Although Danni has not experienced formal ABA, you can see from their post that the exact same issues apply to behaviourism in all its forms.
You don’t need to look at healthcare and education to encounter behaviourism. Most of us use behavioural strategies on ourselves and each other as motivators for positive outcomes. For instance I might say to myself I will reply to some emails and then have a bath or I will eat some dinner first and then have some chocolate. Being an autonomous adult I can decide to have a bath first and then reply to emails after. Of course there are instances when I need to prioritise a task over my personal needs.
I feel the conflict arises when people impose behavioural strategies on another without flexibility, alternatives and often a deep understanding of the individual’s difficulties, wants and needs. I have had many different behavioural strategies used on me in the past and they have done far more harm than good.
During one of my first hospital admission for self-harm I had to sign a contract. If I self-harmed 3 times I would be discharged from hospital. This made no sense to me. Had I been able to control my self-harming behaviours at the time I would not have been seeking treatment for it.
On another admission I was repeatedly told by psychiatric nursing staff to listen to a mindfulness recording before they would talk to me each time I sought support. The goal was to teach me coping skills but instead I have developed a strong dislike for mindfulness recordings, breathing exercises etc.
On another occasion as an inpatient on an intensive behavioural programme I had very little control over what food I consumed as well as everything else, this was not an eating disorder programme by the way. I had to choose different foods from a menu eg. I could not have soup with bread more than twice a week for lunch. I had 45 minutes to finish a meal and I had to stay in the dining room for a minimum of 30 minutes. If I could not finish my meal during the allocated time I had to make it up later that day with a snack from the same food group and equivalent calorie count.
If I did a behaviour (left a meeting early, self-harmed, didn’t make up my daily calorie intake etc.) I had to write a chain analysis and could not seek 1 to 1 support from nursing staff for 24 hours. The objective of the chain analysis is to reflect on why the behaviour occurred and find solutions to avoid the behaviour occurring in the future however in reality for me they ended up being apology letters which strengthened my feelings of shame and did little to help me change those behaviours. If I needed support during this 24 hour period post behaviour I had to call an emergency meeting which meant bringing every patient and staff member from the ward together to do a safety plan and yes even at 3am.
Another time when I was admitted to an acute psychiatric unit I communicated that I needed my noise cancelling headphones to dampen overwhelming sounds and my Ipadand keyboard to communicate when my verbal speech was not fluent and to communicate complex thoughts. My request was refused which resulted in a mental breakdown on top of the one I was already having. The psychiatrist’s solution was to draw up a contract that meant I could have these items all long as I didn’t harm myself. I spent the next 3 months unable to speak due stress from the contract and spent more time worrying about it than any of the reasons that led me to hospital in the first place. Despite my daily requests to remove the contract my pleas were ignored until one day when I had a severe prolonged meltdown and caused serious harm to myself. All of this was unnecessary and completely avoidable.
Do these strategies sound conducive to positive mental wellbeing to you?