Psychiatric Conditions and Applied Behavior Analysts
Dr. Gonzales is a doctoral-level behavior analyst with 14 years of experience and currently serves as the Chief Clinical Officer of Alamo Behavior Analysis. She has early-career experience in general education, holding an MAT in early childhood education from Trinity University (class of 2008), along with an M.Ed in Special... more
I am doing a CE course (while drinking Malbec and eating pizza) on collaborating with psychiatric practitioners as a behavior analyst.
I got to this particular slide and, as a person who has been hospitalized for psychosis, I need to say that I am aghast at the professor's apparent praise for this experiment's results (caveat: I have not read this paper).
I will, of course, give the authors grace because this was written in 1959.
However, I want you to look at the dependent variables they targeted for decrease: "Entering the nursing station, verbalizing delusional statements, refusing to eat, hoarding."
As a person who has been hospitalized for acute psychosis, the behaviors that the authors chose to eliminate bring up a visceral reaction.
ENTERING THE NURSING STATION: I have a memory of sitting and holding a BHT named Bryan's hand and sobbing, while he patiently used his other hand to chart. I thought that he was my brother, even though he was over six feet tall, Black, and had braids. That kind man gave me comfort during a horrific time. But, hey, maybe we should use ABA to keep patients out of the nurses' station.
VERBALIZING DELUSIONAL STATEMENTS: While in my postpartum psychosis episode, I frequently believed that I had killed my newborn by giving her Ambien. The BHTs who repeatedly told me that my newborn was alive and that I wasn't a murderer saved me from greater suffering.
REFUSING TO EAT: Why might someone refuse to eat in a psychiatric hospital? Perhaps they are so depressed that they are suicidal? Perhaps they are lonely and afraid? Perhaps, like a friend of mine recently, they were assaulted by another patient? Hmmm... let's use ABA to reduce that, shall we?
HOARDING: I was prescribed high doses of antipsychotics that caused overnight binge-eating. I was sleeping about 20 minutes every 24 hours and I was not allowed to leave my bed between the hours of 9:00pm and 6:00am. Starving, I was told I could not eat anything until breakfast at 8:00am. I didn't hoard, but I can imagine why others do.
I'm pretty unusual.
I have been psychotic and unable to speak for myself.
But I have memories.
And I think these dependent variables are nowhere near as simple as they seem.
And trust me, they are not compassionate.
This is a reminder, that, as I work with complex cases with psychiatric hospitalization, that each member is treated as a human being first, even if their behavior seems strange or is challenging.
