THE ORIGINS AND NATURE OF MALADAPTIVE COGNITIONS: …



THE ORIGINS AND NATURE OF MALADAPTIVE COGNITIONS: PART 1.

A HEDONIC HOMEOSTATIC MODEL OF MALADAPTIVE BEHAVIOUR AND COGNITION

MERCURIO CICCHINI

1986 a

SUMMARY

An aetiological theory of maladaptive cognitions and behaviour is presented which highlights the role of hedonic affective processes in normal and dysfunctional adaptation. The paper traces the affective consequences of psychological need-frustration during childhood development and introduces the concept of negative affective suppositions. These are dual-component (affective/cognitive) structures arising from need-frustration or other affect-producing trauma which persist over time and which can be re-activated by environmental or covert stimuli. The content and motivational effects of negative affective suppositions are viewed as the building blocks of other psychological phenomena. These structures and their contents have predictable effects on motivation and perception hence they make comprehensible a variety of clinical phenomena including maladaptive cognitions, personality traits, and anti-social acting out. The interconnectedness of affect, cognition and behaviour in human motivation is emphasised.

THE ORIGINS AND NATURE OF MALADAPTIVE COGNITIONS: PART 1.

A HEDONIC HOMEOSTATIC MODEL OF MALADAPTIVE BEHAVIOUR AND COGNITION

MERCURIO CICCHINI

Recent cognitive theories (eg. Ellis, 1962; Beck, 1967; 1974), have played a significant part in drawing attention to the phenomenological world of thought in clients seeking therapy. These theories have emphasized cognitive factors in the manifestation of emotional and behavioural disorder, and indicated that cognitive change is a desirable therapeutic goal. As Marzillier (1980) has noted, since Beck (1970) introduced the cognitive framework to the field of behaviour therapy, a "cognitive revolution" has occurred in the latter. The two systems have merged, giving birth to the cognitive-behavioural approach (eg. Meichenbaum, 1977; Kendall and Hollon, 1979; 1981).

Despite it's influence, the cognitive approach is not without it's deficiencies. For example, Marzillier (1980) points out that whilst cognitive therapy touches on three broad areas - "cognitive events", "cognitive processes" and "cognitive structures" - the latter term "as yet lacks precise meaning" (p. 256). A further issue is "whether cognitive constructs add anything to the prediction or control of behaviour" (Marzillier, 1980, p. 256). Of even greater concern are the theoretical foundations upon which the cognitive approach rests. A critical view of current cognitive theories suggests that they are incomplete or over-simplistic. For example, Eschenroeder (1982) suggests that Ellis' Rational Emotive Therapy is "one sidedly concerned with the influence of cognitive processes on human emotions and behaviour. It does not take systematically into account how environmental influences contribute to the development and maintenance of irrational beliefs" (p. 384). Coyne (1982) has also criticised the common assumption "that cognitions are the linearly causal antecedents of other psychological phenomena" (p. 4). Similarly Sarason (1979) points out that, as a result of cognitive theories' concern with current cognitions and their effects, a number of important issues have yet to be addressed. Of these, "one concerns the histories of our cognitions and the variables that shape them. A second, concerns the need for some concept of motivation reflecting the fact that some thoughts seem more energized than others" (Sarason, 1979, p. 234).

The need for a motivational aetiological theory within the cognitive perspective is demonstrated by the following quotations from Beck in which he describes the developmental antecedents and cognitive underpinnings of depression:

"In the course of his development, the depression-prone person may become sensitized by certain unfavourable types of life situations such as the loss of a parent or chronic rejection by his peers. Other unfavourable conditions of a more insidious nature may similarly produce vulnerability to depression. These traumatic experiences predispose the individual to overreact to analogous conditions later in life. He has a tendency to make extreme, absolute judgments when such situations occur." (Beck, 1974 (a)).

"The vulnerability of the depression-prone person is attributable to the constellation of enduring negative attitudes about himself, about the world, and about his future. Even though these attitudes (or concepts) may not be prominent or even discernible at a given time, they persist in a latent state like an explosive charge ready to be detonated by an appropriate set of conditions. Once activated, these concepts dominate the person's thinking and lead to the typical depressive symptomatology" (Beck, 1967, p277).

These quotations lead to questions such as "by what processes does the person become sensitised to adverse experiences?", "how and why does the individual acquire his idiosyncratic concepts?", "what are the processes by which these concepts are maintained over time?", "how are they activated?", what properties do they have?", "how are they related to other psychological processes?", and so on.

It is intended to begin an exploration of these questions in two papers which outline the acquisition, maintenance and activation of maladaptive cognitions, as well as their motivational propensities.

The first article provides a theoretical overview of the aetiology of maladaptive cognitions in the context of a broader model of psychopathology. The model deviates from the dominant cognitive emphasis of cognitions as determinants of emotion, and highlights the role of negative affect (in particular, augmented negative feeling states), in the development of psychopathology – including maladaptive cognitions. The model acknowledges reciprocal influences between cognition, affect and behaviour, and attempts to provide a global view, and hence understanding, of a variety of phenomena encountered in clinical practice.

The second paper examines in more detail the influence of certain maladaptive cognitions (which we term "negative affective suppositions") on perception and behaviour.

Section A. The nature of maladaptive cognitions: an hypothesis

It is proposed that the attitudes and concepts ("schemas") which Beck has identified in depressed individuals, and which Ellis has conceptualized as irrational beliefs to which neurotics subscribe, are manifestations of a unique type of structure within memory. These structures will be called "negative affective suppositions"*.

A negative affective supposition is comprised of two components or elements, one involving the affective (emotional) system, and the other the cognitive system. The affective component is a somatic/physiological hedonic response represented centrally and accessible to awareness. This component could be considered an unconditioned response in the classical conditioning paradigm, but its intensity might be a conditioned phenomena.# (In these articles this affective component - the origins of which will be described later - will be referred to as a "negative feeling state" or "augmented negative feeling state").

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* The word "supposition" is taken to mean a subjective belief, or hypothesis. The term "negative affective supposition" is employed to denote a memory structure incorporating both negative affect and a cognitive belief.

# For a possible mechanism in the conditioning of distress states see Gilbert (1984, pp 123-124).

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The cognitive component is an assumption or belief - a type of attribution or predictive hypothesis which explains, or accounts for, the occurrence of the affective response. In other words, the cognitive component is a sequel to the affective response - a type of "theory" about the negative feeling state. This attribution or theory may be held in awareness, or may be held tacitly (unconsciously). Negative affective suppositions are normally established during childhood development as a result of the frustration of psychological needs, but may be acquired subsequently in response to trauma or other events which stimulate intense affective reactions.

The great majority of so-called maladaptive cognitions are, or stem from, affective suppositions which are invalid or dysfunctional in the context of current environment in which the individual is living and responding. (The second paper illustrates how once activated these structures may have unproductive perceptual and motivational influences - including mis-perceptions, avoidance, and other pseudo-adaptive responses which are not actually necessary for current survival).

The sections to follow highlight the inter-relationship between affective, behavioural and cognitive systems in facilitating biological survival. The role of the affective system in the motivation of survival-relevant responses is especially singled out for attention because this role is crucial to the development of maladaptive cognitions and behaviour, and to the understanding of a variety of clinical conditions.

Section B: Interaction of Affective, Behavioural and Cognitive Systems in Mediating Survival

The origin and function of negative affective suppositions can most clearly be understood by reference to the basic mechanisms which enable animals, including humans, to survive. In particular the individual's dependence upon the external environment, and the collaborative interplay between affective, behavioural, and cognitive systems in optimally exploiting this dependence, has to be appreciated. The interplay between the systems can be summarised via Figure 1 below:

FIGURE 1

THE INTERRELATIONSHIP OF AFFECT, COGNITION, AND BEHAVIOUR (DIRECTION OF INFLUENCE IS DENOTED BY ARROWHEADS)

The curved arrows in Figure 1 show that affect influences, and is influenced by, both behaviour and cognition; that cognition influences, and is influenced by, both behaviour and affect; and that behaviour influences, and is influenced by, both affect and cognition. Further, the arrows along the interior demonstrate that each system may be influenced by the conjoint influences of the other two systems in interaction i.e. affect and cognition may jointly influence behaviour, affect and behaviour may jointly influence cognition, and behaviour and cognition may jointly influence affect.

It is not within the scope of this paper to explore the above interrelationships, other than to note them. We will focus instead on the basic affective/behavioural/cognitive processes by which physiological homeostasis (which facilitates survival) is maintained.

Homeostasis, of course refers to the regulatory mechanisms which ensure than an organism's internal state remains constant or balanced. Homeostatic processes facilitate adaptation of the individual to changes in the external environment, ensure that needs are met, and enable survival - relevant responses and habits to be acquired.

Affect (feelings and emotions) play a crucial role in the homeostatic processes involved in the motivation of behaviour and the acquisition of adaptive response patterns - including maladaptive cognitions which are of interest to us. We will describe this role in detail because cognitive theory in the main has neglected this area.

Section C: The role of affect (feelings) in homeostasis, in the motivation of behaviour, and in the development of maladaptive cognitions

An animal’s survival is dependent upon ongoing processes of interaction between itself and the external environment. The animal must extract from the external environment the raw materials needed for maintaining bodily functions as well as avoid destructive or harmful stimuli. Survival thus requires the capacity to perceive and respond to the internal environment, the capacity to perceive and respond to the external environment, and the existence of mechanisms within the organism which link the interactions between the two in a biologically useful manner.

a) The role of feelings in the mechanisms which link the internal and external environments

Feelings may be considered to be somatic hedonic sensations represented centrally and of which the animal has awareness. They are subjective indices of the animal's physiological state of homeostatic equilibrium. As a rule, negative (unpleasant) feelings indicate an imbalance requiring to be rectified, while positive (pleasant) feelings indicate that a desirable state of equilibrium has been realised, or is in the process or realisation.

Let us take as an example the animal's need for food. Without food the animal would eventually perish. Food-related maintenance behaviour is facilitated by the animal possessing neural mechanisms (sensors) within it's brain which register both the need for food, and whether environmental stimuli meet that need (Evidence suggests that in the case of food, these sensors are located in the hypothalamus, which incidentally is also known to be a "pleasure" centre - Rolls, 1975.)

The chemical and electrical changes within these sensors are experienced (felt) by the animal (human) as subjective somatic sensations along a continuum of pleasantness - unpleasantness. Specifically, need for food is experienced as a sensation of bodily discomfort (feeling of hunger), and fulfilment of that need by appropriate stimuli is experienced as a feeling of pleasure. That is, eating and drinking behaviour are maintained by sensory stimuli (such as the smell or taste of food) which have a reward effect on the hypothalamic cells gated by need (hunger and thirst).

Hence feelings perform a vitally important function in motivating behaviour which ensures the biological survival of the individual, and thus the species. Feelings of discomfort (e.g. hunger, pain) serve to energise the animal to seek stimuli which will reduce the discomfort, whilst positive feelings function mainly as reinforcers of behaviour (including attentional processes) which brought them about. Hence over time, patterns of behaviour emerge (or are learnt) which ensure the ongoing fulfilment of needs and the survival of the animal.

In daily living the animal will respond first to those needs which are experienced as most distressing or uncomfortable; the more distressing the affect, the more it will be at the fore of awareness. When a felt need (negative feeling) is displaced by a more intense one before it is satisfied, the lesser need will normally return to the fore of awareness when the greater need has been dealt with and the negative affect associated with it dissipates. These processes ensure that the important business of restoring homeostatic equilibrium is not neglected.

To summarise, the above analysis attempts to show that feelings serve a multiplicity of functions that have biological survival value. Feelings provide a feedback channel to the animal about it's needs. They supply information about the value of external stimuli to the animal's survival needs. Feelings also indicate to the animal the appropriateness (or value) of it's behaviour in the task of survival. (The aversive or pleasant attributes of feelings arising from contact with the environment provide the reinforcement or punishing effects required to consolidate some forms of learning.*) Finally, feelings provide the impetus which mobilises the animal to respond when it is not in homeostatic balance and its needs are threatened.

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* After Gagne' (1970), it is noted that in humans there may be as many as eight distinct types of learning processes.

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The above considerations lead us to present a hedonic-homeostatic model of motivation which highlights the importance of the affective system in the motivation of behaviour and the survival of the species. Implicit in this model is the assumption that the basic processes and principles which facilitate biological survival also underlie and explain clinical psychological phenomena. In the words of Stagner (1977, p 130) "Whether man seeks food, sex, power, or salvation, the mechanisms employed are biological".

b) The Hedonic Homeostatic Model of Motivation and Maladaptive Cognitions

PROPOSITIONS

1.      The organism possesses a capacity to react with and experience affective responses to biologically relevant stimuli within both its internal and external environment.

 

2.      These affective responses fall along a continuum ranging from pleasure and elation (positive affect or feeling state) through indifference (neutral affect), to displeasure or misery (negative affect).

 

3.      Some stimuli produce negative feeling states (discomfort) and others produce positive feeling states (pleasure). Still others produce neither, but may elicit an orientation reaction. (These later stimuli will be habituated to unless they become associated with biologically relevant stimuli).

 

4.      Feeling states are closely linked to the homeostatic condition of the organism. Negative feeling states generally indicate an imbalance - a threat to survival or a need to be met, whilst positive feeling states generally indicate that homeostatic equilibrium is in the process of being achieved.

 

5.      Negative feeling states are affective responses to stimuli internal or external to the organism which function as motivating stimuli to promote biological and psychological survival.

 

6.      The motivation of behaviour is governed by affective processes which follow the hedonic principle of minimising negative affectivity (distress) and maximising positive affectivity (pleasure or delight) (Young, 1961).

 

As an elaboration of the above principle, the following assumptions from Seeman and Schwartz (1974, P386) are adopted. These assumptions enable the prediction of an individual's motivation to act as a function of his affective state at a particular point in time:

 

7. a) "Individuals are motivated to avoid, reduce, or terminate negative affective states and to attain, maintain, or augment positive affective states." (This suggests that the transformation of feeling states from negative to positive is an important motivational principle).

7. b) "The closer the current affective state to the negative pole, the stronger the motivation to attain positive events (rewards) and avoid negative events (punishments) ..."

 

7. c) “The closer the affective state to the positive pole, the weaker the motivation to attain rewards and avoid punishments …”

 

The addition of the following assumptions enables us to understand the development of psychopathology in the form of negative affective suppositions:

 

8. The persistent frustration of a need during psychological development (or a significant threat to the organism's integrity) produces an intensified negative feeling state which, unless transformed into a positive feeling state by appropriate events, will remain recorded as a permanent affective structure. The permanence of this affect is discernible from the ability to reactivate it in the therapeutic situation in adulthood.

 

9. The intensified negative feeling state referred to in (8) stimulates the formation of a belief or hypothesis (supposition) about its cause. (That is, each augmented negative feeling state is accompanied by an attribution in the form of a cognitive assumption or supposition). Once formed the supposition may be held in awareness (in consciousness), or may be held tacitly (unconsciously, or outside of awareness).

 

10. The process described in (8) and (9) remain as permanent dual-component (affective/cognitive) structures in memory which can be activated at a future time by relevant stimuli in accordance with the principle of stimulus generalisation. When activated, these structures may be, or may not be, accompanied by conscious awareness. Awareness depends on whether the supposition was developed during the verbal phase of childhood development, and on the individual's defense system.

 

11. When activated these structures (which we will call "affective suppositions") obey the same laws as other negative feeling states. (Refer to 7a, 7b and 7c).

 

12. Negative affective suppositions can be said to correspond to the “core beliefs” proposed by Beck to underlie various clinical conditions. They motivate and give rise to the "maladaptive cognitions" observed in clinical practice, including automatic thoughts and irrational or biased attributions.

 

13. Negative affective suppositions, being the most primitive causal attributions, may be construed as a fundamental type of perceptual motivational structure whose content and dynamic properties shape and determine other cognitive-behavioural-affective responses. They are crucial determinants of maladaptive human responses.

 

Examples of negative affective suppositions include negative self-concepts such as “I am bad”, “I’m stupid”, and the belief, “nobody cares about me”.

c) Feeling States, Homeostasis, and the Development of Negative Affective Suppositions

- an Elaboration

Figure 3 (above) summarises the processes involved in the maintenance of homeostatic equilibrium.

In this diagram, the aversive feelings which are indices of homeostatic imbalance, are labelled "negative feeling states". Figure 3 illustrates that negative feeling states may originate from factors internal to the organism (need-deficit stimuli: Type "A"), or factors external to the organism, e.g. noxious environmental threat stimuli. The latter are labelled Type "B". However, to simplify discussion, this paper will employ the term need when referring to either need-deficit stimulation or environmental threat stimulation.

Regardless of the source of stimulation, the organism processes the chemical and electrical changes which the stimuli produce via the peripheral and central nervous systems. At the affective level these changes are experienced as a negative feeling state. It is assumed that every need or threat has its own unique psychosomatic manifestation which the organism can experience as a specific negative feeling state.* The function of every negative feeling state is to energise adaptive behaviour. (This involves the activation of a number of systems: arousal; attentional; emotional; cognitive and behavioural).

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* Whilst this may not be an entirely satisfactory assumption, it will be retained until a more suitable one is found.

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The negative feeling state, and the stimuli from which it arises, are processed cognitively: there is awareness both of stimuli and of affect and a process occurs which matches or relates this input to data from previous experiences and existing expectations. At the behavioural level, the organism responds to the stimuli with responses which may vary in their specificity. In general, the more cognitive processing occurring, the more specific or goal-oriented the ensuing action on the environment is likely to be. The responses which are energised are not random but are species-specific.

Figure 3 shows that the energized responses can be categorised into those which involve approach to, and contact with, environmental stimuli, and those which involve avoidance of environmental stimuli. In general, the latter responses attempt to provide some form of protective barrier between the organism and the noxious environmental stimuli. (These tendencies of approach or avoidance of stimuli are generalised coping mechanisms, or defense styles, which humans also utilise for dealing with internal stimuli which produce intense negative affect.)

Returning to Figure 3, it can be seen that the relations between the organism's responses and the environment are mediated via the peripheral and central nervous systems. Actions which enables the organism to contact needed stimuli bring about an affective change - a positive feeling state. The positive feeling state reinforces the behaviours which brought it about, i.e. produces learnt habits. (Similarly, avoidance responses which terminate a negative feeling state also produce a more positive feeling state which is reinforcing). Viewed developmentally, this means that over time patterns of responses (habits) are energised and acquired that are successful in transforming negative feeling states into positive ones since these transformations have biological utility - namely the maintenance of homeostatic equilibrium.

With reference to the cognitive system, it is proposed that perceived environmental events, affects, and the relationships between these events and the organism are processed and "structured" (or recorded) in memory. These records typically involve the formulation of hypotheses or suppositions, including causal attributions.

Suppositions may be viewed as hypotheses of relationships between events, as perceived by the individual. They are generalisations, conclusions, or rules about events which may or may not have objective accuracy. They manifest as propositions of diverse content. One of their functions is to anticipate future environmental events; that is, enhance predictability of the environment, and hence facilitate adaptation and survival. (Cf. the "constructs" of George Kelly, 1955).

Whilst the suppositions which are of greatest clinical importance are those which encapsulate and flow from, intensified negative feeling states (i.e. need - frustration), not all suppositions have affective content. For example, a simple supposition may merely record an association between events which are perceived by the organism: e.g. "A follows B", or "X and Y occur together", when the events themselves may not have current biological or affective relevance.

Suppositions which have a high affective component (i.e. derive from, incorporate and explain the cause of, intense negative feeling states) are believed to underlie many kinds of psychopathology, and should thus be the focus of therapeutic intervention. (The clinical relevance of these negative affective suppositions and their perceptual/ motivational properties are examined in the second paper of this series).

The next section deals with the role of defences in facilitating survival and impacting upon psychopathology as a consequence of need-frustration. The discussion will involve a detour from the central issue - maladaptive cognitions - so that these may be viewed in the context of other adaptive mechanisms.

Hence in Section (d) we see that maladaptive cognitions in the form of negative affective suppositions are but one of several consequences arising from need-frustration.

d) Development of psychopathology: The role of defences

In exploring the development of psychopathology we need to look at the sequence of events which ensue from the experience of need by the individual. The need is experienced as a negative feeling state. Under normal benign circumstances the feeling state energizes behaviour, resulting in fulfilment of that need. For example, a hungry infant cries. This stimulates the mother to attend and to respond by feeding the infant. Consumption of food produces a change in the negative feeling state - the infant stops crying and may contentedly go off to sleep.

From the infant's subjective perspective, one may infer that the negative feeling state has been transformed into a positive one. This same feeling state, or some other, will then re-emerge at a later time when the infant again needs food, or warmth, or some other stimulus.

We assume that the affective/cognitive/behavioural mechanisms which facilitate biological survival also mediate psychological phenomena, including the development of psychopathology. Hence a predisposition to psychopathology may arise when, during infant or childhood development an insensitive, unresponsive or inimical environment frustrates the appropriate transformation of a negative feeling state into a positive one. (That is, the organism is unable to approach stimuli or avoid stimuli which enable an intense negative feeling state it experiences to dissipate or be transformed). Certain contingencies involving the repeated withdrawal of positive reinforcers may, according to Gilbert (1984), also produce augmented negative feeling states which endure.

Psychopathology may also arise at any time when a single event (trauma) produces an extremely intense or aversive negative feeling state. In both cases the individual develops a negative affective supposition which guides subsequent behaviour when elicited or activated by relevant cues. (The activation of negative affective suppositions will be the subject matter of the second paper). These suppositions motivate ongoing adaptive responses indefinitely, even when not actually necessary for survival, such as when the traumatic event that gave rise to the negative feeling state has a low probability of recurring.

Yet a third kind of pathology may develop when biologically or psychologically inappropriate stimuli (or responses) are associated with the production of intense positive feeling states, and the utilisation of these stimuli (and/or responses) become habitual in accordance with the hedonic and reinforcement principles. This paper focuses on the development of the first type of psychopathology and not the latter two.

The genesis of various types of psychopathology are organism-environment interactions which fail to appropriately alleviate organismic needs. These include not only biological needs related to bodily survival 'but also psychological needs related to the growth of the personality and the fulfilment of human potentiality. The frustration of psychological needs during an individual's early development can, via the development of negative affective suppositions, result in impediments in the person's subsequent perceptions and capacity to adapt to life situations, as well as impairing the individual's self-concept and sense of well-being. (Maslow (1968) and Janov (1972) also view "neurosis and the byproduct of need-frustration during childhood development. It is likely, however, that because the socialization process invariably involves the frustration of some needs, all individuals and not only so-called neurotics have unfulfilled negative feeling states which influence the direction of their adult behaviour).

Individuals differ with respect to the types of needs frustrated during development, the degree of frustration of each need, and the manner in which they cope with the ensuing negative feeling states and suppositions. Differences exist in the content of negative affective suppositions, and in the responses utilised for dealing with the accompanying negative affect.

Therefore, whether psychopathology is manifested and the form taken is dependent not only on the degree of frustration but also on the nature of the coping mechanisms - cognitive, affective, and behavioural. This means, in principle, that it is possible for the same individual to manifest different kinds of symptomatology should the coping mechanisms change over time. In the main, however, individuals will primarily manifest those symptoms or behaviours which are a by-product of the coping mechanisms utilised successfully for handling augmented negative feeling states in childhood. That is, all things equal, the coping strategies established in childhood are likely to be maintained in later life. (However, this is not to deny the possible impact of naturally occurring therapeutic influences).

The most common psychological needs which are frustrated in our culture and which are sources of maladjustment are the needs for affection and caring, the need for security, the need for self esteem, the need to feel a sense of mastery and competence, and the need to be accepted and approved of by others. The impression that these are commonly frustrated needs comes from the recurring clinical observation of negative feeling states, suppositions, and behavioural habits pertaining to one or more of the needs mentioned.

Following the theorizing of Gilbert (1984) who examines psychobiological aspects of depression, it is suggested that the psychological needs for affection, caring, security, esteem, competence, acceptance and approval are linked with, and have their roots in, biological survival. These needs act as motives which promote survival of the individual by facilitating attachment behaviour and avoidance of abandonment. Innate affective processes link these psychological needs with biological survival mechanisms. According to Gilbert, "many of the emotional systems of the brain are wired up to encourage this development, facilitating positive emotional experience for high attachment security (love, friendship, joy), and negative emotional experiences for low attachment security (loneliness, sadness, depression)" (Gilbert 1984, p. 219).

Initially the frustration of a need merely augments the experience of distress (negative feeling state) associated with that need, and energises greater activity on the part of the individual (e.g. increased crying activity in a hungry infant). If, despite an increase in the variety and intensity of individual responses, there is still no appropriate environmental event which enables the negative feeling state to be transformed, a series of coping strategies ensue. The function of these is to promote survival in the face of the inimical environmental conditions.

These adaptive (or self-preserving) responses are varied and include the following:

2. Behavioural responses which introduce into awareness positive feeling states as substitutes for, or distractors to, the unabated negative feeling state (e.g. a hungry infant attempting to alleviate it's negative feeling state by sucking it's thumb);

3. Cognitive "wish fulfilment" fantasies having the same function as the behavioural responses mentioned above;

4. Cognitive or perceptual responses which block out or attenuate the experience of negative affect (such as the conscious coping strategy of suppression and the classical defenses of repression and denial);

5. Autonomic and somatic tension - reducing responses which attenuate the experience of negative affect;

6. The formation and recording in memory of affective suppositions. (As previously described these are dual-component responses to need frustration or trauma which record both the affective experience (augmented negative feeling state) somatically, and its perceived cause). These attributional structures serve to increase control and adaptation by enabling prediction of future events;

7. Avoidance responses generated by negative affective suppositions -more specifically, by the anticipation of the augmented negative feeling state. These responses are strongly reinforced by their perceived success in "preventing" the occurrence of the anticipated painful experience, hence may become habitual. (The persistence of these habitual behaviours during adulthood accounts for certain personality or character traits - e.g. compliance, submissiveness, approval-seeking etc. These recurring tendencies are the "scripts" of the transactional analysts - e.g. Steiner, 1974). Clinically these responses are not easy to detect unless one is alerted to their possibility because they may not be experienced as problematical by the client. Often these behaviours are rationalised as being individual preferences. For example, an offender convicted of fraudulent financial activities engaged in a variety of "friendship-buying" approval-seeking habits which led to his arrest because of his inability to pay. He was preoccupied with gift-giving, taking people out to expensive restaurants, and otherwise trying to impress. His self-perceptions, however, were somewhat more positive: "I like to be complimented", "I like to be well-thought of", "I want to give my friends the best". He was unaware of the driven or compulsive quality of his lifestyle and behaviour.

Any or all the above defensive responses may arise during childhood when intensified negative feeling states cannot be attenuated through appropriate interaction with the environment. They all operate on the hedonic principle of minimising negative affect and maximising positive affect, whether by removing negative affect from awareness or by introducing positive affect into awareness, or by both. Functionally, the defences listed above' play useful roles in facilitating short-term adaptation or survival. However, because they endure over a lifetime these same defences underlie many psychopathological response patterns which are observed in later life.

Understanding psychopathology, including maladaptive cognitions involves an appreciation that the above defence mechanisms often operate jointly. (For example, consider an individual with acting-out compulsions who lacks awareness of the internal feeling states which repeatedly impel him into certain types of actions).

Following the hedonic and reinforcement principles, (summarised in Figure 2), any defensive responses which are successful in attenuating or transforming a negative feeling state will be reinforced and may be deployed habitually - that is; become part of the personality structure.

The model suggests that a significant proportion of those behaviours and attributes constituting an individual's personality are in effect clusters of responses developed or acquired for coping with the negative feeling states of childhood. As such, enabling a client to become aware of, and alter the ways in which he deals with negative feeling states via therapy amounts to enabling changes in personality. (It is acknowledged, however, that genetic or constitutional factors may play a part in the predisposition towards relying on a certain type of defence mechanism: for example, whether a person is a "repressor" or a "sensitizer" (Byrne, 1964) might be genetically determined).

In the remainder of this paper the main concepts of the model are related to the clinical material from which it was derived and to other relevant phenomena.

e) Therapeutic activation of augmented negative feeling states

"The infant's world is first biological and gradually social-biological in nature. A child's well-being, physical and emotional, is dependent totally upon the responses of other people, especially his parents. And it is during this period of life that the most basic assumptions about the nature of one's existence are formed. Thus man's view of reality tends to continue to be governed by this "fleshly" perspective of his early years. For his early assumptions about himself and life live on, potently, as a secret inner mythology that determines his stance in life. He may consciously adopt totally different ideas, but, as anyone who has undergone psychotherapy has discovered, his life behaviour is actually related to these secret inner perspectives to which the only clue, at first, may be his feeling-reactions." (Linthorst, 1973, 359-360).

For several years my attention was repeatedly attracted by a type of emotional reaction, unique to the individual, which emerged and recurred during the assessment and treatment of offenders. These reactions are the augmented negative feeling state components of frustrated childhood needs that have endured into adulthood. (That is, the intensified negative feeling states that failed to be transformed appropriately into positive feeling states by relevant environmental stimuli or self initiated change).

These reactions are intensely aversive but, like other memories may be outside of awareness until elicited or activated by relevant stimuli. An augmented negative feeling state in a clinical context will be defined as "an intense dysphoric emotional experience which can be elicited in a therapeutic setting by the client's self-stimulation via relevant cognitive cues."

Augmented negative feeling states are observable directly in the form of physiological changes (e.g. flushing). They may also be inferred from verbal affective expressions usually (though not always related to self-concepts (e.g. "feeling stupid"). They are invariably experienced as negative in hedonic tone.

I refer to these experiences as "states" because of their permanent existence within the person. That is, whilst not permanently active or visible, they can in many cases be elicited by appropriate verbal and/or environmental manipulations given a co-operative client willing to explore his verbal associations.

The procedure typically used is as follows. The therapist attends to the client's verbalizations and selects a phrase for further exploration. (The selection is based on what the therapist considers may be of significance, given the need-frustration framework detailed in this paper). The client is asked to close his eyes, repeat the chosen phrase (out loud or covertly), and attend to any ensuing thoughts or feelings.

For example, a client made the following statements, "I won't listen to anybody - I have a tendency to forget things very quickly ... I don't want people to tell me what to do". The modified phrase, "don't tell me what to do" was selected by the therapist for exploration. After a couple of repetitions, the client spontaneously changed the phrase to "don't tell me why". On repetition of this phrase he appeared distressed and reported feelings of "getting wild, getting hot in the head". He also reported "butterflies" in the stomach and "going dizzy". He appeared shocked by the intensity of these reactions which are regarded as constituting an augmented negative feeling state.

When fully experiencing a negative feeling state, adult clients may “regress” temporarily back to childhood. They feel as a child, become overwhelmed with affect, momentarily lose contact with the present, and their thoughts (verbal or imagery) are of childhood events. When in touch with negative feeling states, clients can become aware of which need was frustrated in childhood, because they experience the associated affect as if the frustration was occurring in the here and now.

Augmented negative feeling states normally lie outside of awareness unless activated by relevant stimuli because they have generated a variety of avoidance responses or defenses, in accordance with the hedonic principle regarding affectivity. These coping responses, which were listed in Section (d) above, protect the individual from experiencing unpleasant negative affect in the short-term, but simultaneously ensure the long-term potency and durability (non-extinction) of that negative affect.

The association procedure described above is seen as enabling negative affect associated with particular cognitions to be elicited because the instructional set (namely to attend to ensuing thoughts and feelings) runs counter to, and interferes with, an individual's natural tendency to avoid negative affect through learned defensive strategies. The instructions serve, therefore, as a type of response-prevention procedure.

Negative feeling states such as the one above should be seen as distinct from the mood shifts which can be produced by asking subjects to read or repeat negative self-statements in the Velten (1968) manner*.

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* See also Rimm and Litvak (1969); Coleman (1975).

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Firstly, negative feeling states can be produced by verbal statements or other stimuli that are not negative self-statements, and clients are not instructed to generate feelings. Secondly, they are more intense than induced moods. Thirdly, unlike Velten's mood shifts which require considerable stimulus inputs, only a single presentation of an appropriate stimulus can elicit a negative feeling state.

Negative feeling states are also distinct in that they are elicited by stimuli or events having a particular theme or meaning for a specific individual. Hence a stimulus which elicits a negative feeling state in one person will normally have no impact on others - that is, negative feeling states and the stimuli which elicit them are individual-specific.

Without doubt the reactions which I refer to as negative feeling states are encountered by clinicians in the course of psychotherapy or behaviour therapy with their clients.

At least two systems of therapy; implosive therapy (Stampfl and Levis, 1967), and primal therapy (Janov, 1970) - appear to derive their effectiveness from the fact that they modify augmented negative feeling states. In fact the phenomena of repressed pain which Janov calls "Primal Pain" seems equivalent to the concept of “augmented negative feeling state.” Janov describes primal pains as unmet needs and hurts which are denied consciousness. They are seen as the cause of neuroses.

To summarise, it is proposed that augmented negative feeling states are the psycho-physiological manifestation of frustrated or unmet needs during childhood development, and that they are of fundamental importance in the understanding of human behaviour, cognition, psychopathology, and personality.

f) Clinical significance of augmented negative feeling states

Recurring clinical observations with offenders suggest that augmented negative feeling states are not only the source of maladaptive cognitions, but that they also have a motivational relationship with acting-out behaviour. The motivational effects are illustrated by the client mentioned earlier who reacted with a negative feeling state to the phrase "don't tell me why". This man tended to react with impulsive anti-social acts in situations where he was told what to do. This man, who was 23 years of age had eight convictions for drunk driving twenty three convictions for driving under suspension, and three life suspensions. The events leading up to his latest arrest for drunken driving were as follows:

The client had been drinking at a hotel for some time. He was advised by the publican to leave his car in the hotel car park in order not to risk being caught for drunk driving. The publician's advice made him wild (activated a negative feeling state). Then he began to ram the hotel fence with his car repeatedly until he knocked it down. He then drove off and around the streets until apprehended by the police.

This case is one of many which has led me to infer that augmented negative feeling states are powerful motivators of behaviour.

My clinical observations can be summarised as follows:

1. In a great number of offenders the behaviour which brought them into conflict with the law served a psychological function, namely that of transforming a negative feeling state which had been activated by environmental events prior to the offence, into a more positive or satisfying one. (The satisfaction may have been short-lived however.)

2. The client’s self-concepts and views of the world (suppositions) derived from, and incorporated augmented negative feeling states unique to each case. (These negative affective suppositions are further examined in the second paper.)

3. The person often displayed a wide range of habits, interests and attitudes (i.e. personality features and life themes) which shared a communality: this being that they served to bring about transformations of the augmented negative feeling state(s) detected.

4. The augmented negative feeling state or negative affective supposition in every case seemed to be historically related to the frustration of a psychological need during childhood development.

It has not been possible to include in this presentation the evidence on which the above generalisations are based. However, in Appendix 1 two cases are discussed which exemplify the relationship between augmented negative feeling states and antisocial acting out.

Negative affective suppositions not only motivate acting-out behaviour, but are implicated in a variety of clinical phenomena. A review of our theory demonstrates this possibility.

According to our model individuals vary with respect to the degree, type, and number of frustrated needs during childhood development. These frustrations are recorded affectively and cognitively in the form of specific negative affective suppositions which endure over time and can be activated by environmental events. When activated these structures (and in particular the augmented negative feeling state component) have motivational influences: they energize behaviours some of which are successful in attenuating the negative affect, or produce positive affect in the immediate short-term, and these behaviours can become habitual.

The model therefore suggests that many behavioural disturbances ranging from bulimia, over-eating, drug and alcohol abuse, compulsive gambling and so forth may be established and maintained by the above processes. Inability to delay gratification (or the preference of short-term satisfactions which may preclude long-term benefits) can be seen as a function of earlier need frustration, and as a predictable by-product of the activation of augmented negative feeling states. Our model states that need-frustration is recorded both affectively and cognitively by means of negative affective suppositions, and that when activated by relevant stimuli these will have predictable motivational effects. As previously stated, "the closer the current affective state to the negative pole, the stronger the motivation to attain positive events (rewards) and avoid negative events (punishments)." Hence it may be predicted that those individuals with more intense feeling states, or more frequent activation of these states by environmental events will demonstrate greater impulsivity or inability to delay gratification. These predictions of the model have yet to be empirically tested.

The part played by negative affective suppositions in conditions such as obsessional-compulsive disorders, depression, phobias, and so forth has yet to be examined. It is nevertheless proposed that in keeping with Beck's (1974) general model of psycho-pathology, negative affective suppositions deriving from different kinds of augmented negative feeling states underlie all these phenomena. It is anticipated that future research will elucidate the role played by negative affective suppositions, in combination with different kinds of coping mechanisms or defenses, in determining specific types of clinical disorders.

General Clinical Implications

The aim of this paper has been to propose that maladaptive human behaviour and cognitions can be understood within a context of hedonic processes, need-frustration, and homeostasis. The model suggests that the identification and modification of negative affective suppositions of which augmented negative feeling states are a significant component should be a primary goal of therapy. The model is consistent with the Gestalt Therapy notion (Perls, 1969) that unmet needs keep pushing for expression. However it offers greater specificity in suggesting to the clinician what features to look for, and what the underlying processes are.

The clinician is alerted to a number of possible signs which may be indicative of need-frustration, and thus psychopathology. A clinician is aware that since the frustration of a need (and the attempts to cope with such frustration) is processed via a number of systems -physiological, affective, cognitive and behavioural - symptoms of pathology are also evident within these systems. This is shown in Figure 4, "The effects of need-frustration".

Figure 4 shows that symptoms may emerge as physiological manifestations of frustrated needs; as disturbing affective responses (negative feeling states or their derivatives); as negative affective suppositions (beliefs); as dominant cognitive defense styles for dealing with negative feeling states; and as high frequency fantasies that serve a wish-fulfilment function with respect to the frustrated need. Furthermore, the model suggests that all these manifestations are inter-related and interconnected in view of the part each plays maintaining homeostasis (i.e. attenuating or transforming intense negative affect). The importance of negative affective suppositions mediators of other cognitive and behavioural responses is recognised.

Thus, for example, the observation of high frequency fantasy activity with the theme of social recognition would suggest the possibility of frustration of that need, and the existence of a negative feeling state and associated supposition, which the clinician could then assess. Therapy would involve not only modification of a symptom at one level, but also the structures (including affect) maintaining it. Such interventions should prove superior to those arising from current therapy models which specialize at intervening at a specific level only - for example bio-feedback techniques at the physiological level; abreactive and cathartic therapies at the affective level; cognitive therapies at the cognitive level, and so on. A further expansion of the cognitive behavioural framework to include the very important area of affect particularly negative feeling states - seems desirable. This is because augmented negative feeling states influence the development of negatively evaluated self-concepts which endure and which are the hall-marks of individuals seeking therapy (Raimy, 1975; Rogers, 1968).

RESUME OF PART ONE

The motivation of human behaviour is principally dependent on affective processes which follow the hedonic principle of minimising negative affect and maximising positive affect. These processes underlie biological and psychological homeostasis and are fundamental to individual adaptation and survival. It is proposed that organismic needs and threats to survival (both biological and psychological) are experienced as negative feeling states. Negative feeling states have motivational and adaptive functions: they energize responses which bring about contact with needed resources, or distance from, threatening or harmful stimuli. Responses which transform or attenuate negative feeling states are reinforcing, have survival value, and may become habitual. (Similarly, responses which precede positive feeling states have an increased probability of recurring). Negative feeling states that are not transformed into positive feeling states by appropriate events, or which occur at levels beyond the individual's ability to make successful coping responses become augmented or intensified.

In addition to affective processes, human behaviour is dependent on cognitive processes and structures. Augmented negative feeling states and their antecedents are recorded in memory as particular dual-component structures, which we term "negative affective suppositions". Negative affective suppositions are cognitive - affective records of augmented negative feeling states and their perceived cause. They assist in the anticipation of future events, and are utilised to guide adaptation and survival. Negative affective suppositions, then, are internal representations (emotionally loaded hypotheses) of the person's transactions and interactions with the external world which gave rise to intensified negative affect.

Psychopathology in the form of behavioural, cognitive, or affective disturbances are viewed as the consequences of negative affective suppositions. Deep seated disturbances in adjustment may arise when needs are frustrated during childhood psychological development. Frustration of needs by an unsupportive or inconsistent environment results in intensified negative feeling states which endure physiologically and which motivate short term adaptive or defensive responses, including the formation of negative affective suppositions. These adaptive responses may persist over time and interfere with adult adjustment and perception of reality, as well as impeding performance and affective well-being.

The manifestations of negative affective suppositions include negative self-concepts, attributions, attitudes, personality traits, as well as maladaptive and irrational behaviour and cognitions. Negative affective suppositions tend to remain as permanent active structures which influence behaviour and cognition when activated by relevant cues throughout a lifetime, unless modified therapeutically or by naturally occurring events. The features and properties of negative affective suppositions are further described in another paper (Cicchini, 1986b: “The Origins and Nature of Maladaptive Cognitions: Part 2. Perceptual and Motivational Effects of Negative Affective Suppositions”).

APPENDIX 1. The role of augmented negative feeling states in acting out behaviour: a summary and examples

The bulk of my work has been involved with the assessment and treatment of criminal offenders. As a general statement (with obvious exceptions) it could be said that these people have attempted to solve emotional problems with actions which have brought them to the attention of the criminal justice system. These clients have as a group impressed as somewhat removed from, and unaware of, their feelings (with the exception of feelings of anger and depression).

I have observed the existence of a motivational relationship between augmented negative feelings states and acting-out behaviour. In many cases the negative feeling state which was detected in therapy had been aroused in some form* by environmental stimuli immediately prior to the offence. Furthermore, the offending behaviour served to replace the negative feeling state in awareness with a positive feeling state, even if only temporarily.

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*. The clients were aware of some tension or discomfort which was not attended to or dealt with consciously.

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To illustrate the relationship between negative feeling states and offending behaviour, case material will be presented of two recidivists, who will be referred to as Mr Jones and Mr Green. Mr Jones had a habit of breaking and entering, and Mr Green a habit of wilful exposure accompanied by masturbation. (In these examples we will not be focusing on negative affective suppositions, but the role of negative feeling states within these suppositions, in motivating behaviour. Negative affective suppositions are examined further in Part 2.)

Case Example No 1: Mr Jones

Mr Jones was a 25 year old married man serving a three year sentence for breaking, entering and stealing. This conviction occurred seven weeks after he had completed a prison term for the same type of offence. Assessment by another professional indicated that he had a record for breaking and entering commencing at age 13 and a history of consistent offending since then. It was noted that, "when drunk he gets an impulse to do a break and enter and then can't get it off his mind until he has followed it through. The more difficult the entry into the target, the more persistent he becomes about breaking in. Doesn't seem to take much care over offences - leaves finger prints etc. An important element seems to be thinking about the victim's reactions when they discover they have been broken into (... ) quite often he doesn't even steal anything when breaking in or if he does he may just dump the stuff in the bush".

Negative feeling state

At one point during therapy I detected a marked change in Mr Jones' appearance. His face flushed and he looked somewhat bewildered. I asked him to share with me what he was feeling at that moment. He replied that he felt "stupid". At a later date he informed me that he recalled experiencing similar feelings when involved in arguments with his wife. (his wife, by the way, had a better education and superior verbal skills). By deploying various exercises in therapy it was possible to elicit the negative feeling state almost at will - for example by asking Mr Jones a question which he was unlikely to answer correctly - such as "what is the capital of Afghanistan?" The feeling state which was triggered was described as unpleasant, and incorporated a negative perception of himself as stupid. (That is, Mr Jones had an affective supposition "I'm stupid").

Behaviours motivated by the negative feeling state

It is suggested that any behaviour which succeeds in transforming a negative feeling state into a positive one is reinforcing and will tend to be repeated. That is, negative feeling states motivate behaviour which brings about a transformation to a more positive one. These behaviours can, over time, become habitual.

In Mr Jones’ case a number of such behaviours came to light during the course of therapy.

During an early session I gave Mr Jones an exercise to do which I hoped would stimulate some thoughts and feelings related to his offending. The exercise involved writing something he had said - a short phrase - on a foolscap sheet until a new thought or feeling emerged in his awareness. He was to write~ down any new thought or feeling as it occurred. Mr Jones diligently wrote the phrase down the page - all the way to the last line, with no new thought or feeling emerging.

I responded by saying, "that didn't get us too far," and noticed my client's face light up with a smile of delight. I enquired as to what he was feeling, and he reported a feeling of satisfaction. I asked him in what situations he had a similar reaction to the one he had just experienced. He replied "when I do something wrong and get away with it". He reported a number of incidents from his childhood years which had in common the fact that he was doing something wrong, getting away with it, and was consequently feeling "smart" (or clever). As examples he mentioned the following:

- stealing fruit from orchards.

- gaining access to factory yard with friends and driving fork lift truck around for fun.

- climbing over a school fence after hours and playing on the trampoline.

- climbing over someone's fence, stealing eggs by blowing them out, and replacing the shells.

A favourite incident recalled by Mr Jones occurred when he was about thirteen years of age. He and some friends broke into a neighbour's cellar by removing a bar from the window. Inside the cellar they drank wine, then replaced the window bar in its place on their way out. Mr Jones remembered the feelings of satisfaction when the neighbour subsequently discussed his problem with him - namely his being perplexed by the fact that someone was somehow getting into his cellar. And the young Mr Jones agreeing to keep an eye out for would-be offenders

Mr Jones' wife independently informed me that he often engaged in patterns of teasing behaviour with their six year old daughter. This too, appeared to be serving the same function of making him feel "smart".

On another occasion I gave Mr Jones a different exercise in therapy. He was to repeat a certain phrase and then note any ensuing thoughts or feelings. When nothing eventuated I fed back to him my feeling that he was withholding. I asked him to repeat the phrase "I don't want to give it to you" whilst I "pleaded" with him. Mr Jones commented, "if someone wants something off me r won't give it to them (...) I give it to them eventually. I make them fight for it." As an example, he said that should his wife ask him the time, he would reply "no I won't tell you," then three minutes later he would give her the time.

I remarked that it seemed to me he was keeping someone in suspense, on tender hooks for a little while, and asked him how he felt when he kept someone in suspense. Mr Jones replied, "I feel smart. Feeling smart puts me a little bit above the person I'm smart to."

In summary, one can see that Mr Jones developed an affinity for engaging in behaviours which made him feel smart or, viewed differently, which transformed or annulled the negative feeling state detected in therapy. His offending was part of this behaviour pattern.

Childhood origins of the negative feeling state

The psychologist who originally saw him had noted that during Mr Jones' childhood his father “would become extremely angry over the kids doing 'stupid and clumsy things', but would virtually ignore bad things.” The father was described by Mr Jones as being very "touchy".

During therapy Mr Jones mentioned several attitudes and feelings (sensitivities) which appeared to be linked with his father’s behaviour towards him, and which indicated that his self esteem been frustrated through his father's intolerance. Specifically indicated that he disliked "people who play on it if I make a mistake." He resented being asked to change the way he worked being reminded that he is doing something wrong - such as by bosses or teachers. He also acknowledged a tendency to get upset when told he was wrong, and a realisation that he was normally unable to he was wrong. Furthermore, he stated that he always felt he "second best".

My interpretation of the above is that during childhood Mr Jones' self-esteem - particularly relating to his sense of competence - was frustrated by paternal intolerance. One can observe a thread connecting the paternal behaviour to the client's negative feeling state observed in therapy, and between the feeling state and behaviour patterns including the offending.

In Mr Jones' case therapy was focused on assisting him to see the link between his need to feel "smart" and his offending, and on encouraging him to reject his conception of himself as "stupid". The therapist provided a rationale for the client's reactions and made inputs such as "although you may sometimes feel stupid, you are not stupid. You are not your feelings". At the time of writing Mr Jones has remained conviction-free for five years since his release.

Case Example No 2: Mr Green

Mr Green was referred for treatment as a seventeen (17) year old when placed on probation for the second time for wilful exposure. The offences, which commenced when he was thirteen (13) years of age, involved his going to a public place likely to be frequented by people and masturbating. The referring agent noted that the client "frankly admitted that such behaviour afforded him sexual excitement".

The precursors to him exposing were investigated during assessment. Mr Green indicated that, "something sort of clicks. I feel sort of frustrated inside ... not sexy ... I feel like I want to have sex, but I'm not randy". He reported experiencing something like an urge to expose: "feels like something I have to do and I want to do. I want to masturbate. I want people to see me ... and I don't". Whilst exposing he would have fantasies of being seen by females. In reality, if people approached him he would become more excited, would continue to masturbate, but would attempt to conceal himself to some degree.

In the second interview, Mr Green was given a negative feeling state association exercise. He was asked to close his eyes and repeat the phrase "I want to be noticed" whilst simultaneously attending to what he was feeling. As he repeated the phrase, Mr Green as voice appeared to become angry and terse in tone. I asked him what he was feeling. He replied, “I feel hot, nervous, tensed up. Tension's building up going all tight". This reaction is seen as an important negative feeling state in Mr Green.

I then asked Mr Green "who do you want to notice you?" to which he replied "anybody". I asked, "Who doesn't notice you?" He replied, "My family: my father and my sister". This led to discussion of relationships within the family, in particular to his expression of resentment that his father did not pay much attention to him.

An exercise involving him repeating the phrase, "You’re not paying me much attention" produced feelings of tension and intense affect (i.e. the negative feeling state).

It is concluded that Mr Green's need for attention was frustrated in childhood, hence the negative feeling state detected. This interpretation was supported by the spontaneous re-emergence in therapy of the theme of his resentment of his father's preference for his younger brother. The referring source had also noted this theme:

"He has a nine year old brother adopted by his parents shortly after birth. There seems to be some jealousy towards the younger brother. Mr Green feels that his father particularly gives the young brother attention which he himself never received". In therapy Mr Green made comments to the effect that his father spoiled his brother and that “I never win with my Dad”.

Subsequently an attempt was made to examine the relationships within Mr Green's family by means of family counselling. It was observed that Mr Green Senior was particularly insensitive and unresponsive towards the client’s communications. Mr Green Senior freely admitted that he had, in his own words, "switched off" from his son, and couldn't be bothered with him. One can see, therefore, some reality base to Mr Green's perception that his need for attention had been frustrated within the family.

Therapy with Mr Green was discontinued after some time when it was acknowledged by the client that he had no great investment in wanting to change his exposure habit. (He was attending therapy primarily because he saw it as a condition of his Probation).

I had further contact with him two (2) years later, after the expiration of his probation period when he again re-offended. By this time, Mr Green had left home and was living with his girl-friend and their infant child .At this point in time the dynamics of his exposure, and the role of his negative feeling state in it became clearer. An analysis of the stimulus conditions associated with his offending indicated that certain environmental factors induced a sense of restlessness and tension in him. These included when his girl-friend was watching T.V., doing the washing, shopping, reading a book, playing with the baby after 7.00 p.m. when he felt the baby should have been in bed. He stated that he didn’t like his girl-friend reading a book, "when there's someone you can talk with".

In essence Mr Green experienced tension and restlessness (negative feeling state) in situations where his girl-friend was attending to things other than himself. Insufficient attention or perceived disinterest produced in him involuntary feelings of tension, restlessness and discomfort. Since his teens, he had learnt to dissipate these feelings by going away from the situation where they were triggered (home) to public places where sexual excitement and gratification through masturbation and reinforcement of his fantasies of being seen produced relief from the discomfort and tension.

Whilst the habit of exposing and masturbating was based on the need for attention, over time the habit had acquired a life of its own - namely as a pleasurable way of engaging in, and fulfilling, sexual fantasies.

Because the exposure episodes achieved two goals for Mr Green (i.e. 1. alleviating tension or negative feeling state from a frustrated need for attention, and 2. producing pleasure) he had come to anticipate and look forward to his episodes. In fact, he would forego the opportunity of working overtime on weekends as it limited his opportunities to expose.

The habit was so strong (we calculated that it had occurred over one thousand times) and so gratifying that Mr Green had no desire at all to give it up.

End of Part 1.

Part 2 (Cicchini 1986 b) examines the perceptual and motivational effects of negative affective suppositions.

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