How do BCBAs define 😵‍💫 anxiety?

Tuesday, July 12, 2022

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6 minute read | contribution authored by Keira Moore, Ph.D., BCBA-D

Generally speaking, psychologists (and lay people) treat anxiety as something people “have” rather than something people “do.”  In other words, anxiety is treated as this sort of mystical thing inside of us that causes us to feel and act a certain way. It is generally viewed as some sort of private event that causes behavior as well as physiological responses like sweating, shaking, increased heart rate, or butterflies in the stomach. As we know from Skinner’s early writings, this dualistic conceptualization of private events causing behavior doesn’t really serve us well as behavior analysts. Conceptualizing anxiety (or any other emotion) as this sort of “special case” of a stimulus inside of a person that causes behavior does not allow us to measure anxiety, define it, or even verify that it is happening, and more importantly it leaves us powerless over how to change behavior that is supposedly “caused” by it.

As behavior analysts, we have to be careful to avoid that dualistic view of anxiety as a thing that causes behavior. Instead we should treat anxiety AS behavior and understand that it is learned through interaction with the environment just like any other behavior. I like to think of anxiety as a “category” of behavior, much like “aggression” or “self-injury.” Anxiety is a cluster of responses which can include many different topographies that can be operant and/or respondent behavior. Those responses may be public, private, or both. The important thing is the context in which those behaviors occur; and that context is specifically when an upcoming aversive event is signaled. So, for example if a child is sitting outside the principal’s office waiting for a meeting, he may describe himself as anxious. This anxiety may include respondents like increased heart rate, butterflies in the stomach, or sweaty palms, and may also include operants like biting his nails or fidgeting with his clothes. In this case, these anxious behaviors are a result of signaling of an upcoming aversive event (a meeting with the principal). The difference between the behavior analytic conceptualization of anxiety and the traditional/layman’s conceptualization of anxiety is that behavior analysts would say environmental events (signaling the upcoming aversive event of going to the principal) are causing anxious behavior, whereas the layman’s conceptualization would be that anxiety itself is causing the responses of nail biting and fidgeting and the feelings of butterflies in the stomach and increased heart rate.

When we define anxiety as behavior instead of a thing that causes behavior it becomes easier to measure, assess, and treat it. We can operationally define all of the different topographies that make up anxiety for an individual, then manipulate the environment to determine what environmental events elicit or evoke anxiety, and what consequences may reinforce anxious behavior. From there, we can treat anxiety functionally, just like we do with any other behavior!