Psych 102 Midterm Study Guide
Psych 102 Midterm Study Guide PSYC 102
Popular in Honors Introduction to Psychology
Popular in Psychology (PSYC)
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PSYCHOGERIATRICS 2004; 4: 40–42 ORIGINAL ARTICLE Animal assisted therapy for people with dementia Naoyasu MOTOMURA, Takayoshi YAGI and Hitomi OHYAMA 3 1National Mental Support Center for School CrisAbstract Osaka Kyoiku University; Nursing Home Arontia Club; and Japan Rescue Association, Osaka, Japanackground: The effects of animal assisted therapy on patients with dementia were investigated through the use of mental state batteries. Correspondence: Dr N. Motomura, National Mental Support Center for School Crisis, Osaka Kyoiku Methods: The subjects were eight patients admitted in a local nursing home. University, 1-2-10, Midorigaoka, Ikeda, Osaka, Their mean age was 84.8 years±7.0; four were dementia of Alzheimer’s type Japan. Email: email@example.com patients, and the others were vascular dementia patients. Mental state tests Received 15 June 2004; accepted 25 August 2004. included the apathy scale, the irritability scale, the depression scale, the activities of daily living and mini-mental state examination. Dog therapy with two dogs from the Japanese Rescue Association took place for 1h over four consecutive days. Results: The patients could communicate with and observe the dogs, and the dogs could interact with the humans. The results indicated no signiﬁcant difference in the irritability scale, the depression scale, activity of daily living and mini-mental state examination. However, most patients had a good impression of dog therapy, and all improved their apathetic state. Key words: Alzheimer’s disease, animal assistedConclusions: These results might imply that animal assisted therapy has therapy, patients with dementia, vascular dementhe possibility to inﬂuence the mental state of patients with dementia. INTRODUCTION SUBJECTS AND METHODS The elderly compose the fastest growing population Subjects were eight female patients admitted in a group in Japan. It is projected that in the year 2020, local nursing home. Their mean age was 84.8years 25% of the Japanese population will be 65years ±7.0; four were DAT patients and the others were VD or older. The care of people with dementia is one of patients. The diagnosis of dementia was performed the most important problems in Japan today. Many according to the Diagnostic and Statistical Manual of causes of dementia has been shown; with dementia Mental Disorders, Forth Edition (DSM IV) diagnostic of Alzheimer’s type (DAT) and vascular dementia criteria, NINCDS-ADRDA or NINCDS-AIREN. All of (VD) being the most common forms of dementia. these patients agreed to attend the dog therapy activ- Demented patients manifest many neurobehavioral ities and informed consent was obtained. As there problems. 1–3For example, they demonstrate delusion, was very mild cognitive change in the subjects of depression, apathy, irritability, anxiety, sleep disorders present study, we did not request informed consent or difﬁculty in social activities. For managing such from their families. In the present study we did not behavioral problems associated with dementia, strat- prepare control subjects, because we could not ﬁnd egies such as planned walking, pet therapy, an atten- a matched control group. tion focusing program, music and visual barriers show We conducted mental status tests before and after promising results in improving these behavioral the dog therapy activity. Mental status examination abnormalities in Western countries. 4–6 However, in included the apathy scale, the irritability scale, geriat- Japan we have only a few reports regarding the ric depression scale (GDS), physical self-maintenance effects of animal assisted therapy (AAT) for managing scale (PSMS) and mini-mental state examination patients with dementia through the use of mental (MMSE). The irritability tests were composed of seven 7,8 state batteries. questionnaires and the apathy tests; four questions. 40 Animal assisted therapy for people with dementia Apathy scale is composed of ﬁve questions and they would like to attend this activity again. Further- evaluates activity and apathy state of the patients. 10 more, all improved their apathy state and a signiﬁcant Scores vary from 0 to 25 points. Irritability scale is difference was found before and after the dog therapy also constructed by ﬁve questions and evaluate (Table 1). patients’ irritability. Scores vary from 0 point to 17 10 points. GDS includes 30 questions and if the DISCUSSION patients have more than eleven points, they may be diagnosed as ‘depressive state’. 11 PSMS composes We conducted AAT for patients with dementia and found that most of them prefer to take AAT. Further- eight questions in terms of activity of daily living. more, patients with dementia had improved apathy These include telephone use, shopping, dining, state by taking AAT. Zisselman et al. reported that housekeeping, washing, going outside, taking medi- women with dementia who received AAT had cine, and managing money. 12MMSE is composed by improved irritable behavior scores after treatment, tests for orientation, attention, calculation, recall, rep- although no signiﬁcant differences in the multidimen- etition, reading and writing. The scores vary from 0 to 30 points. 13 sional observation scale for elderly subjects scores (MOSES), which has 40 subscale items, were found Animal assisted therapy with two dogs from the between or within groups before and after the inter- Japanese Rescue Association took place for 1h 6 vention. Their AAT was for 1 h a day for ﬁve consec- over four consecutive days. Two therapy dogs, aged utive days. These results are almost consistent with 3 years participated in this AAT program. There were three types of activities which were done by therapy our data although our results mainly change in the apathy scale rather than irritability scale. Kongable et dogs. First type of the activity was the communication al. mentioned the presence of a pet dog on a special- with dogs. The dogs were introduced and the partic- care DAT unit signiﬁcantly increased social behaviors, ipants instructed them to sit down or wait. Then they such as greeting other people, speaking with other could touch the dogs or call dog’s name. The second 14 people or attending activities in the nursing home. type of activity was to observe the dog’s exercise. For On the basis of these observations we believe that examples, they could see dogs jumping into the ring. Third type of the activity was that the dogs interact AAT programs are desirable components of multidis- ciplinary treatment for patients with dementia and with the humans. AAT is essential to increase socialization, activity and sense of mastery. As we could conduct dog therapy RESULTS on only a small number of patients and could not The results indicated no signiﬁcant difference in the irritability scale, the depression scale, ADL and MMSE perform a controlled study. This pilot study shows the need for further research on animal-assisted interven- between before therapy and after therapy (Table1). tions for people with dementia. However, most patients had a good impression of dog therapy. Seventy-ﬁve percent of the patients quoted that it is a fun to attend dog therapy and they like REFERENCES 1 Motomura N, Sawada T, Inoue N, Asaba H, Sakai T. Neurop- dogs very much. sychological and neuropsychiatric ﬁndings in right hemi- Sixty-three percent of the patients mentioned that sphere damaged patients. Jap J Psychiatry Neurol 1988; 42: they like dogs better after attending this activity and 745–752. 2 Seo T, Motomura N et al. The signiﬁcance of delusions in Table 1 Mental state change before and after dog therapy dementia patients of Alzheimer type from clinical, neuropsycho- logical and neuroimaging view points.Bulletin of Osaka Medical Before therapy (SD) After therapy (SD) P-value College 1995; 41: 61–65. 3 Motomura N, Tomota Y et al. A study of language disorders MMSE 20.5 (6.3) 19.5 (7.4) NS associated with dementia of Alzheimer type in Japanese: a PSMS 5.2 (2.1) 5.0 (2.1) NS preliminary study. Psychologia 2000; 43: 84–89. GDS 12.5 (7.8) 13.4 (3.8) NS 4 Fick KM. The inﬂuence of an animal on social interactions of Irritability 7.5 (3.8) 7.0 (3.1) NS nursing home residents in a group setting.J Occup Ther Apathy 19.4 (3.7) 14.0 (3.5) £0.05 1993; 47: 529–534. 5 Forbes DA. Strategies for managing behavioral symptomatol- GDS, geriatric depression scale; MMSE, mini-mental state examinatiogy associated with dementia of the Alzheimer type: a system- NS, not signiﬁcant; PSMS, physical self-maintenance scale; SD, standard deviation. atic overview. Can J Nurs Res 1998; 30: 67–86. 41 N. Motomura et al. 6 Zisselman MH, Rovner BW, Shmuely Y, Ferrie P. A pet therapy 11 Yesavage JA, Brink TL, Rose TL et al. Development and valida- intervention with geriatric psychiatry inpatients.Am J Occup tion of a geriatric depression screening scale: a preliminary Ther 1996; 50: 47–51. report. J Psychiatr Res 1982–83; 17: 37–40. 7 Kato K, Atsumi T. Effects of dog therapy at geriatric hospital: 12 Lawton MP, Brody EM. Assessment of older people: self- the changing process of collectivity. Abstracts of the Third maintaining and instrumental activities of daily living. Gerontol- Conference of the Asian Association of Social Psychology , ogist 1969; 9: 179–186. 1999. 13 Folstein MF, Folstein SE, McHugh PR. ‘Mini-mental state’. A 8 Ogura T, Ohyama H. Dog therapy in rehabilitation. Hodanren practical method for grading the cognitive state of patients for 2000; 643: 14–17. the clinician. J Psychiatr Res 1975; 12: 189–198. 9 American Psychiatric Association. Diagnostic and Statistical 14 Kongable LG, Buckwalter KC, Stolley JM. The effects of pet Manual of Mental Disorders, Forth Edition (DSM IV).Washington therapy on the social behavior of institutionalized Alzheimer’s DC: American Psychiatric Association, 1995. clients. Arch Psychiatr Nurs 1989; 3: 191–198. 10 Burns A, Folstein S, Brandt J, Folstein M. Clinical assessment of irritability, aggression and apathy in Huntington and Alzhe- imer disease. J Nerve Ment Dis 1990; 178: 20–26. 42 Classics in the History of Psychology An internet resource developed by Christopher D. Green York University, Toronto, Ontario (Return to Classi index) CONDITIONED EMOTIONAL REACTIONS By John B. Watson and Rosalie Rayner(1920) First published in Journal of Experimental Psychology, 3(1), 114. In recent literature various speculations have been entered into concerning the possibility of conditioning various types of emotional response, but direct experimental evidence in support of such a view has been lacking. If the theory advanced by Watson and Morgan  to the effect that in infancy the original emotional reaction patterns are few, consisting so far as observed of fear, rage and love, then there must be some simple method by means of which the range of stimuli which can call out these emotions and their compounds is greatly increased. Otherwise, complexity in adult response could not be accounted for. These authors without adequate experimental evidence advanced the view that this range was increased by means of conditioned reflex factors. It was suggested there that the early home life of the child furnishes a laboratory situation for establishing conditioned emotional responses. The present authors have recently put the whole matter to an experimental test. Experimental work had been done so far on only one child, Albert B. This infant was reared almost from birth in a hospital environment; his mother was a wet nurse in the Harriet Lane Home for Invalid Children. Albert's life was normal: he was healthy from birth and one of the best developed youngsters ever brought to the hospital, weighing twentyone pounds at nine months of age. He was on the whole stolid and unemotional. His stability was one of the principal reasons for using him as a subject in this test. We [p.2] felt that we could do him relatively little harm by carrying out such experiments as those outlined below. At approximately nine months of age we ran him through the emotional tests that have become a part of our regular routine in determining whether fear reactions can be called out by other stimuli than sharp noises and the sudden removal of support. Tests of this type have been described by the senior author in another place. In brief, the infant was confronted suddenly and for the first time successively with a white rat, a rabbit, a dog, a monkey, with masks with and without hair, cotton wool, burning newspapers, etc. A permanent record of Albert's reactions to these objects and situations has been preserved in a motion picture study. Manipulation was the most usual reaction called out. At no time did this infant ever show fear in any situation. These experimental records were confirmed by the casual observations of the mother and hospital attendants. No one had ever seen him in a state of fear and rage. The infant practically never cried. Up to approximately nine months of age we had not tested him with loud sounds. The test to determine whether a fear reaction could be called out by a loud sound was made when he was eight months, twentysix days of age. The sound was that made by striking a hammer upon a suspended steel bar four feet in length and threefourths of an inch in diameter. The laboratory notes are as follows: One of the two experimenters caused the child to turn its head and fixate her moving hand ; the other stationed back of the child, struck the steel bar a sharp blow. The child started violently, his breathing was checked and the arms were raised in a characteristic manner. On the second stimulation the same thing occurred, and in addition the lips began to pucker and tremble. On the third stimulation the child broke into a sudden crying fit. This is the first time an emotional situation in the laboratory has produced any fear or even crying in Albert. [p.3] We had expected just these results on account of our work with other infants brought up under similar conditions. It is worth while to call attention to the fact that removal of support (dropping and jerking the blanket upon which the infant was lying) was tried exhaustively upon this infant on the same occasion. It was not effective in producing the fear response. This stimulus is effective in younger children. At what age such stimuli lose their potency in producing fear is not known. Nor is it known whether less placid children ever lose their fear of them. This probably depends upon the training the child gets. It is well known that children eagerly run to be tossed into the air and caught. On the other hand, it is equally well known that in the adult fear responses are called out quite clearly by the sudden removal of support, if the individual is walking across a bridge, walking out upon a beam, etc. There is a wide field of study here which is aside from our present point. The sound stimulus, thus, at nine months of age, gives us the means of testing several important factors. I. Can we condition fear of an animal, e.g., a white rat, by visually presenting it and simultaneously striking a steel bar? II. If such a conditioned emotional response can be established, will there be a transfer to other animals or other objects? III. What is the effect of time upon such conditioned emotional responses? IV. If after a reasonable period such emotional responses have not died out, what laboratory methods can be devised for their removal? I. The establishment of conditioned emotional responses. At first there was considerable hesitation upon our part in making the attempt to set up fear reactions experimentally. A certain responsibility attaches to such a procedure. We decided finally to make the attempt, comforting ourselves by the reflection that such attachments would arise anyway as soon as the child left the sheltered environment of the nursery for the rough and tumble of the home. We did not begin this work until Albert was eleven months, three days of age. Before attempting to set up a conditioned response we, as before, put him through all of the regular emotional [p.4] tests. Not the slightest sign of a fear response was obtained in any situation. The steps taken to condition emotional responses are shown in our laboratory notes. 11 Months 3 Days 1. White rat suddenly taken from the basket and presented to Albert. He began to reach for rat with left hand. Just as his hand touched the animal the bar was struck immediately behind his head. The infant jumped violently and fell forward, burying his face in the mattress. He did not cry, however. 2. Just as the right hand touched the rat the bar was again struck. Again the infant jumped violently, fell forward and began to whimper. In order not to disturb the child too seriously no further tests were given for one week. 11 Months 10 Days 1. Rat presented suddenly without sound. There was steady fixation but no tendency at first to reach for it. The rat was then placed nearer, whereupon tentative reaching movements began with the right hand. When the rat nosed the infant's left hand, the hand was immediately withdrawn. He started to reach for the head of the animal with the forefinger of the left hand, but withdrew it suddenly before contact. It is thus seen that the two joint stimulations given the previous week were not without effect. He was tested with his blocks immediately afterwards to see if they shared in the process of conditioning. He began immediately to pick them up, dropping them, pounding them, etc. In the remainder of the tests the blocks were given frequently to quiet him and to test his general emotional state. They were always removed from sight when the process of conditioning was under way. 2. Joint stimulation with rat and sound. Started, then fell over immediately to right side No crying.[p.5] 3. Joint stimulation. Fell to right side and rested upon hands, with head turned away from rat. No crying. 4. Joint stimulation. Same reaction. 5. Rat suddenly presented alone. Puckered face, whimpered and withdrew body sharply to the left. 6. Joint stimulation. Fell over immediately to right side and began to whimper. 7. Joint stimulation. Started violently and cried, but did not fall over. 8. Rat alone. The instant the rat was shown the baby began to cry. Almost instantly he turned sharply to the left, fell over on left side, raised himself on all fours and began to crawl away so rapidly that he was caught with difficulty before reaching the edge of the table. This was as convincing a case of a completely conditioned fear response as could have been theoretically pictured. In all seven joint stimulations were given to bring about the complete reaction. It is not unlikely had the sound been of greater intensity or of a more complex clang character that the number of joint stimulations might have been materially reduced. Experiments designed to define the nature of the sounds that will serve best as emotional stimuli are under way. II. When a conditioned emotional response has been established for one object, is there a transfer? Five days later Albert was again brought back into the laboratory and tested as follows: 11 Months 15 Days 1. Tested first with blocks. He reached readily for them, playing with them as usual. This shows that there has been no general transfer to the room, table, blocks, etc. 2. Rat alone. Whimpered immediately, withdrew right hand and turned head and trunk away. 3.Blocks again offered. Played readily with them, smiling and gurgling. [p.6] 4. Rat alone. Leaned over to the left side as far away from the rat as possible, then fell over, getting up on all fours and scurrying away as rapidly as possible. 5. Blocks again offered. Reached immediately for them, smiling and laughing as before. The above preliminary test shows that the conditioned response to the rat had carried over completely for the five days in which no tests were given. The question as to whether or not there is a transfer was next taken up. 6. Rabbit alone. The rabbit was suddenly placed on the mattress in front of him. The reaction was pronounced. Negative responses began at once. He leaned as far away from the animal as possible, whimpered, then burst into tears. When the rabbit was placed in contact with him he buried his face in the mattress, then got up on all fours and crawled away, crying as he went. This was a most convincing test. 7. The blocks were next given him, after an interval. He played with them as before. It was observed by four people that he played far more energetically with them than ever before. The blocks were raised high over his head and slammed down with a great deal of force. 8. Dog alone. The dog did not produce as violent a reaction as the rabbit. The moment fixation occurred the child shrank back and as the animal came nearer he attempted to get on all fours but did not cry at first. As soon as the dog passed out of his range of vision he became quiet. The dog was then made to approach the infant's head (he was lying down at the moment). Albert straightened up immediately, fell over to the opposite side and turned his head away. He then began to cry. 9. The blocks were again presented. He began immediately to play with them. 10. Fur coat (seal). Withdrew immediately to the left side and began to fret. Coat put close to him on the [p.7] left side, he turned immediately, began to cry and tried to crawl away on all fours. 11. Cotton wool. The wool was presented in a paper package. At the end the cotton was not covered by the paper. It was placed first on his feet. He kicked it away but did not touch it with his hands. When his hand was laid on the wool he immediately withdrew it but did not show the shock that the animals or fur coat produced in him. He then began to play with the paper, avoiding contact with the wool itself. He finally, under the impulse of the manipulative instinct, lost some of his negativism to the wool. 12. Just in play W. put his head down to see if Albert would play with his hair. Albert was completely negative. Two other observers did the same thing. He began immediately to play with their hair. W. then brought the Santa Claus mask and presented it to Albert. He was again pronouncedly negative. 11 Months 20 Days 1. Blocks alone. Played with them as usual. 2. Rat alone. Withdrawal of the whole body, bending over to left side, no crying. Fixation and following with eyes. The response was much less marked than on first presentation the previous week. It was thought best to freshen up the reaction by another joint stimulation. 3. Just as the rat was placed on his hand the rod was struck. Reaction violent. 4. Rat alone. Fell over at once to left side. Reaction practically as strong as on former occasion but no crying. 5. Rat alone. Fell over to left side, got up on all fours and started to crawl away. On this occasion there was no crying, but strange to say, as he started away he began to gurgle and coo, even while leaning far over to the left side to avoid the rat. 6. Rabbit alone. Leaned over to left side as far as possible. Did not fall over. Began to whimper but reaction not so violent as on former occasions. [p.8] 7. Blocks again offered. He reached for them immediately and began to play. All of these tests so far discussed were carried out upon a table supplied with a mattress, located in a small, welllighted darkroom. We wished to test next whether conditioned fear responses so set up would appear if the situation were markedly altered. We thought it best before making this test to freshen the reaction both to the rabbit and to the dog by showing them at the moment the steel bar was struck. It will be recalled that this was the first time any effort had been made to directly condition response to the dog and rabbit. The experimental notes are as follows: 8. The rabbit at first was given alone. The reaction was exactly as given in test (6) above. When the rabbit was left on Albert's knees for a long time he began tentatively to reach out and manipulate its fur with forefingers. While doing this the steel rod was struck. A violent fear reaction resulted. 9. Rabbit alone. Reaction wholly similar to that on trial (6) above. I0. Rabbit alone. Started immediately to whimper, holding hands far up, but did not cry. Conflicting tendency to manipulate very evident. 11. Dog alone. Began to whimper, shaking head from side to side, holding hands as far away from the animal as possible. 12. Dog and sound. The rod was struck just as the animal touched him. A violent negative reaction appeared. He began to whimper, turned to one side, fell over and started to get up on all fours. 13. Blocks. Played with them immediately and readily. On this same day and immediately after the above experiment Albert was taken into the large welllighted lecture room belonging to the laboratory. He was placed on a table in the center of the room immediately under the skylight. Four people were present. The situation [p.9] was thus very different from that which obtained in the small dark room. I. Rat alone. No sudden fear reaction appeared at first. The hands, however, were held up and away from the animal. No positive manipulatory reactions appeared. 2. Rabbit alone. Fear reaction slight. Turned to left and kept face away from the animal but the reaction was never pronounced. 3. Dog alone. Turned away but did not fall over. Cried. Hands moved as far away from the animal as possible. Whimpered as long as the dog was present. 4. Rat alone. Slight negative reaction. 5. Rat and sound. It was thought best to freshen the reaction to the rat. The sound was given just as the rat was presented. Albert jumped violently but did not cry. 6. Rat alone. At first he did not show any negative reaction. When rat was placed nearer he began to show negative reaction by drawing back his body, raising his hands, whimpering, etc. 7. Blocks. Played with them immediately. 8. Rat alone. Pronounced withdrawal of body and whimpering. 9. Blocks. Played with them as before. 10. Rabbit alone. Pronounced reaction. Whimpered with arms held high, fell over backward and had to be caught. 11. Dog alone. At first the dog did not produce the pronounced reaction. The hands were held high over the head, breathing was checked, but there was no crying. Just at this moment the dog, which had not barked before, barked three times loudly when only about six inches from the baby's face. Albert immediately fell over and broke into a wail that continued until the dog was removed. The sudden barking of the hitherto quiet dog produced a marked fear response in the adult observers! [p.10] From the above results it would seem that emotional transfers do take place. Furthermore it would seem that the number of transfers resulting from an experimentally produced conditioned emotional reaction may be very large. In our observations we had no means of testing the complete number of transfers which may have resulted. III. The effect of time upon conditioned emotional responses. We have already shown that the conditioned emotional response will continue for a period of one week. It was desired to make the time test longer. In view of the imminence of Albert's departure from the hospital we could not make the interval longer than one month. Accordingly no further emotional experimentation was entered into for thirtyone days after the above test. During the month, however, Albert was brought weekly to the laboratory for tests upon right and lefthandedness, imitation, general development, etc. No emotional tests whatever were given and during the whole month his regular nursery routine was maintained in the Harriet Lane Home. The notes on the test given at the end of this period are as follows: 1 Year 21 Days 1. Santa Claus mask. Withdrawal, gurgling, then slapped at it without touching. When his hand was forced to touch it, he whimpered and cried. His hand was forced to touch it two more times. He whimpered and cried on both tests. He finally cried at the mere visual stimulus of the mask. 2. Fur coat. Wrinkled his nose and withdrew both hands, drew back his whole body and began to whimper as the coat was put nearer. Again there was the strife between withdrawal and the tendency to manipulate. Reached tentatively with left hand but drew back before contact had been made. In moving his body to one side his hand accidentally touched the coat. He began to cry at once, nodding his head in a very peculiar manner (this reaction was an entirely new one). Both hands were withdrawn as far as possible from the coat. The coat [p.11] was then laid on his lap and he continued nodding his head and whimpering, withdrawing his body as far as possible, pushing the while at the coat with his feet but never touching it with his hands. 3. Fur coat. The coat was taken out of his sight and presented again at the end of a minute. He began immediately to fret, withdrawing his body and nodding his head as before. 4. Blocks. He began to play with them as usual. 5. The rat. He allowed the rat to crawl towards him without withdrawing. He sat very still and fixated it intently. Rat then touched his hand. Albert withdrew it immediately, then leaned back as far as possible but did not cry. When the rat was placed on his arm he withdrew his body and began to fret, nodding his head. The rat was then allowed to crawl against his chest. He first began to fret and then covered his eyes with both hands. 6. Blocks. Reaction normal. 7. The rabbit. The animal was placed directly in front of him. It was very quiet. Albert showed no avoiding reactions at first. After a few seconds he puckered up his face, began to nod his head and to look intently at the experimenter. He next began to push the rabbit away with his feet, withdrawing his body at the same time. Then as the rabbit came nearer he began pulling his feet away, nodding his head, and wailing "da da". After about a minute he reached out tentatively and slowly and touched the rabbit's ear with his right hand, finally manipulating it. The rabbit was again placed in his lap. Again he began to fret and withdrew his hands. He reached out tentatively with his left hand and touched the animal, shuddered and withdrew the whole body. The experimenter then took hold of his left hand and laid it on the rabbit's back. Albert immediately withdrew his hand and began to suck his thumb. Again the rabbit was laid in his lap. He began to cry, covering his face with both hands. [p.12] 8. Dog. The dog was very active. Albert fixated it intensely for a few seconds, sitting very still. He began to cry but did not fall over backwards as on his last contact with the dog. When the dog was pushed closer to him he at first sat motionless, then began to cry, putting both hands over his face. These experiments would seem to show conclusively that directly conditioned emotional responses as well as those conditioned by transfer persist, although with a certain loss in the intensity of the reaction, for a longer period than one month. Our view is that they persist and modify personality throughout life. It should be recalled again that Albert was of an extremely phlegmatic type. Had he been emotionally unstable probably both the directly conditioned response and those transferred would have persisted throughout the month unchanged in form. IV. "Detachment" or removal of conditioned emotional responses. Unfortunately Albert was taken from the hospital the day the above tests were made. Hence the opportunity of building up an experimental technique by means of which we could remove the conditioned emotional responses was denied us. Our own view, expressed above, which is possibly not very well grounded, is that these responses in the home environment are likely to persist indefinitely, unless an accidental method for removing them is hit upon. The importance of establishing some method must be apparent to all. Had the opportunity been at hand we should have tried out several methods, some of which we may mention. (I) Constantly confronting the child with those stimuli which called out the responses in the hopes that habituation would come in corresponding to "fatigue" of reflex when differential reactions are to be set up. (2) By trying to "recondition" by showing objects calling out fear responses (vsual) and simultaneously stimulating the erogenous zones (tactual). We should try first the lips, then the nipples and as a final resort the sex organs. (3) By trying to "recondition" by feeding the subject candy or other food just as the animal is shown. This method calls for the food control of the subject. (4) By building up "constructive" activities around the object by imitation and [p.13] by putting the hand through the motions of manipulation. At this age imitation of overt motor activity is strong, as our present but unpublished experimentation has shown. INCIDENTAL O BSERVATIONS (a) Thumb sucking as a compensatory device for blocking fear and noxious stimuli. During the course of these experiments, especially in the final test, it was noticed that whenever Albert was on the verge of tears or emotionally upset generally he would continually thrust his thumb into his mouth. The moment the hand reached the mouth he became impervious to the stimuli producing fear. Again and again while the motion pictures were being made at the end of the thirtyday period, we had to remove the thumb from his mouth before the conditioned response could be obtained. This method of blocking noxious and emotional stimuli (fear and rage) through erogenous stimulation seems to persist from birth onward. Very often in our experiments upon the work adders with infants under ten days of age the same reaction appeared. When at work upon the adders both of the infants arms are under slight restraint. Often rage appears. They begin to cry, thrashing their arms and legs about. If the finger gets into the mouth crying ceases at once. The organism thus apparently from birth, when under the influence of love stimuli is blocked to all others. This resort to sex stimulation when under the influence of noxious and emotional situations, or when the individual is restless and idle, persists throughout adolescent and adult life. Albert, at any rate, did not resort to thumb sucking except in the presence of such stimuli. Thumb sucking could immediately be checked by offering him his blocks. These invariably called out active manipulation instincts. It is worth while here to call attention to the fact that Freud's conception of the stimulation of erogenous zones as being the expression of an original "pleasure" seeking principle may be turned about [p.14] and possibly better described as a compensatory (and often conditioned) device for the blockage of noxious and fear and rage producing stimuli. (b) Equal primacy of fear, love and possibly rage. While in general the results of our experiment offer no particular points of conflict with Freudian concepts, one fact out of harmony with them should be emphasized. According to proper Freudians sex (or in our terminology, love) is the principal emotion in which conditioned responses arise which later limit and distort personality. We wish to take sharp issue with this view on the basis of the experimental evidence we have gathered. Fear is as primal a factor as love in influencing personality. Fear does not gather its potency in any derived manner from love. It belongs to the original and inherited nature of man. Probably the same may be true of rage although at present we are not so sure of this. The Freudians twenty years from now, unless their hypotheses change, when they come to analyze Albert's fear of a seal skin coat assuming that he comes to analysis at that age will probably tease from him the recital of a dream which upon their analysis will show that Albert at three years of age attempted to play with the pubic hair of the mother and was scolded violently for it. (We are by no means denying that this might in some other case condition it). If the analyst has sufficiently prepared Albert to accept such a dream when found as an explanation of his avoiding tendencies, and if the analyst has the authority and personality to put it over, Albert may be fully convinced that the dream was a true revealer of the factors which brought about the fear. It is probable that many of the phobias in psychopathology are true conditioned emotional reactions either of the direct or the transferred type. One may possibly have to believe that such persistence of early conditioned responses will be found only in persons who are constitutionally inferior. Our argument is meant to be constructive. Emotional disturbances in adults cannot be traced back to sex alone. They must be retraced along at least three collateral lines to conditioned and transferred responses set up in infancy and early youth in all three of the fundamental human emotions. Footnotes  'Emotional Reactions and Psychological Experimentation,' American Journal of Psychology, April, 1917, Vol. 28, pp. 163174.  'Psychology from the Standpoint of a Behaviorist,' p.202.  The stimulus to love in infants according to our view is stroking of the skin, lips, nipples and sex organs, patting and rocking, picking up, etc. Patting and rocking (when not conditioned) are probably equivalent to actual stimulation of the sex organs. In adults of course, as every lover knows, vision, audition and olfaction soon become conditioned by joint stimulation with contact and kinaesthetic stimuli. 10/11/2016 Classics in the History of Psychology Freud (1900) Chapter 3 Classics in the History of Psychology An internet resource developed by Christopher D. Green York University, Toronto, Ontario (Return to index) The Interpretation of Dreams Sigmund Freud (1910) CHAPTER 3 THE DREAM AS WISHFULFILMENT When, after passing through a narrow defile, one suddenly reaches a height beyond which the ways part and a rich prospect lies outspread in different directions, it is well to stop for a moment and consider whither one shall turn next. We are in somewhat the same position after we have mastered this first interpretation of a dream. We find ourselves standing in the light of a sudden discovery. The dream is not comparable to the irregular sounds of a musical instrument, which, instead of being played by the hand of a musician, is struck by some external force; the dream is not meaningless, not absurd, does not presuppose that one part of our store of ideas is dormant while another part begins to awake. It is a perfectly valid psychic phenomenon, actually a wish fulfilment; it may be enrolled in the continuity of the intelligible psychic activities of the waking state; it is built up by a highly complicated intellectual activity. But at the very moment when we are about to rejoice in this discovery a host of problems besets us. If the dream, as this theory defines it, represents a fulfilled wish, what is the cause of the striking and unfamiliar manner in which this fulfilment is expressed? What transformation has occurred in our dreamthoughts before the manifest dream, as we remember it on waking, shapes itself out of them? How has this transformation taken place? Whence comes the material that is worked up into the dream? What causes many of the peculiarities which are to be observed in our dreamthoughts; for example, how is it that they are able to contradict one another? Is the dream capable of teaching us something new concerning our internal psychic processes and can its content correct opinions which we have held during the day? I suggest that for the present all these problems be laid aside, and that a single path be pursued. We have found that the dream represents a wish as fulfilled. Our next purpose should be to ascertain whether this is a general characteristic of dreams, or whether it is only the accidental content of the particular dream (the dream about Irma's injection) with which we have begun our analysis; for even if we conclude that every dream has a meaning and psychic value, we must nevertheless allow for the possibility that this meaning may not be the same in every dream. The first dream which we have considered was the fulfilment of a wish; another may turn out to be the realization of an apprehension; a third may have a reflection as its content; a fourth may simply reproduce a reminiscence. Are there, then dreams other than wishdreams; or are there none but wishdreams? It is easy to show that the wishfulfilment in dreams is often undisguised and easy to recognize, so that one may wonder why the language of dreams has not long since been understood. There is, for example, a dream which I can evoke as often as I please, experimentally, as it were. If, in the evening, I eat anchovies, olives, or other strongly salted foods, I am thirsty at night, and therefore I wake. The waking, however, is preceded by a dream, which has always the same content, namely, that I am drinking. I am drinking long draughts of water; it tastes as delicious as only a cool drink can taste when one's throat is parched; and then I wake, and find that I have an actual desire to drink. The cause of this dream is thirst, which I perceive when I wake. From this sensation arises the wish to drink, and the dream shows me this wish as fulfilled. It thereby serves a function, the nature of which http://psychclassics.yorku.ca/Freud/Dreams/dreams3.htm 1/6 10/11/2016 Classics in the History of Psychology Freud (1900) Chapter 3 I soon surmise. I sleep well, and am not accustomed to being waked by a bodily need. If I succeed in appeasing my thirst by means of the dream that I am drinking, I need not wake up in order to satisfy that thirst. It is thus a dream of convenience. The dream takes the place of action, as elsewhere in life. Unfortunately, the need of water to quench the thirst cannot be satisfied by a dream, as can my thirst for revenge upon Otto and Dr. M, but the intention is the same. Not long ago I had the same dream in a somewhat modified form. On this occasion I felt thirsty before going to bed, and emptied the glass of water which stood on the little chest beside my bed. Some hours later, during the night, my thirst returned, with the consequent discomfort. In order to obtain water, I should have had to get up and fetch the glass which stood on my wife's bed table. I thus quite appropriately dreamt that my wife was giving me a drink from a vase; this vase was an Etruscan cinerary urn, which I had brought home from Italy and had since given away. But the water in it tasted so salt (apparently on account of the ashes) that I was forced to wake. It may be observed how conveniently the dream is capable of arranging matters. Since the fulfilment of a wish is its only purpose, it may be perfectly egoistic. Love of comfort is really not compatible with consideration for others. The introduction of the cinerary urn is probably once again the fulfilment of a wish; I regret that I no longer possess this vase; it, like the glass of water at my wife's side, is inaccessible to me. The cinerary urn is appropriate also in connection with the sensation of an increasingly salty taste, which I know will compel me to wake.  Such conveniencedreams came very frequently to me in my youth. Accustomed as I had always been to working until late at night, early waking was always a matter of difficulty. I used then to dream that I was out of bed and standing at the washstand. After a while I could no longer shut out the knowledge that I was not yet up; but in the meantime I had continued to sleep. The same sort of lethargydream was dreamed by a young colleague of mine, who appears to share my propensity for sleep. With him it assumed a particularly amusing form. The landlady with whom he was lodging in the neighbourhood of the hospital had strict orders to wake him every morning at a given hour, but she found it by no means easy to carry out his orders. One morning sleep was especially sweet to him. The woman called into his room: "Herr Pepi, get up; you've got to go to the hospital." Whereupon the sleeper dreamt of a room in the hospital, of a bed in which he was lying, and of a chart pinned over his head, which read as follows: "Pepi M, medical student, 22 years of age." He told himself in the dream: "If I am already at the hospital, I don't have to go there," turned over, and slept on. He had thus frankly admitted to himself his motive for dreaming. Here is yet another dream of which the stimulus was active during sleep: One of my women patients, who had been obliged to undergo an unsuccessful operation on the jaw, was instructed by her physicians to wear by day and night a cooling apparatus on the affected cheek; but she was in the habit of throwing it off as soon as she had fallen asleep. One day I was asked to reprove her for doing so; she had again thrown the apparatus on the floor. The patient defended herself as follows: "This time I really couldn't help it; it was the result of a dream which I had during the night. In the dream I was in a box at the opera, and was taking a lively interest in the performance. But Herr Karl Meyer was lying in the sanatorium and complaining pitifully on account of pains in his jaw. I said to myself, 'Since I haven't the pains, I don't need the apparatus either'; that's why I threw it away." The dream of this poor sufferer reminds me of an expression which comes to our lips when we are in a disagreeable situation: "Well, I can imagine more amusing things!" The dream presents these "more amusing things!" Herr Karl Meyer, to whom the dreamer attributed her pains, was the most casual acquaintance of whom she could think. It is quite as simple a matter to discover the wishfulfilment in several other dreams which I have collected from healthy persons. A friend who was acquainted with my theory of dreams, and had explained it to his wife, said to me one day: "My wife asked me to tell you that she dreamt yesterday that she was having her menses. You will know what that means." Of course I know: if the young wife dreams that she is having her menses, the menses have stopped. I can well imagine that she would have liked to enjoy her freedom a little longer, before the discomforts of maternity began. It was a clever way of giving notice of her first pregnancy. Another friend writes that his wife had dreamt not long ago that she noticed milkstains on the front of her blouse. This also is an indication of pregnancy, but not of the first one; the young mother hoped she would have more nourishment for the second child than she had for the first. http://psychclassics.yorku.ca/Freud/Dreams/dreams3.htm 2/6 10/11/2016 Classics in the History of Psychology Freud (1900) Chapter 3 A young woman who for weeks had been cut off from all society because she was nursing a child who was suffering from an infectious disease dreamt, after the child had recovered, of a company of people in which Alphonse Daudet, Paul Bourget, Marcel Prevost and others were present; they were all very pleasant to her and amused her enormously. In her dream these different authors had the features which their portraits give them. M. Prevost, with whose portrait she is not familiar, looked like the man who had disinfected the sickroom the day before, the first outsider to enter it for a long time. Obviously the dream is to be translated thus: "It is about time now for something more entertaining than this eternal nursing." Perhaps this collection will suffice to prove that frequently, and under the most complex conditions, dreams may be noted which can be understood only as wishfulfilments, and which present their content without concealment. In most cases these are short and simple dreams, and they stand in pleasant contrast to the confused and overloaded dreamcompositions which have almost exclusively attracted the attention of the writers on the subject. But it will repay us if we give some time to the examination of these simple dreams. The simplest dreams of all are, I suppose, to be expected in the case of children whose psychic activities are certainly less complicated than those of adults. Child psychology, in my opinion, is destined to render the same services to the psychology of adults as a study of the structure or development of the lower animals renders to the investigation of the structure of the higher orders of animals. Hitherto but few deliberate efforts have been made to make use of the psychology of the child for such a purpose. The dreams of little children are often simple fulfilments of wishes, and for this reason are, as compared with the dreams of adults, by no means interesting. They present no problem to be solved, but they are invaluable as affording proof that the dream, in its inmost essence, is the fulfilment of a wish. I have been able to collect several examples of such dreams from the material furnished by my own children. For two dreams, one that of a daughter of mine, at that time eight and a half years of age, and the other that of a boy of five and a quarter, I am indebted to an excursion to Hallstatt, in the summer of 1806. I must first explain that we were living that summer on a hill near Aussee, from which, when the weather was fine, we enjoyed a splendid view of the Dachstein. With a telescope we could easily distinguish the Simony hut. The children often tried to see it through the telescope I do not know with what success. Before the excursion I had told the children that Hallstatt lay at the foot of the Dachstein. They looked forward to the outing with the greatest delight. From Hallstatt we entered the valley of Eschern, which enchanted the children with its constantly changing scenery. One of them, however, the boy of five, gradually became discontented. As often as a mountain came into view, he would ask: "Is that the Dachstein?" whereupon I had to reply: "No, only a foot hill." After this question had been repeated several times he fell quite silent, and did not wish to accompany us up the steps leading to the waterfall. I thought he was tired. But the next morning he came to me, perfectly happy, and said: "Last night I dreamt that we went to the Simony hut." I understood him now; he had expected, when I spoke of the Dachstein, that on our excursion to Hallstatt he would climb the mountain, and would see at close quarters the hut which had been so often mentioned when the telescope was used. When he learned that he was expected to content himself with foothills and a waterfall he was disappointed, and became discontented. But the dream compensated him for all this. I tried to learn some details of the dream; they were scanty. "You go up steps for six hours," as he had been told. On this excursion the girl of eight and a half had likewise cherished wishes which had to be satisfied by a dream. We had taken with us to Hallstatt our neighbour's twelveyearold boy; quite a polished little gentleman, who, it seemed to me, had already won the little woman's sympathies. Next morning she related the following dream: "Just think, I dreamt that Emil was one of the family, that he said 'papa' and 'mamma' to you, and slept at our house, in the big room, like one of the boys. Then mamma came into the room and threw a handful of big bars of chocolate, wrapped in blue and green paper, under our beds." The girl's brothers, who evidently had not inherited an understanding of dreaminterpretation, declared, just as the writers we have quoted would have done: "That dream is nonsense." The girl defended at least one part of the dream, and from the standpoint of the theory of the neuroses it is interesting to learn which part it was that she defended: "That Emil was one of the family was nonsense, but that about the bars of chocolate wasn't." It was just this latter part that was obscure to me, until my wife furnished the explanation. On the way home from the railway station the children had stopped in front of a slotmachine, and had wanted exactly such bars of chocolate, wrapped in paper with a http://psychclassics.yorku.ca/Freud/Dreams/dreams3.htm 3/6 10/11/2016 Classics in the History of Psychology Freud (1900) Chapter 3 metallic lustre, such as the machine, in their experience, provided. But the mother thought, and rightly so, that the day had brought them enough wishfulfilments, and therefore left this wish to be satisfied in the dream. This little scene had escaped me. That portion of the dream which had been condemned by my daughter I understood without any difficulty. I myself had heard the wellbehaved little guest enjoining the children, as they were walking ahead of us, to wait until "papa" or "mamma" had come up. For the little girl the dream turned this
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