Q.

1 The behavioral therapy that can help James reduce his fear of spiders is systematic
desensitization. It is a way of reducing undesirable responses to the stimuli. This makes it a
particularly appropriate way of managing phobias, such as spider phobia. It is referred to as
counterconditioning as it includes the idea of reciprocal inhibition. James will undergo certain stages
with the therapist to desensitize his fearful feelings. He will learn the process of muscle relaxation
and visualization exercises for the anxiety hierarchy. James hierarchy could include watching the 2D
black and white picture of the spider preferably the first task of his hierarchy to holding the real
spider in his hands that could be the last item of his list.

Q.2 a) The nomothetic debate includes the research methods that look for generalizations such as
experiments. This contrasts with the idiographic approach which focuses on individual and unique
cases such as case studies.

b) One strength of the idiographic debate of the explanations of anxiety is that it supports specific
phobias and case studies such as little albert rat phobia by Watson and Rayner can help in collecting
in depth data of classical conditioning. Similarly, the case study on little Hans about horse phobia by
Freud gives us a clear understanding of psychodynamics. Thus, explanations of phobias are
supported by an idiographic approach.

Q.3 a) Ash with BII while exposed to medical techniques can experience a drop in blood pressure that
leads to fainting. To overcome the lower blood pressure Ash must work on applied muscle tension
techniques that can help in reducing instances of fainting.

Another way Ash can undergo with is CBT that can helps him in challenging irrational thoughts and
replace them with rational ones. This can include a fear hierarchy. These thoughts can help Asch to
overcome the anxiety while exposed to the medical procedures.

b) BII is measured through a psychometric tool called blood injection phobia inventory. It is a self-
report with 18 items on situations about blood and injection that collects quantitative data. Hence, it
lacks in-depth explanations about the blood and injection situation patients are rating. For e.g this
numerical data cannot give reasoning behind the scores the patient rated from 0 to 3, comprising
data collection of individual differences.
Q.4 a) The treatment and management of phobias includes behavioral therapy, systematic
desensitization. It is a way of reducing undesirable responses to situations. It is a behavioral therapy
based on the principles of classical conditioning. It helps patients unlearn phobic reactions by putting
the feeling of fear associated with a phobic stimulus directly in conflict with feelings of deep
relaxation and calm. Once a frightening stimulus eventually becomes neutral and provokes no real
anxiety. The first stage of therapy involves teaching the patient muscle relaxation and breathing
exercises that can also involve the use of anti-anxiety drug. Secondly, a fear of hierarchy is created
with the list of anxiety provoking situations relating to the specific phobia, from top to bottom least
anxious scenario to the most. Lastly, patients work their way up the hierarchy practicing the
relaxation techniques on exposure to each level until they reach the highest fear.

The introduction of behavioral therapy for anxiety disorders such as systematic desensitization paved
the way for further forms of treatment, including applied tension to muscles to increase the blood
pressure to treat blood phobia that is associated with lowered blood pressure and fainting. Cognitive
behavioral therapy can also be an effective treatment of specific phobias including BII phobia. CBT
includes The case study has been conducted by Chapman and DeLapp (2014) to investigate whether
BII phobia could be successfully treated using CBT and applied tension muscle. The sample includes a
42-year-old white male, diagnosed with BII phobia by blood injection symptom scale (BISS).
Interviews and questionnaires were used to collect in-depth data on him. This includes details about
the death of his several family members and that other family members had fainting history during
medical procedures. He was also diagnosed with depressive disorder by Beck depression Inventory
(BDI). He underwent nine sessions of CBT and applied muscle tension while exposed to fear
hierarchy. The Subjective Unit of Discomfort Scale (SUDS) was used to collect anxiety rating of him.
Self-report measures showed his anxiety dropped significantly even after the 4, 10 and 12 month
follow up and showed no signs of BII. This concludes the success of CBT and applied tension as now
he was able to engage in medical procedures with minimal symptoms.

b) Case study allows the participants to be studied in detail for e.g in study by Chapman and DeLapp
the 42-year-old was interviewed about his family histories that gives us detailed understanding of
specific circumstances surrounding him. This can also help us in getting a range of behaviors to
understand changes over time and their trends. A series of questionnaires were used in several areas
of his life, and its findings were compared overtime that helped in comparing the BII symptoms and
its reduction even after the follow up. Case studies support longitudinal study plan. However, a key
weakness of case study comes from the difficulties in generalizing the results. As it talks only about a
particular person in this case a 42-year-old man so its cannot be generalized to the females and other
age groups in the wider population. Furthermore, a case study cannot be replicated as there won’t
be another person of the same circumstances for e.g this man not only had blood phobia but also
was diagnosed with depressive symptoms so this study cannot be checked for reliability.

The various treatments of anxiety disorders can be useful in their application to real life. The
research into systematic desensitization can be applied to everyday life as it can be used as a non-
drug treatment to help to treat or reduce the severity of phobias and therefore help patients to
regain a higher quality of life. The methods they learn during the treatment can be used again if
needed, so this can offer a long-term solution to their problem. But CBT requires a therapist which
can be too expensive and time consuming for a person. However, the type of phobia could limit the
application of the treatments for e.g successful for blood phobia is particularly significant due to the
importance of medical procedures when necessary but someone with water phobia could avoid the
water and still life a healthy life. Furthermore, applied tension and systematic desensitization are
ethically questionable because the individual requires to encounter or actively think about the
phobic stimulus which causes extreme distress and there is no protection from psychological harm.

With regards to the treatments of phobias, one evaluative debate could be nature versus nurture
debate. The nature debate states that the behaviors are caused due to innate biological reasons,
applied tension assumes that phobias can be treated just by tensing the muscles to increase blood
pressure and since this is a biological response it supports nature side. The advantage can be that
simple cause and effect between physiology can be made. The nurture debate states that behaviors
can be learnt through interactions with the environment. Thus, systematic desensitization on the
other hand uses classical conditioning to desensitize the individual who has a phobia. Since the
participants makes the learned associations this treatment, therefore, supports the nurture side.
However, the nature and nurture sides are difficult to separate as applied tension was supported by
the sessions of CBT in the study of Chapman and DeLapp. Conclusively, Nature and nurture
techniques complement each other side by side.

Reductionism versus holism is another aspect since which treatments of phobias can be evaluated. It
is the argument that we can explain disorders with reference to only one factor such as genes
whereas holism explains the disorder by considering the multiple factors. The use of systematic
desensitization to treat phobias is a reductionist approach because the treatment is mainly based on
classical conditioning which only considers learnt behaviors and ignore other factors like genetic
explanations which could possibility cause phobias. The advantage of this side could be that it helps
in establishing the cause-and-effect relationship while minimizing the extraneous variable as
conducting research on simpler factors is more practical. However, the case study by Chapman and
DeLapp is more holistic because it takes a lot of approaches into account for treating BII for e.g
applied muscle tension supports physiological and biological explanations whereas CBT supports the
background of cognitive and behavioral approaches, but this study could be reductionist to some
extent because of research method was case study. The advantage can be that this side of debate is
more valid due to a lot of factors explaining the phenomena.

Lastly, the methods that psychologists use to collect data about the treatments of anxiety disorder
can also be evaluated. Many different techniques were used to gather information in the study by
Chapman and DeLapp including the BAI, BDI, Q-LES-Q and BISS; all of which provide quantitative data
to allow for statistical analysis to be carried out, and for data pre and post treatment o be compared.
This makes these psychometrics face, predictive and concurrent valid. In addition, there were
detailed interviews to gather qualitative data in the nature of the full history of T’s (42-year-old man)
life. A weakness, however, of all these measures is that they rely on self-report so this may lead to
inaccurate information. This may be due to social desirability subjective interpretation, or misleading
information that decreases the validity. For e.g the patient feels that they should report an
improvement of symptoms even if it is not fully the case. Patients can also misinterpret the
information or evading questions can influence the responses.

NOTE: Only THREE paragraphs on evaluation is required. ONE on named issue (1st paragraph)
followed by other two of your own choice.
Q.5 a) The biological genetic explanation suggests that it is in our genes transmitted through
generations to fear and avoid stimuli in the environment which may pose a threat to survival. An
example study was conducted in which blood phobic participants underwent a behavioral test while
59 injection phobic saw performance of live injection procedure. All participants also completed a
questionnaire on their thoughts during the test and had their blood pressure and heart rate
monitored. Blood phobic subjects that more first-degree relatives with the same phobia 61%
compared to injection phobia subject 29%. In addition, the blood phobic patients were more likely to
fear that they would faint in the phobic situation than the injection-phobic patients (77% vs 48%). In
conclusion there appears to be a strong genetic link for both these phobias and are more likely to
lead to a strong physiological response that is fainting.

The behavioral explanation of phobias is based on the principles of classical conditioning i.e. an
individual can develop a phobia of a neutral stimulus (NS) if it is paired with something the individual
is afraid of (the unconditional stimulus) multiple times. Then, even in the absence of the UCS the NS
produces a reaction of fear in the individual. Thus, the NS has now become the CS (conditioned
stimulus). A case study is evidence of this principle where a phobia of white rats was produced in an
11-month infant. The banging on a metal bar behind child every time when he touched the rat which
made him cry. Eventually, just the sight of the white rat was enough to cause fearful crying and
avoidance. Thus, fear was inculcated in the child.

The psychoanalytical explanations states that phobias are defense mechanism against the anxiety
created by any resolved conflict between the id and the ego. The ego displaces the unconscious
anxiety onto harmful external objects. A case study was conducted on a five-year-old boy who had
horse phobia. He was experiencing the Oedipus complex when he saw the horse dying in the street
and in the meantime, he was passing the phallic stage. He was subconsciously afraid of his and this
was the fear of his father which was manifested in a fear of horses.

b) With regards to the explanations of phobias, one evaluative issue can be nature versus nurture
debate. The nature side of the debate states that behaviors are caused due to innate biological
reasons, whereas the nurture side of the debate states that behaviors can be learnt through our
interaction with the environment. The biological explanation supports the nature side of the debate
as it relies on innate tendencies e.g genes to explain the prevalence of fear such as in blood phobia
due to strong physiological response (fainting). The advantage of this debate is that it helps in
innovations of appropriate drug therapies. The behavioral explanations rely on nurture debate as
through classical conditioning the rat phobia was made learnt to the infant. This debate can help in
generating different behavioral therapies. However, a disadvantage of this debate is that both nature
nurture factors often interact with each other, making it hard to disassociate both their influences.
Consequently, both the factors are important, the interaction between nature and nurture could best
explain the causes of phobias.

The use of children in research regarding the explanations of phobias can be evaluated. Both the
case studies used children as a participant as they are easily available. Children are the blank slates
as they have not learnt much from previous life experiences. This control can help in giving valid
results. Also, children do not have developed thought process so it can help in controlling
confounding variables as they will not figure out the aim of the study, reducing demand
characteristics and increasing validity that were drawn from the results in the case studies above.
However, the use of children is not ethical as they cannot speak up for themselves in case of any
psychological harm and cannot give informed consent or be debriefed. For example, there was no
protection from psychological harm in the case of the child who underwent traumatic conditioning
experience of loud sound and rats.
Lastly, determinism versus freewill could be another evaluative point for explanations of phobias. A
determinist explanation refers to something that we do not have control over our behaviors and that
we merely responding to factors that have pre-determined our behaviors by factors such as genes,
whereas the free will suggest that people do have control over their behaviors and emotions they
can alter them and can choose to respond according to own needs. So, the psychodynamic and
biological explanation for phobias is determinist because individuals who develop the phobia have
no choice but to develop be due to physical factors or conflict in unconscious mind. The advantage of
this side of debate can be that it removes blame from the individual as these pre-deterministic things
are not in control, leading to liberating effects but offers less hope to patients to change their
behaviors. On the other hand, freewill can be the behavioral explanations as the environmental
factors can be in control to some extent. Mostly the associations are done in subconscious mind. The
classical conditioning can be desensitized which gives more power and motivation to the individual
for betterment. However, if the individual does not improve then can be criticized.