Policies about "Behavior"

I have been working in the disability community since 1970. When I first started, people were using cattle prods to alter the behavior of children with autism, based on research done a few years before. I saw this done. I wish I could tell you that I opposed its use, but I was 23 at the time, and still bought into the "cure" model of dealing with disability. I found it "disgusting, but necessary".

Over time, I saw the limitations and the cruelty of aversive behavior management techniques, and I came to oppose their use as an advocate both inside and outside the mental health system. As another example of my naivety, I thought that such opposition by advocates and activists would eliminate the use of aversive techniques.

Well, recently, I reviewed a draft of a behavior management policy for the Michigan mental health system that was strong on rhetoric, but didn't actually disallow the use of any aversive technique. A couple of years ago, the State Board of Education created a behavior management policy with the same rhetoric and the same kinds of loopholes.

The problem isn't just the policies. It is the rabid, panicky desperation in the eyes of the supporters when the use of such techniques is questioned or opposed. The use of such techniques is not some academic quest for the most effective form of treatment. Those who use aversives in school, mental health, or other treatment settings view these techniques as the only defense they have against total chaos in their work environments.

The professor who taught my Abnormal Psych class in college (many decades ago) had 8 years as an orderly in a State hospital before deciding to go to school in psychology. When we (as his students) would get too academic about the concepts, he would tell us stories about people he knew in the hospital, to re-focus us on the individual humanity of each person, and the similarities between us and individuals who, by circumstance, happened to be in an institution.

When we discussed behavior modification, he pointed out that the most powerful consequence to any behavior is the relief of pain or anxiety. He said that many of the behaviors of addicts aren't a result of the physical tolerance to the drug. Rather, the behaviors arise from the terror of not being able to control the withdrawal. He said that the same applies to adult behavior that leads to relief. His example was putting a child in a time out room. Whether it changes the child's behavior is immaterial as long as it relieves the parent's pain. Time out will continue to be used.

I think something similar occurs in systems that use aversives. Their use is maintained by the fear of staff and management over the personal consequences if the techniques are no longer available.