Today would have been B.F. Skinner‘s 111th birthday. One of the first to apply the scientific method to psychology, Skinner built on the work of theorists like John B. Watson and Edward Thorndike to create a comprehensive explanation of behavior.  His theory of operant conditioning states that behaviors that get rewarded tend to repeat themselves. This deceptively simple point is now the foundation for everything from business-management theory to weight-loss apps.

AboutBehaviorismWhen he retired from Harvard in 1974, no one would have predicted such dominance. Outside of psychology’s community, “therapy” was synonymous with “psychoanalysis” and his theories were seen as totalitarian mind control. About Behaviorism, published that year, was his parting shot; a comprehensive defense of his work for non-academic readers.

He starts by discarding most of other theorists’ concerns. As he saw it, psychology has only one sensible question to ask: why do people behave the way they do? Inside that limit, there are only two reasons to inquire: either to predict someone’s behavior or to control it. An explanation like, “I went to a movie because I was in the mood,” is useless because we can’t predict when or why the mood might strike. An account based in operant conditioning, such as, “I went to a movie because I expected it would relieve feelings of boredom and reward me with feelings of being entertained,” tells us when someone might go (when they are bored) and how you might get them to go (bore them).

When he claims there are no such thing as ethics, motives, concepts or goals, Skinner sounds nihilistic. In fact, he believes in three things: behavior, reinforcers and rules. Rules are just  summarized predictions of how behavior and reinforcers will work together, so they only half-count. He believed in reflexes and evolution too, but didn’t see them as being relevant to psychology. Although he denies purist black-box thinking, he relentlessly pares all that is human down to operant conditioning.

bfskinnerbjorklol2On topics where his theories are best-validated, he writes with confidence, even benevolence towards his detractors. When he hits the edges of what behaviorism adequately explains, a detectable hint of snippiness leaks through.  Knowledge? It’s a behavior of responses reinforced by others telling us we are right. Language? It’s a behavior reinforced by people responding the way we like when we speak. Creativity? It’s the behavior of experimenting with different combinations until something reinforcing emerges.  Thought? It’s a behavior, too. Or anyway it’s the mental articulation of words, so it might as well be the same thing.What goes on in the brain? It doesn’t matter. Physiologists, he says with a sniff, will someday understand.

That someday has come closer. Neuroimaging has revealed both insights into brain function and the limits of Skinner’s work. In considering his views, we have to consider our luxury of a viewpoint illuminated by MRI scans. All-encompassing theories hold a seductive allure that can infect our perceptions.  Psych 101 students often develop “Freud-o-Scope”, a temporary disturbance that causes unresolved conflicts, todestrieb and phallic symbols to dominate the visual field. Most sufferers recover in a few weeks when the class moves on to operant conditioning. Given the confines of 1974’s technology, Skinner’s insistence that everything comes down to behavior and reinforcement is understandable.

Java the cat, 1998-2015

Java the cat, 1998-2015

When our cat reached old age, the vet recommended canned food to supplement the dry stuff.  After fourteen years of kibble, pâté with Pacific salmon was so intoxicating, she ate until she vomited. I managed to wipe up only half of the mess before she came back, purring and sniffing. “Forget it, Java,” I told her. “You’ve had enough,” She cocked her head at the strangest angle and meowed – imploringly, it seemed – with sounds and cadences we’d never heard from her before. Skinner-Vision took effect. “Of course,” I thought. “She’s experimenting with new behaviors to see what will get reinforced with more canned food.”

@ 2015 Jonathan Miller All Rights Reserved

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Emotion Differentiation and the strengths of specificity

“I have learned now that while those who speak about one’s miseries usually hurt, those who keep silence hurt more.” – C.S. Lewis

The last post covered a metaphor to encourage people to embrace their emotions. More research is showing there is power in calling them by name.


Lisa Feldman Barrett, PhD, Distinguished Professor of Psychology at Northeastern University.

“Emotion differentiation” is the ability to say what one feels. It’s a central focus for emotional-intelligence researchers such as Lisa Feldman Barrett at Northeastern U. and Todd B. Kashdan at George Mason U. They’ve found that the people best able to regulate their feelings are the ones who can say they feel more regret than remorse, less guilt than shame or more miffed than peeved¹. Compared with those who only report feeling, “fine,” or “bad,” those with a fine-grained view of their emotions respond more resiliently to rejection². While they are more likely to employ many strategies to cope with unhappiness, they’re less likely to cope via alcohol abuse³ or violence⁴.


Todd B. Kashdan, PhD, professor of clinical psychology at George Mason University.

Trouble with emotion differentiation seems to appear in different emotional health issues. Demiralp and Thompson⁵ found that people with depression had, “less-differentiated negative emotional experiences”; i.e., they could distinguish more specific positive feelings than negative ones. Kashdan and Farmer found similar findings for those with Social Phobia⁶.

Kashdan, Barrett and McKnight suggest knowing exactly what you’re feeling makes it easier to get those emotions’ message. That information connects us with other knowledge about what to expect and what to do. It also makes it easier to regulate the feelings, because they’re now classified either as motivation or as irrelevant. With less energy devoted to controlling one’s emotions, there’s more to put towards the things you want to achieve⁷.

Poor emotional differentiation in action.

Poor emotional differentiation in action.

They also point to evidence that emotion differentiation is a skill that can be taught⁷. This includes findings that emotionally-differentiating children behave and perform better in school⁹.One study found naming emotions helped arachnophobes tolerate exposure therapy better than distraction or cognitive reframing¹⁰.

For therapists working in community mental health, these findings can be a selling point. Live in a tough neighborhood? Need to keep up a strong front? You want to know what you feel so you can recover more quickly. If a client only values logic, emotion differentiation can be a way of getting them to look at their feelings; Ciarrochi,  Caputi and Mayer⁸ found that those who can identify specific emotions make decisions with less emotional bias.


Clients can get confused when we ask them to identify negative feelings. They come to us to feel better. Why are we asking them to feel worse?  The assumption that it is safest to suppress your emotions is a spin on the post hoc fallacy: “I feel vulnerable when I pay attention to my feelings, so  if I ignore them, I’ll be less vulnerable.” We may be able to tell our clients, “Emotions are only a vulnerability if you treat them that way. Treat them like information and they become a strength.”

All this gives us one more reason to pull out our emotion-word sheets and encourage clients  to name their feelings.  I’ve asked clients rate the intensity of their distress before and after identifying emotions. More often than not, they’re surprised to find their stress level has dropped.

Two examples to motivate clients to practice identifying feelings at home:

1. The tale of Rumplestiltskin. At the end of the story, the wicked little man had to give up his claim on the princess’ child. Why? Because she found out his name.

2. Tribal societies around the world, where members have a public name for common use, and a secret name kept private among family members. Why? Because knowing something’s name gives you power over it.

n.b.: Dr. Barrett responded to this post, and she suggested these for further reading:

Lindquist, K., & Barrett, L. F. (2008).  Emotional complexity. Chapter in M. Lewis, J. M. Haviland-Jones, and L.F. Barrett (Eds.), The handbook of emotion, 3rd Edition (p. 513-530). New York: Guilford.

Barrett, L. F., Wilson-Mendenhall, C. D., & Barsalou, L. W.  (2015).  The conceptual act theory: A road map.  Chapter in L. F. Barrett and J. A. Russell (Eds.), The psychological construction of emotion(p. 83-110).  New York: Guilford. — this explains one theory for how to become more emotionally granular


(1) LF Barrett, J Gross, TC Christensen, M Benvenuto.  “Knowing what you’re feeling and knowing what to do about it: Mapping the relation between emotion differentiation and emotion regulation” Cognition & Emotion 15 (6), 713-724

(2) Kashdan, T.B., *DeWall, C.N., Masten, C.L., Pond, R.S., Jr., Powell, C., Combs, D., Schurtz, D.R., & †Farmer, A.S. (2014). Who is most vulnerable to social rejection? The toxic combination of low self-esteem and lack of emotion differentiation on neural responses to rejection. PLoS ONE 9(3): e90651. doi:10.1371/journal.pone.0090651

(3) Kashdan, T.B., †Ferssizidis, P., Collins, R.L., & Muraven, M. (2010). Emotion differentiation as resilience against excessive alcohol use: An ecological momentary assessment in underage social drinkers. Psychological Science, 21, 1341-1347.

(4)  Pond, R.S., Kashdan, T.B., Dewall, C.N., †Savostyanova, A. A., Lambert, N.M., & Fincham, F.D. (2012). Emotion differentiation buffers aggressive behavior in angered people: A daily diary analysis.-7- Emotion, 12, 326-337.

(5) Demiralp E1, Thompson RJ, Mata J, Jaeggi SM, Buschkuehl M, Barrett LF, Ellsworth PC, Demiralp M, Hernandez-Garcia L, Deldin PJ, Gotlib IH, Jonides J. Feeling blue or turquoise? Emotional differentiation in major depressive disorder. Psychol Sci. 2012;23(11):1410-6. doi: 10.1177/0956797612444903. Epub 2012 Oct 15.

(6) Kashdan, T. B., & Farmer, A. S. (2014, February 10). Differentiating Emotions Across Contexts: Comparing Adults With and Without Social Anxiety Disorder Using Random, Social Interaction, and Daily Experience Sampling. Emotion. Advance online publication.

(7) Kashdan, T.B., Barrett. L.F., & McKnight, P. E. (in press). Unpacking emotion differentiation: Transforming unpleasant experience by perceiving distinctions in negativity. Current Directions in Psychological Science.

(8) Ciarrochi, J., Caputi, P., Mayer, JD . The distinctiveness and utility of a measure of trait emotional awareness. Personality and Individual Differences 34 (8), 1477-1490

(9) Brackett, M. A., Rivers, S. E., Reyes, M. R., & Salovey, P. (2012). Enhancing academic performance and social and emotional competence with the RULER feeling words curriculum. Learning and Individual Differences, 22, 218-224. doi:10.1016/j.lindif.2010.10.002

(10) K. Kircanski, M. D. Lieberman, M. G. Craske. Feelings Into Words: Contributions of Language to Exposure Therapy. Psychological Science, 2012; DOI: 10.1177/0956797612443830

 @ 2015 Jonathan Miller All Rights Reserved

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The Skunk in the Basement

“Never, for any reason on earth, could you wish for an increase in pain. Of pain you could wish only one thing: that it should stop.” – George Orwell, Nineteen Eighty-Four, Part Three, Chapter One.

Therapy can get stuck for the same reason our clients come in: their emotions are too upsetting to bear. It’s easy to vent on how unreasonably others  behave; addressing how it affected us is harder. To focus a client on their own thoughts and feelings can take sales-work. Some are satisfied with explanations of why catharsis is not therapy, how containment exercises can save them from being a wreck, or how mindfulness practice lets us both experience and contain our emotions. Others want an answer to a more basic question: why feel pain you could suppress?

Skunk, copyright 2006 by Torli

“Just stay present with that emotion. It’ll rise… peak… decline… and go trundling off through the grass.

Suppressed emotions are like a skunk in the basement. Our clients weren’t raised with wildlife-management skills, so down in the basement it went. Even though the animal can’t be seen, the house stinks from the foundation up. To experience an emotion means to let the skunk out. If we tolerate the disgusting sight and smell of Mephitis mephitis parading through our home, it can walk out the door and leave.

Most people believe little comes from painful emotions but pain. There can also be relief and increased tolerance for one’s feelings. Why accept sadness, fear or embarrassment? For the same reason we exercise, floss, save money, give birth, and eat habanero peppers. The pain fades. It’s replaced with relief, and sometimes joy.

@ 2014 Jonathan Miller All Rights Reserved

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Stress Management Blogging #6

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“Hard on yourself” can mean a hard time seeing support.

If you’ve been in a child therapist’s office, you’ve seen posters illustrating basic emotions – joy, terror, humiliation, etc. Research using photos of such broadly-expressed feelings has shown those with schizophrenia and autism struggle partly due to difficulty identifying others’ emotions. At the University of Cardiff, Kirsten McEwan and  her research team investigated people’s responses to photos of more-understated sentiments. They’ve found that highly self-critical people may have subtler difficulties recognizing a subtler emotion: compassion.  

McEwan, et al began by photographing actors they’d asked to express ‘social emotions’, such as sympathy, embarrassment or a critical attitude. They kept or discarded images for future research, based on whether their first group of study subjects could consistently agree on the emotion shown.


A sample set of social-emotion expressions from the research study.

They asked their second group of study subjects to watch the images on a screen, and press a button whenever a dot appeared. Such “computer visual probe tests” give clues to a person’s attention: the farther their eyes are from the dot, the longer they take to press the button. McEwan, et al separated their study participants into two groups: those who were highly self-critical and those who were no tougher on themselves than average. They found that those in the average category were quicker to respond when a compassionate face was replaced by a dot. Those who were higher in self-criticism took just as long or longer  – suggesting they were less attentive to supportive expressions.

High self-criticism is a common aspect of depression. While our depressed clients tell us, “Nobody cares,” their friends and family may well be wondering, “Can’t they see how worried we are? That we’re all here for them?” McEwan, et al’s data shows the answer, to an extent, may be, “No. They can’t.”


Therapists in private practice may want to consider the researchers’ comments about beaming faces:

“Recent research suggests the ‘full-smile’ of a happy/joyful face can actually be aversive, and processed as a threat by some individuals. Schultheiss and colleagues (2005, 2007) suggest that this is because some types of smile – especially broad smiles – communicate social dominance; hence, smiles can be aversive.”

Psychology Today‘s “Find a Therapist” site is a parade of clinicians grinning like lottery winners. Our photos may draw more clients if our expressions say, “Compassionate, gently-concerned clinician,” more, and “The cat who ate the canary,” less.


McEwan K, Gilbert P, Dandeneau S, Lipka S, Maratos F, et al. (2014) Facial Expressions Depicting Compassionate and Critical Emotions: The Development and Validation of a New Emotional Face Stimulus Set. PLoS ONE 9(2): e88783. doi:10.1371/journal.pone.0088783

@ 2014 Jonathan Miller All Rights Reserved

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Wim Wenders on Psychotherapy

An opposing view from the director of Wings of Desire and Pina:

"My advice is don't spend your money on therapy. Spend it in a record store." Wim Wenders




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New Warning Signs of Suicide

Doctors worry they might kill their patients. Therapists have to worry their clients will kill themselves. Lethality assessment shouldn’t be a nerve-wracking process of guesswork and intuition, but clients can’t always think clearly enough in crisis to give us straightforward answers. Three recent studies identify newly-substantiated risk factors for us to consider.

Trauma and suicide are clearly linked. In a 2009 article [i] for the Journal of Traumatic Stress, Jakupcak, Cook, et al found that veterans who meet criteria for post-traumatic stress disorder are four times more likely to consider suicide than those who don’t. Researchers at the University of Manitoba [ii] have identified key post-traumatic symptoms that indicate higher risk. After talking to 2,322 subjects and controlling for other mental health issues, they found that physical reactions to reminders of the trauma, being unable to recall some part of the trauma, and having a sense of foreshortened future were all strongly associated with suicide attempts. If you felt wrenched with every reminder of something you couldn’t remember properly, how long could you tolerate a persistent sense of doom?

Client’s families can also give clues to the risk of suicide.  Anju Mathew and Anil Prabhakaran of the Government Medical College, Thiruvanathapuram, Kerala, India, tracked “expressed emotion,” a measure of how much criticism, hostility, or emotional over-involvement family members show. Per their findings [iii], the more clients felt criticized after a suicide attempt, the more likely they were to try it again. We wish all of our clients returned from the hospital to supportive, understanding families. Unfortunately, it’s too rare that people with such serious issues have families that respond in a caring, validating way.  Prabhakaran and Mathew suggest therapists involve the family members in sessions after a suicide attempt. They suggest families will be less critical if they have the chance to work through their thoughts and feelings, and better understand their loved one’s needs. At the very least, we should ask such clients, “How did your family take this?”

If you’ve ever told clients, “Everyone thinks about suicide now and then,” stop.  A 1999 review of nine western countries [iv] found the highest percentage that had considered suicide at some point during their lives was only 18.51%.  (This was in New Zealand – apparently a hobbit-ridden archipelago of despair.) Ideation is highly correlated with attempts. Simon, Rutter, et al [v] reviewed Patient Health Questionnaire (PHQ-9) Depression Screens  completed between 2007 and 2011 by 84,418 primary-care patients; 704 of whom would attempt suicide and forty-six of whom would die from it. The PHQ-9 asks, “Over the past two weeks, how often have you been bothered by the following problems?” Those who reported, “Thoughts that you would be better off dead, or of hurting yourself,” had bothered them nearly every day were ten times more likely to attempt suicide over the next year than those who answered, “Not at all.” They were ten times more likely to succeed. If the actual percentages are relatively small,  (from 0.4% to 4% for an attempt, and 0.03% to 0.3% for successful suicide), the factor of ten makes it worth our time to ask how often clients think about ending their lives.

Marsha Linehan’s UWRAP and UWRAMP protocols are helpful checklists to use when assessing suicidal clients. They don’t tell us which clients are more likely to reach a suicidal crisis. These studies give us three more questions to ask when considering how carefully to watch a client: “How did your family respond when you attempted suicide?” “Have you been having physical reactions to reminders something you can’t remember, but left you feeling jinxed?” and, most simply, “How often does suicide cross your mind?”

@ 2014 Jonathan Miller All Rights Reserved


[i] Jakupcak MCook JImel ZFontana ARosenheck RMcFall M. Posttraumatic stress disorder as a risk factor for suicidal ideation in Iraq and Afghanistan War veterans. J Trauma Stress. 2009 Aug;22(4):303-6. doi: 10.1002/jts.20423.

[ii] 2. Zeynep M.H. Selamana, Hayley K. Chartrandb,  James M. Boltona, Jitender Sareena, Which symptoms of post-traumatic stress disorder are associated with suicide attempts?

[iii] Mathew A, Prabhakaran, A. Perceived Expressed Emotion as a Risk Factor for Attempted Suicide – A Case Control Study International Journal of Recent Trends in Science and Technology, Volume 9, Issue 2, December 2013 pp 299-302

[iv] Weissman MM, Bland RC, Canino GJ, Greenwald S, Hwu HG, Joyce PR, Karam EG, Lee CK, Lellouch J, Lepine JP, Newman SC, Rubio-Stipec M, Wells JE, Wickramaratne PJ, Wittchen HU, Yeh EK. Prevalence of suicide ideation and suicide attempts in nine countries. Psychological Medicine, Volume: 29  Issue: 1  Pages: 9-17, DOI: 10.1017/S0033291798007867

 [v] Simon GE, Rutter CM, Peterson D, Oliver M, Whiteside U, Operskalski B, Ludman EJ. Does response on the PHQ-9 Depression Questionnaire predict subsequent suicide attempt or suicide death? Psychiatric Services 2013; doi: 10.1176/


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