of seizures, in this case.)
- What antecedents happen before the behavior?
- What consequences happen after the behavior?
As good behavior analysts, we would gather information in a number of ways, especially by listening to Sally describe what went on before, during, and after her seizures. We would gather as much data as possible, searching for patterns.
In Sally’s case, we would have noticed particular types of antecedents from the environment, like losing out on a job. But antecedents can be tricky because what happensinside a person can be more important than what happens outside. A simple conversation with Sally revealed that certain types of arguments and bad news led to a tempest of unpleasant thoughts, feelings, and memories.
The same conversation revealed that Sally found such thoughts and feelings to be terribly painful. They were so painful, in fact, that she would do almost anything to avoid them. Does that mean that the seizures served the purpose of escaping painful internal experiences?
We don’t know. FBA doesn’t try to read minds. We do know, however, that Sally reported relief from her thoughts and feelings both during and after a seizure. We also know that, as miserable as the seizures were, Sally rated them as less painful than the thoughts and memories she wanted to escape.
With those important facts in hand, the next step would be to form a hypothesis about the function of the seizures. In this case, it’s a good guess (but only a guess) that the seizures provided escape from thoughts, feelings, and memories. From there, we could enlist Sally’s help in designing an intervention.
Sometimes Control is the Problem
One possible intervention would have been to help Sally control her mind and get rid of those unpleasant internal experiences. But in her case, that might have been a mistake. She was already working so hard to control her internal experience that it was likely contributing to, or even causing, her seizures.
I don’t know what your experience has been, but I’ve noticed that my mind often throws around thoughts and feelings without my permission. Same goes for memories, which can be pretty tough to control. It seems that every time I attend a professional meeting, my mind ruthlessly reminds me of the time I sneezed at a meeting and… well… enough said. Thanks, mind, for the timely reminders of old embarrassments.
A person can easily get caught up in trying to control or eliminate internal experiences. That’s one reason for the popularity of drugs and alcohol. They help us forget, if only for a little while. Sometimes, more control is not the answer.
For Sally, in fact, control seemed to be the problem. Helping her end the struggle against thoughts and emotions might have been a good place to start. If the number of seizures decreased, then we would have known that we did something effective. If they stayed the same or increased, then it would have been time to reexamine the data and create a new hypothesis.
And that’s the beauty of functional analysis. When it works, you know it. When it doesn’t, you gain new information about the problem. Other assessment tools have no such self-correcting mechanism.
FBA has proven useful for problems ranging from dog training to family therapy. Not that there’s any similarity. And FBA is central to cutting-edge research that is leading to new and effective treatments for anxiety, depression, and other common ailments. Curious? Ask me about relational frame theory sometime, Sponge.
References & Good Reads:
Baum, W.M. (2005). Understanding Behaviorism: Behavior, Culture, and Evolution. Malden, MA: Blackwell Publishing.
Chance, P. (1998). First Course in Applied Behavior Analysis. Albany, NY: Brooks/Cole Publishing Company.