Trauma Psychology Research

Pioneering Contributions of Psychoanalysis and Behaviorism

Shortly after World War I and again following World War II, a few investigators identified a severely [Page 724]disabling condition occurring after combat exposure, which involved symptoms such as startle reactions, sleep disturbances, dizziness, and blackouts. The terms shell shock, traumatic war neurosis, combat fatigue, and irritable heart were used to describe a condition similar to what is now recognized as post-traumatic stress disorder (PTSD). At that time, psychoanalytic theory predominated and, in an attempt to determine the etiology of the condition, inquiries were made into the veteran's premilitary home life and adjustment, assuming personality problems were merely exacerbated by combat. Although some studies found that parental discord, “broken” homes, and parental alcoholism were more likely in the enlisted men with “combat fatigue,” other scholars warned against viewing the condition as entirely from premilitary family or personality stability.

In the early 1900s, behaviorism, or the learning perspective, ran concurrently with the psychoanalytic movement. Two of the most important and relevant theories put forth by behaviorists to modern trauma theory were classical and operant conditioning. The theory of classical conditioning was developed by Ivan Petrovich Pavlov, who unknowingly uncovered a hallmark of posttraumatic reaction when he realized a neutral stimulus could be reconditioned to a meaningful stimulus if the neutral stimulus is paired with a new reaction-invoking stimulus, creating a conditioned response. For instance, in Pavlov's infamous experiment, his dogs reacted by salivating at the sound of a bell when their food was being delivered. The implications for trauma of this discovery were recognized much later when in 1987 Lawrence C. Kolb hypothesized that PTSD reactions could be a manifestation of Pavlovian conditioning.

The second major contribution of the early behav-iorists was the concept of operant conditioning. Among others, Burrhus Frederic (B. F.) Skinner postulated that a behavior, or operant, would increase or decrease based on the consequences of the operant. Operant conditioning has great relevance to the maintenance of PTSD. For instance, avoidant coping is considered a negative reinforcer of PTSD because the individual's anxiety may be reduced by avoiding the stimulus, thereby reinforcing avoidant behavior and maintaining the posttraumatic reaction by inhibiting exposure to the conditioned response.

Orval Hobart Mowrer was one of the first psychologists to recognize the limitations of classical and operant conditioning as individual theories. He sought to show the complementary relationship of each in his two-factor theory of conditioned fears. Part one of the two-part theory, as it was translated to the study of posttraumatic stress by Dean G. Kilpatrick and colleagues in 1979, suggests that classical conditioning explains the basis for post-traumatic response when stimuli associated with the trauma later evoke emotional, behavioral, and physiological responses at subsequent encounters (e.g., a combat veteran may later experience loud noises such as the sound of a door slamming as a conditioned stimulus). The second part of the theory suggests operant conditioning maintains the maladjusted response through behavioral avoidance and negative reinforcement (e.g., isolation, substance use).

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