2 从情境行为角度出发

第二章 采取情境行为科学的视角

了解一切就是宽恕一切。 — 安妮·路易丝·杰曼·德·斯塔尔

卡尔·罗杰斯在美国乃至全世界声名鹊起，因为他清晰而热情地表达了一个观点：在心理治疗过程中最重要的不是治疗师的专业知识，而是他们的个人品质以及他们如何将这些品质带入与来访的关系中。他的工作促进了助人职业的重大变革，并影响了临床医生至今的培训方式。他所发展的治疗方法仍然是许多其他方法比较的标准。值得注意的是，罗杰斯反对试图控制或改变来访；他是滋养和无条件支持的声音，与那些提倡操纵和控制的人相对立。

鲜为人知的是，罗杰斯也对治疗过程的科学研究感兴趣。为此，他允许一些研究人员访问他的心理治疗会话录音。其中一个特别相关的研究是查尔斯·特鲁克斯在1966年发表的关于罗杰斯对来访的反应的研究。事实上，他对来访的温暖和支持并不是无条件的；他的反应并非对所有来访的行为都是一样的。罗杰斯对某些类型的评论（特别是代表来访成长的评论）回应得更加热情或鼓励，而对其他类型的评论则更为保留。这种模式的结果是，在治疗过程中，罗杰斯以滋养的方式回应的来访评论频率增加，而其他类型的评论频率减少。

为什么一个宣扬无条件支持的人实际上却是有条件地回应呢？答案很简单：正如第一章回顾的科学和原则所述，治疗关系（或任何关系，亲密关系往往更具影响力）可能会对来访施加或多或少微妙的影响，从而作为行为改变的过程发挥作用。这种影响在一个感觉完全接纳和支持的社会联系中自然发生。

如今，这样的过程被有意识地利用——并与其它已建立的行为改变过程相结合——包括动机访谈、接受与承诺疗法和辩证行为疗法等一系列基于证据的疗法中。FAP直接关注塑造影响社交功能和心理福祉的人际行为，并培养有意识且真诚地塑造这些行为的关怀性治疗关系。这种立场代表了行为科学视角、罗杰斯的观点以及关怀关系和学习原则的一致性。这一一致性的一个关键方面是以质量（如温暖和真诚）以及行为、学习和影响的过程来思考治疗关系。

情境行为科学（CBS）是当代最能代表FAP关于学习原理及其在治疗关系中临床应用观点的研究领域。在本章中，我们将向您介绍这一理论视角。我们的立场是，临床使用CBS并不需要大量投入其理论或哲学的学习。相反，它需要理解一套相对较小的核心原则或假设。可以将这种方法视为临床CBS的80-20规则：CBS原则和假设的20%解释了该方法80%的临床实用性。如果您想花时间阅读和探索其余的80%，您可以这样做。（我们强烈推荐乔纳斯·拉姆内罗和尼克拉·托恩克的《人类行为ABC》一书。）

以下是您需要知道的20%的内容：

• 人们做的一切都是行为。
• 行为是事件。
• 所有行为都在当下发生。
• 行为由后果引导。
• 通过后果学习有时会产生次优结果。
• 您无法完全理解行为受到的所有影响，但部分迭代的理解可以导致有用的结果。
• 这些理解和看待人们及行为的方式本质上是同理心和同情心的体现。

下面我们将详细讨论每一点。

人们所做的一切都是行为

让我们从这个讨论的核心术语“行为”开始。行为是我们研究、理解和影响的对象。行为是人们所做的；它是行动。它是我们在世界中移动、从一个情境过渡到另一个情境以及施加影响的方式。

许多人习惯于区分思考和行为，其中行为指的是外在可观察的行为，如行走或说话。但在情境行为科学（CBS）中，我们将人们所做的一切都包括在一个包中：说话、思考、想象、听觉、感知、感觉、怀疑、知道、相信、直觉等。如果一个人能做的事情，那就是行为。现在当你阅读这段文字时，这就是行为。现在当你思考你正在阅读的内容是否有意义时，这也是行为。现在当你注意到自己在思考时，这同样是行为。意识到自己的行为也是行为。这一切都是同一行为流的一部分，与世界互动，与自身互动，也与其他人的行为互动。

将所有这些活动打包在一起变得非常有用，正如我们接下来会解释的那样。

顺便说一句，当你与来访交谈时，不必使用笨拙的术语“行为”。你可以根据上下文使用任何合适的词语：行动、思考、选择、精神运动等。这并不重要，只要你记住这个词语云中心的概念：人们做的许多事情都可以通过学习的原则来审视。

行为是事件

行为的一个关键特征是它是一个事件，在特定的时间和地点发生，并涉及特定的人。想一想今天到目前为止你已经进行了多少行为。想想所有的外显行为——那些如果我们通过摄像机观看你会看到的行为。同时，想想所有内隐的心理行为：每一个想法、每一个感觉、每一个决定等等。想想构成瞬间的离散而短暂的行为。再想想构成我们日常生活和生命意义的复杂而持续的行为——阅读这本书、获得研究生学位等等。

观察一下此刻你内心的行为流动：

• 现在我在思考这个……
• 现在我感觉这样……
• 现在我要去这里……
• 并且在思考这个……

正如你所预料的，可以处理的行为数量是无穷无尽的。行为是一条连续而复杂的流，贯穿地球上七十亿人中的每一个人（睡眠也是一种行为）。事实上，在任何给定的时刻，有如此多的行为发生，以至于我们根本无法保持对所有行为的意识，更不用说对我们行为的所有影响了。结果是一种混乱——不是指无序，而是指复杂到常常难以用机械的方式来理解的程度。这就是心理学的媒介。

所有行为都发生在当下

行为的一个特点是，我们经常脱离对当前正在发生的行为的接触或意识。

这里有一个大多数心理治疗师都很熟悉的例子：你问一个来访他现在的感受，意思是他的身体此时的感觉，而他只是简单地说“不好”，或者“我觉得我什么都做不好”。当然，这些都是常规且合理的回答。然而请注意，这些回答使来访远离了实际发生的情况：他的身体感到某种方式，他没有怎么呼吸，他没有注意到肩膀的紧张或双手环抱膝盖的方式。特别是，他没有注意到他在想“我什么都做不好”或“我感觉不好”，这与他实际上经历的感觉是非常不同的。他可能会以这种方式度过大部分生活，沉浸在对正在发生的事情的一般性思考中，却很少接触到瞬息万变的事件流以及这种行为是如何形成和自我塑造的。

同样地，作为治疗师，我们可能会谈论来访有人格障碍、抵抗性、移情反应、反社会、抑郁或某种依恋风格。然而，如果我们只停留在这样的术语或标签上，就很难甚至不可能在时间和空间上定位我们所指的具体行为。除非我们提供更多信息，否则我们就是在要求他人猜测我们的意思，或者更糟的是，让他们盲目假设他们完全知道我们的意思。如果另一位治疗师告诉你，她转介给你的来访是抑郁的，你可能有一些关于正在发生的事情的一般想法，并且你知道应该问哪些问题来获取更多具体信息，但你不知道任何具体的细节。这个人可能是失眠者，痴迷于自杀，但没有任何明显的悲伤感，只有空虚的响声。或者这个人可能每天在床上躺十八个小时，沉浸在悲痛和哭泣中。充其量，另一位治疗师的描述只能引导你去问哪些问题可能对来访有帮助。这确实非常有用，但这只是评估的开始。

当然，一般的标签并不是无害的

它们塑造了我们与被贴标签的人之间的关系。一个自认为失败者的来访会远离自己，并对自己不友好。我们对被贴上反社会标签的来访会产生不信任或厌恶的情绪。标签成为了判断和歧视的基础。而且，这些标签甚至在我们没有故意恶意或评判的情况下，也能潜移默化地引导我们的行为。

因为行为流是心理学的媒介，而我们经常以一种使自己远离实际发生的事情的方式失去对这种流动的追踪，所以在CBS视角下，最基本的第一步是将自己定位为看到行为实际上是事件的流动。这样看待事件的流动是关于人道、连接和同理心的理解——保持贴近实际发生的故事，而不是关于我们对这些事件的故事和标签。这是关于接触此时此地正在发生的事情——以及我们希望改变的一切。

在心理治疗中，我们关注的一些基本行为包括：

• 行动
• 思考
• 话语
• 想象
• 冲动
• 感觉
• 情感
• 问题

行为由后果引导

CBS的经验基础在于注意到当下的情况。我们旨在以某种程度的精确度和正念来注意，判断如何可能模糊了我们对实际情况的看法。反过来，这种当下的意识让我们开始注意到我们的行为是如何被它产生的后果所塑造的——即被导向某个方向或另一个方向。换句话说，CBS的观点是根据一些学习的基本原则来理解体验的流动。

再次强调，真正有用的只有几个原则特别需要理解：

• 有些行为的功能是增加与某些事物的接触。
• 有些行为的功能是减少与某些事物的接触。
• 当一个行为的功能是为了获得回报时，一个人更有可能在得到该回报的情境中重复这一行为。
• 当一个行为没有得到回报，或者导致了成本，一个人在没有得到回报或产生了成本的情境中重复该行为的可能性就会降低。

在接下来的部分中，我们将更详细地探讨每一个想法。

有些行为的功能是使我们接近事物

世界上有一些事物、状态或情境是我们倾向于接近的。当我们口渴时，我们会喝水。当我们感到孤独时，我们会寻求社交联系。通常，我们会接近那些感觉良好、满足某些生物需求或赋予意义的事物。我们所接近的事物被称为“趋近性”的。

重要的是不要假设事物本身固有地具有趋近性，因为对我们来说什么是趋近性的取决于我们所处的情况（例如，我们是否口渴或孤独）以及在某种程度上，我们是谁以及我们的特定历史。许多人喜欢甜甜圈并会去吃它们，但在吃了几个之后，甜甜圈就不再具有吸引力了。相应地，在任何一大群人中，会有各种不同的目的、价值体系、品味等——换句话说，就是不同的趋近性事物。

行为的流动往往使我们接近我们认为具有趋近性的事物。今天你的行为功能是什么？当你阅读这本书时，你的行为让你接近什么？

有些行为的功能是使我们远离事物

相反，有时我们的行为功能是减少接触或远离某些事物。我们远离的事物被称为“回避性”的。前三个甜甜圈是趋近性的，第四个甜甜圈——那个让我们感到不适的——变成了回避性的。我们推开某些思想或感受，因为它们令人痛苦。我们反对他人的某些陈述。

行为的回报可以强化该行为

有时行为会得到回报：它使我们接近我们喜欢的趋近性事物，或远离引起我们伤害或困扰的回避性事物。当我们经历这些时，学习就会发生：

• 当我们的行为成功地使我们接近趋近性事物或远离回避性事物时，我们在未来相同或类似情况下重复该行为的可能性就会增加。这被称为强化，即在给定环境中行为发生的概率增加的过程。

行为的代价可以减少该行为

在其他时候，行为会带来代价：它们使我们远离趋近性事物或让我们更接近回避性事物。当这种情况发生时，另一种类型的学习，称为惩罚，就会出现：这些行为在未来类似情境中再次发生的可能性会降低。

就像回避性和趋近性刺激一样，特定后果是否实际上具有强化或惩罚作用是无法预先确定的。你必须等待并观察后果如何影响行为。

当你退后一步观察行为的流动时，你可以更清楚地看到后果以不同方式影响行为的方式。例如：

• 当有强烈的回报即将到来，或者你在当下强烈感受到某种行为的回报时，就更容易忍受过程中可能发生的回避性事情。
• 当没有感觉到任何回报时，在面对回避性事物时坚持下去就会更加困难。
• 一个最绝望的情况是，你知道某个行为因其长期后果而重要，但你却因为过程中的痛苦，或者因为众多其他吸引人的“闪亮金子”（即诱惑）而不断偏离目标。

功能是主动的

CBS并不认为人类是被动的主体或被环境驱使的自动机。我们刚刚概述的原则——关于行为的功能——的核心观点是，人类正在积极地与周围环境互动。人类行为的每一个方面都是与世界持续、相互作用的主动过程。CBS视角考虑了行为是如何被情境塑造的，以及行为如何创造或维持情境和人们所处的情境。

这种相互依赖的关系是“功能”这个词的核心意义。这个行为如何在世界上产生后果？过去的行为产生了哪些后果，使其值得现在重复？

学习的问题

我们现在在这个情境中的行为反映了我们在过去类似情境中收到的结果的历史。因为我们总是将过去的经历带到当前时刻（这就是学习），所以过去总是存在于现在。

同时，过去有效且被强化的行为并不总是在现在同样有效。换句话说，历史结果的影响并不总能长期引导我们走向正确的方向。

一种失效的形式涉及对未来有限的接触。我们可以称之为“即时后果比未来后果更重要”的问题。例如，当人们对香烟上瘾时，他们受到吸烟立即结果（如缓解紧张和戒断症状）的过度影响，尽管长期后果可能是致命的。再比如前面提到的马克，他学会了不向生活中重要的人表达自己的需求，因为他早期的生活经历让他这样做感到焦虑。短期内，他避免了提出请求时的焦虑，但长期内，由于他的需求未得到满足，他很可能感到更加失望或怨恨。

在这种情况下，行为过于受短期结果的约束，尽管这种约束方式从长远来看并不奏效。这种模式在人际交往中经常发生。我们为了避免在当下感到不舒服而不去提及一个棘手的问题，但这会导致持续的不满和更大的后续问题。或者我们会八卦、抱怨或攻击，因为这在当下感觉很爽快，即使几个小时后我们会感到羞愧，并且从长远来看，这会破坏信任和亲密感。

另一种学习失效的形式涉及过去。在这种情况下，过去有效的行为可能会持续到现在，即使它不再非常有效。我们可以称之为“过去的学习与现在脱节”的问题。考虑吉莉安的例子，她避免表达自己的愿望，因为她小时候因此而受到惩罚。她可能会继续这种行为，尽管她的现任伴侣渴望理解她并给予同情的回应。过去因痛苦后果而形成的行为尤其有问题，因为现在这个人会避免引发痛苦的情境或行为，就像吉莉安的情况一样。事实上，她可能仅仅想到表达愿望就会感到恐惧。当人们避免这类情境时，他们剥夺了自己新学习的机会。结果，吉莉安失去了学习到表达愿望实际上会产生积极后果的机会。由于她的回避，她仍然受到旧学习的影响，在当前情境中表现得不够有效。这种回避可能持续几十年。

如果心理问题发生在过去的学习过度控制我们的行为时，那么更有效的行为通常会在人们平衡过去指导和对当前最有用的东西作出反应时出现。换句话说，我们受益于过去的学习，但仍然能够灵活地调整我们的行为以适应当前时刻。同样，如果短期后果过度控制我们的行为导致长期问题，那么更有效的行为通常会在我们建立承受实现长期目标所需的短期后果的能力时出现；当我们能够在当前时刻找到行动的长期价值时，更有效的行为也会出现。换句话说，当我们对自己的行为背后的目的或目标有一个清晰的认识时，我们就更有能力容忍挫折和不适，并放弃容易的分心，从而坚持不懈地追求对我们重要的事情。CBS将这些能力统称为心理灵活性。

反过来，采取CBS的立场——能够清楚地看到我们的行为及其受阻的方式——往往有助于我们变得更加心理灵活。

语言：一种非常特殊的行为

请注意，CBS立场的很大一部分是关于学习如何“观察”，即观察和标记行为以及行为的功能。所有这些都涉及语言——而语言，像人们做的其他事情一样，也是一种行为。因此，语言在CBS框架中扮演着非常特殊的角色。对于人类来说，语言是一种重要的行为，它使我们能够在社会互动中运作并受到其影响。总的来说，治疗是一个语言过程。另一方面，有时语言会严重限制我们的灵活性，例如当人们基于过去的经验决定他们确切知道发生了什么时，结果却错过了真正发生的事情。

在本书中处理语言时，我们以关系框架理论（RFT；Hayes, Barnes-Holmes, & Roche, 2001）为指导，这是一种经实证确立的关于语言和认知的CBS解释。简而言之，RFT认为语言的核心行为是关联行为。例如，我们将物体和词语相互关联起来，就像我们将“树”这个口头标签与实际的树联系起来一样。同样，我们可以将词语相互关联；例如，我们说“蓝色是一种颜色”。我们可以以多种方式关联事物。例如，“蓝色是一种颜色”是一种层次关系，因为颜色是一个包含多个元素的类别，其中之一就是蓝色。另一种关系是对立关系：白天不是黑夜。这些都是非常基本的关系。RFT的分析使我们能够将语言的操作分解成这些基本的行为部分。这些关系反过来又影响了我们对所关联事物的反应。例如，“这个苹果很好”或“这个苹果很坏”引导了我们的行为。

至于自然地在一个成熟的人身上运作的语言，那就是当你把这些非常简单的关联乘以万亿倍，然后把它们与其他人和世界的大块部分一起放入搅拌机中，高速运行几十年后得到的结果。结果是一个非常复杂的关联和影响力汤，以及一种能力，能够将许多不在此时此地的事物与当前存在的事物联系起来。再次强调，这些关系影响了我们对所关联事物的反应。还记得我们在第一章中警告过标签不是中性的吗？例如，如果你将孩子的老师与“愚蠢”联系起来，心里想着“那个老师真笨”，你会对他有不同的反应，而不是将其他词语与他联系起来。同样，有些来访可能带着各种想法来到治疗室，思考如何与你互动——尽管他们之前没有与你或任何治疗师有过经验。

那么，在治疗过程中，通过功能性分析和治疗关系，我们谨慎地做的事情之一就是影响人们如何与自己、他们的行为及周围的世界建立联系。从CBS的角度来看，这无疑是任何形式治疗中的“共同因素”。如果你有兴趣了解更多关于RFT和这一共同因素的信息，我们鼓励你查阅《学习RFT》(Törneke, 2010) 或《掌握临床对话》(Villatte, Villatte, & Hayes, 2015)。在本书中，我们对FAP的呈现受到了RFT的强烈影响；然而，我们在此之后不会直接引用RFT。

来访总是对的：不要假设，要评估

如果你觉得学习极其复杂，你是对的。当我们研究行为时，我们研究的是一个极其复杂的事物。作为治疗师，我们必须见证这种复杂性的持续流动，并且在试图影响它时保持极大的谦逊和欣赏。当然，这是我们作为临床医生都知道的。CBS也反映了这种智慧。正如斯金纳所说，“行为是一个困难的研究对象，不是因为它难以接近，而是因为它极其复杂。由于它是一个过程，而不是一个事物，所以不容易被固定下来进行观察。它是变化的、流动的、易逝的，因此对科学家的聪明才智和精力提出了很高的技术要求。”（1953, 15）。当然，对于心理健康治疗师来说，我们通常每周只有一个小时的时间与特定来访相处，因此这种难度大大增加了：这就像是试图通过一个小孔观看游行队伍。

这种行为的复杂性和不可达性直接影响了我们如何从CBS视角去理解它。要注意避免任何为了维护案例概念化或其他关于事物应该如何的理论而否定或扭曲来访及其经历的倾向。相反，倾听、观察并看看什么有效。早期行为科学的一个轶事说明了这个概念：一位著名的科学家完成了一些艰苦而细致的老鼠实验，发现他的一个经过深思熟虑的假设似乎并不符合现实。但他接受了这一点，说：“老鼠总是对的。”换句话说，来访可能不像我们认为的那样行事，但他们确实按照应有的方式行事。

好消息是我们不需要知道一切就能提供帮助。目标不是正确，而是有帮助。我们可以采取实用的方法，专注于起作用的知识。行为疗法的艺术的一个重要组成部分是知道需要多少事实信息和具体性，以便集中治疗而不使其变得不必要的复杂或僵化。我们不需要找到“最好”的方法或“正确”的方法。毕竟，有许多描述临床现象的方式和实现行为改变的各种路径。作为临床医生的任务是找到一条有效的方法。

为什么理解学习并关注功能很重要

希望你在本章中读到的所有内容都强调了CBS是一种内在的、富有同情心的方式来理解和与来访合作。从根本上说，CBS是关于观察行为以及在当下看到学习的影响，以便我们能够变得更加灵活和有效。

每个人都有一个构成此刻意义的历史。然而，作为观察者，这段历史对我们来说是看不见的。因此，误解人们、错过他们行为的意义是非常容易的。特别是在心理治疗中，我们的工作是改变行为，我们需要方法来揭示这种看不见的学习和功能背景。

社会心理学中关于所谓的基本归因错误（Jones & Harris, 1967; Gilbert, 2002）的研究很好地捕捉了我们在这一点上的观点。一方面，我们倾向于通过情境来解释自己的错误和失败；例如，“我不是懒惰。这周我有很多事情要做。我压力很大，需要休息。”我们可以对自己的行为做出这种宽容的解释，部分原因是，我们能够接触到塑造我们的情境。此外，我们对所关心的人的行为也往往提供类似的宽容解释。

另一方面，我们对陌生人并不那么宽容，因为我们无法超越他们的外表，他们的历史对我们来说是看不见的。对于那些出于某种原因我们不喜欢的人也是如此。我们更有可能根据他们所谓的内在品质来评判他们。在这种情况下，我们犯的归因错误是将人的属性归咎于他们的行为，而不是像对自己一样想象，在他们的情境下，这些行为是有道理的。

另一种说法是，当我们最富有同情心时，我们倾向于在情境中看待人们的行为。从某种意义上说，在情境中看待某人的行为只是描述同理心和理解的另一种方式。同样地，我们更可能被那些对我们行为持宽容态度的人所理解，并且更愿意接受那个人的影响。CBS就是要发展这种在情境中看待行为的宽容立场。事实上，CBS研究人员（Hooper, Erdogan, Keen, Lawton, & McHugh, 2015）最近表明，视角训练可以减少人们犯基本归因错误的可能性。

不出所料，对于许多寻求心理治疗的人来说，他们陷入困境的一种方式就是未能在情境中看待自己的行为。他们陷入了负面和泛化的自我归因：“我是个失败者”，“我不值得被爱”等等。通过帮助他们在情境中看待自己的行为，我们可以帮助他们达到一种更加自我同情的态度。正如我们在上一章所说，当你深刻理解某人并关心她时，对她有益的事情——她的成长——自然会成为你渴望的东西，所以你会倾向于培养或强化更多这样的行为。也许这就是一个熟练的倾听者所做的，即使没有注意到这一点。鉴于第一章讨论的社会联系对人类福祉的重要性，一个亲密的关系能够成为行为改变如此微妙而敏感的工具，这并不令人惊讶。

CBS帮助我们深入表面之下，以探究行为的深层功能，并建立一种更深的同理心和理解力，从而产生影响。反过来，我们试图在问题行为发生时看到它们，以引发新的、更有效的行为，并强化这些行为，使它们不仅在来访与我们的关系中扎根，也在其他情境中扎根。

在下一章中，我们将转向更具体的方法，使用功能性分析在治疗关系中实践CBS视角。

总结

• FAP的心理学基础是情境行为科学（CBS）。
• CBS的观点包括一组基本假设，包括：
  • 人们做的一切都是行为，包括思考、感受、感知等；
  • 行为是在时间和空间中发生的事件；
  • 行为由其后果引导。一些后果导致行为频率增加；其他后果导致行为频率减少。“功能”是指行为在这些后果方面的实现。
• 学习通过后果会产生一些问题。行为可能会过于受过去经验的约束，从而与现在脱节。它也可能过于受到短期后果的影响，即使这会导致长期代价。
• 影响行为的因素是复杂的。你无法获得一个确定的理解，但你可以达到足够的理解来施加影响。
• 理解功能和学习历史是一条通往同理心和同情心理解的道路——理解导致人们行为的背景和经历。

本章知识点阐述

知识点阐述

1. 行为的概念：

   • 从CBS的角度来看，人的所有活动都可以被视为行为。这意味着不仅动作和言语是行为，思想和情感也是行为的一部分。这种全面的行为观有助于更广泛地理解个体的经历和互动。

2. 行为是事件：

   • 行为被视为具体发生的事件，而不是持续的状态。这强调了行为的即时性和具体性，使治疗师能够更准确地识别和干预特定的行为模式。

3. 行为发生在当下：

   • 行为总是发生在特定的时间和情境中。这提醒治疗师要关注当前的情境因素，以便更好地理解行为的功能和背景。

4. 行为由后果引导：

   • 行为受其后果的影响。如果某种行为带来了积极的结果，那么这种行为在未来再次发生的可能性就会增加。反之亦然。这提供了改变行为的有效途径，即通过调整行为的后果来促进期望的行为。

5. 通过后果学习的局限性：

   • 通过后果学习有时会导致次优结果。例如，短期奖励可能强化不健康的行为，长期来看反而有害。因此，治疗师需要考虑行为的长远影响，而不仅仅是眼前的后果。

6. 逐步理解的重要性：

   • 虽然不可能完全理解行为受到的所有影响，但通过逐步和迭代的理解，治疗师可以取得有用的成果。这鼓励了一种灵活和适应性的治疗态度。

7. 同理心和同情心：

   • CBS的方法本质上是同理心和同情心的体现。治疗师需要站在来访的角度去理解他们的行为，同时提供支持和关爱。这种态度有助于建立信任和合作的治疗关系。

通过这些核心原则，治疗师可以更好地理解来访的行为，并制定有效的干预措施。此外，这些原则还强调了治疗关系的重要性，即通过真诚、温暖和同理心来促进来访的心理和社会福祉。

知识点阐述

1. 行为的定义：

   • 在CBS中，行为不仅包括外显的行为，还包括内在的心理过程，如思考、感受、想象等。这种全面的行为观有助于治疗师更全面地理解来访的体验。

2. 行为作为事件：

   • 行为是在特定时间、地点发生的事件。这强调了行为的具体性和即时性，有助于治疗师识别和干预特定的行为模式。

3. 行为的连续性和复杂性：

   • 行为是一个连续而复杂的流，涉及无数的动作和心理过程。这提醒治疗师注意行为的多样性和动态变化，以便更好地理解来访的行为模式。

4. 当下的重要性：

   • 来访常常脱离对当前行为的直接体验，而陷入一般性的思考。治疗师需要帮助来访回到当下，关注具体的身体感觉和心理状态，从而促进更真实的自我认识。

5. 避免标签化：

   • 使用诊断标签（如人格障碍、抑郁等）虽然有助于初步了解，但不应止步于此。治疗师需要进一步探索具体的行为表现，以制定更有效的干预措施。

6. 行为的具体化：

   • 为了更准确地评估和干预，治疗师需要具体化行为，而不是停留在抽象的标签上。这有助于治疗师更精确地理解来访的问题，并制定个性化的治疗计划。

通过这些核心原则，治疗师可以更深入地理解来访的行为模式，并采取更有效的干预措施。此外，这些原则还强调了关注当下的重要性，即通过帮助来访回到具体的体验中，促进更真实和有意义的改变。

知识点阐述

1. 标签的影响：

   • 标签不仅影响我们对来访的看法，也会影响来访对自己的看法。治疗师应避免过度依赖标签，而是关注具体的行为表现，以促进更真实和人性化的理解。

2. 行为的流动：

   • 行为是一个连续且复杂的流动过程，涉及多种内在和外在的表现。治疗师需要帮助来访回到当下，关注实际发生的行为，而不是停留在抽象的概念或故事中。

3. 行为的分类：

   • 在心理治疗中，行为可以分为行动、思考、话语、想象、冲动、感觉、情感和问题等多种形式。这些行为都是理解来访内心世界的重要窗口。

4. 行为的后果：

   • 行为是由其后果引导的。趋近性行为使个体接近他们想要的东西，而回避性行为则使个体远离他们不喜欢的东西。了解行为的后果有助于治疗师更好地理解行为模式。

5. 强化的作用：

   • 当行为带来积极的回报时，个体更有可能在未来重复该行为。反之，如果行为没有带来回报或带来了负面后果，个体重复该行为的可能性就会降低。通过理解和利用强化机制，治疗师可以帮助来访改变行为模式。

通过这些核心原则，治疗师可以更深入地理解来访的行为模式，并采取更有效的干预措施。此外，这些原则还强调了关注当下的重要性，即通过帮助来访回到具体的体验中，促进更真实和有意义的改变。

知识点阐述

1. 行为的代价：

   • 行为有时会带来负面后果，这些后果会使个体在未来减少该行为的发生。了解行为的代价有助于治疗师识别和干预那些不利于长期福祉的行为模式。

2. 功能的主动性：

   • CBS强调人类行为是主动的，而不是被动的。个体通过与环境的互动来塑造自己的行为，并且这些行为又反过来影响环境。这种双向互动是理解行为的关键。

3. 学习的问题：

   • 过去的学习经验会影响当前的行为，但有时这种影响并不适合当前的情境。例如，短期回报可能掩盖长期的负面影响，或者过去有效的行为可能不再适用于新的情境。

4. 心理灵活性：

   • 心理灵活性是指个体能够根据当前情境调整行为，同时保持对长期目标的关注。这种能力有助于个体克服短期困扰，实现长期目标。CBS鼓励培养这种灵活性，以促进更健康的行为模式。

通过这些核心原则，治疗师可以更好地理解来访的行为模式，并帮助他们发展心理灵活性，以应对生活中的挑战。此外，这些原则还强调了关注当下的重要性，即通过帮助来访回到具体的体验中，促进更真实和有意义的改变。

知识点阐述

1. 语言作为一种行为：

   • 语言不仅仅是交流的工具，它本身也是一种行为。根据关系框架理论（RFT），语言的核心在于关联行为，即个体如何将词语与事物、概念以及其他词语相联系。这种关联方式深刻影响了个体的认知和行为模式。

2. 语言的复杂性：

   • 语言的使用和理解是高度复杂的，涉及到大量的关联和多层次的意义构建。这种复杂性意味着语言可以极大地影响个体的行为和心理状态。在治疗中，理解语言的这种特性对于帮助来访重新建构他们的体验至关重要。

3. 来访的正确性：

   • 在治疗过程中，重要的是要尊重来访的主观体验，而不是简单地依据理论或假设来解释他们的行为。即使来访的某些行为看起来不符合预期，它们也是基于个体独特的经历和内在逻辑的。治疗师应该保持开放的态度，倾听和观察，以找到有效的干预方法。

4. 实用主义方法：

   • 治疗的目标是帮助来访，而不是证明某个理论或方法的正确性。治疗师应当采取实用主义的方法，关注那些能够带来积极改变的具体技术和策略。这意味着在治疗过程中灵活调整方法，而不是坚持某种固定的模式或理论。

5. 行为的动态性：

   • 行为是一个动态的过程，受多种因素的影响。治疗师需要认识到行为的流动性，以及个体在其环境中不断变化的需求和情境。通过功能分析和治疗关系，治疗师可以帮助来访更好地理解和适应这种动态性，从而促进更健康的行为模式。

通过这些核心原则，治疗师可以更好地理解和应对来访的行为，同时利用语言的力量来促进积极的心理变化。此外，这些原则还强调了治疗过程中谦逊和灵活性的重要性，以确保治疗方案能够真正满足来访的独特需求。

知识点阐述

1. 基本归因错误：

   • 基本归因错误是指人们倾向于将他人的行为归因于其内在特质，而不是考虑外部情境因素。相反，人们通常会用情境因素来解释自己的行为。这种偏见可能导致对他人的误解和不公平的评价。通过了解这一概念，治疗师可以更好地避免这种偏见，从而更准确地理解来访的行为。

2. 情境行为科学（CBS）的核心原则：

   • CBS认为所有人类活动都是行为，包括思维、情感和感知。行为是在特定的时间和空间中发生的事件，并且行为受到其后果的影响。有些后果会增加行为的频率，有些则会减少。行为的功能是指它在这些后果方面的作用。理解这些原则有助于治疗师更全面地看待来访的体验和行为模式。

3. 学习和行为的复杂性：

   • 通过后果学习的过程可能会导致行为变得过于依赖过去的经验，或者过于受短期后果的影响，即使这会导致长期的负面影响。理解这些复杂性可以帮助治疗师识别和干预那些不利于长期福祉的行为模式。

4. 同理心和同情心：

   • 在情境中看待行为可以帮助治疗师发展同理心和同情心。通过理解来访的行为是如何在特定情境下形成的，治疗师可以更好地与来访建立连接，从而促进更有效的治疗过程。这种理解也有助于治疗师避免对来访进行过度简化的判断。

5. 行为的功能性分析：

   • 功能性分析是一种方法，用于理解行为在特定情境下的功能。通过这种方法，治疗师可以识别出哪些因素在维持或改变行为，并据此制定干预策略。这种方法强调了行为的动态性和环境因素的重要性。

通过这些核心原则，治疗师可以更好地理解和应对来访的行为，同时利用同理心和同情心来促进积极的心理变化。此外，这些原则还强调了治疗过程中灵活性和适应性的重要性，以确保治疗方案能够真正满足来访的独特需求。

CHAPTER 2 Take a Contextual Behavioral Perspective To understand all is to forgive all. oasis-ebl|Rsalles|1490374048 —­Anne Louise Germaine de Staël C arl Rogers rose to fame in the United States and worldwide by expressing clearly and pas- sionately that what matters most in the process of psychotherapy is not the expert knowledge of therapists, but rather their personal qualities and how they bring those qualities to their relation- ships with clients. His work promoted a sea change in the helping professions and influenced the way clinicians are trained to this day. The treatment approach he developed remains the bench- mark against which many others are compared. Of particular note, Rogers stood against efforts to control or change clients; he was the voice of nurturance and unwavering support, in opposition to those who advocated manipulation and control. What is less well-­known is that Rogers was also interested in the scientific study of the process of therapy. To that end, he allowed a number of researchers to have access to recordings of his psychotherapy sessions. One resulting study is particularly relevant to FAP. In 1966, Charles Truax published his findings regarding Rogers’s responses to clients. His expressions of warmth and regard for his clients were not, in fact, unconditional; his responsiveness was not the same regard- less of a client’s behavior. Rogers responded more warmly or with more encouragement to some kinds of remarks, particularly those that represented client growth, and responded in a more reserved way to others. The result of this pattern was that, over the course of therapy, the client remarks that Rogers responded to in a nurturing way increased in frequency, whereas the other types of remarks decreased in frequency. How could it be that the man who preached unconditional support was actually responding conditionally? The answer is simple: in keeping with the science and principles reviewed in chapter 1, the therapeutic relationship (or any relationship, with intimate relationships often being more influential) may exert more or less subtle influence on the client and therefore function as a process for behavior change. This influence happens quite naturally in a social connection that feels com- pletely accepting and supportive. Today, such processes are deliberately harnessed—­and linked to other established processes of behavior change—­in a range of evidence-­based therapies, including motivational interviewing, acceptance and commitment therapy, and dialectical behavior therapy. FAP focuses directly on shaping interpersonal behaviors that affect social functioning and psychological well-­being and on cultivating caring therapeutic relationships that deliberately and authentically shape these behav- iors. This stance represents an alignment of the perspective of behavioral science, Rogers’s per- spective, and caring relationships and principles of learning. A key aspect of this alignment is thinking about therapy relationships in terms of qualities (such as warmth and genuineness) as well as processes of behavior, learning, and influence. Contextual behavioral science (CBS) is the contemporary field of study that best represents FAP’s perspective on learning principles and how to put them to use clinically in a therapeutic relationship. In this chapter we introduce you to that theoretical perspective. Our stance is that using CBS clinically doesn’t require a massive investment in the study of its theory or philosophy. Instead it requires understanding a relatively small set of core principles or assumptions. Think of this approach as the 80–­20 rule for clinical CBS: 20 percent of the CBS principles and assumptions account for 80 percent of the approach’s clinical utility. If you want to spend time reading about and exploring the other 80 percent, you can do that. (We enthusiastically recommend The ABCs of Human Behavior, by Jonas Ramnero and Niklas Törneke for this purpose.) In outline form, here is the 20 percent that you need to know: • Everything people do is behavior. • Behaviors are events. • All behavior happens in the moment. • Behaviors are steered by consequences. • Learning by consequences sometimes creates less than optimal results. • You can’t understand all the ways behavior is influenced, but partial, iterative under- standing can lead to useful results. • These ways of understanding people and behavior are fundamentally empathic and compassionate. We discuss each point in greater detail below. EVERYTHING PEOPLE DO IS BEHAVIOR Let’s start with the term at the center of this discussion: “behavior.” Behavior is what we study, understand, and influence. Behavior is what people do; it’s action. It’s how we move through the world, transition from one situation to the next, and exert influence. Many of us are used to making a distinction between thinking and behavior, in which behavior means outwardly observable actions like walking or talking. But in CBS we include in the same bundle everything that people do: speaking, thinking, imagining, hearing, perceiving, feeling, doubting, knowing, believing, intuiting, hearing, and on and on. If a live person can do it, it’s behav- ior. Right now as you read this, that’s behavior. Right now as you think about whether what you’re reading makes sense, that’s behavior too. And right now as you notice yourself thinking, that’s behavior too. Being aware of your behavior is behavior. It’s all part of the same stream of behavior, interacting with the world, within itself, and with the behavior of others. Bundling all actions together in this way becomes useful, as we will explain. By the way, when you speak with clients, you don’t have to use the clunky term “behavior.” You can use whatever word makes sense in the context: action, thinking, choosing, movement of spirit, or whatever. It doesn’t matter, as long as you keep track of the concept at the center of this word cloud: there are many things people do that can be looked at through the principles of learning.

BEHAVIORS ARE EVENTS A key characteristic of a behavior is that it is an event, occurring at a particular time and place with a particular person. Think for a moment about how many behaviors have occurred for you so far today. Think of all the overt actions you have made—­those we could see if we were watching you via a camera. Think as well of all the covert psychological behaviors that have happened: each thought, each sensation, each decision, and so on. Think of the discrete fleeting behaviors that make up a moment. Think as well of the extended, complex behaviors that make up the meaning of our days and our lives—reading this book, getting a graduate degree, and so on. Watch the flow of behavior inside you in this moment: Now I am thinking this… Now I am feeling this… Now I am going here… And thinking this… As you might expect, there’s no shortage of behaviors to work with. Behavior is a continuous, complex stream that moves through each of the seven billion people on the planet (sleep is a behav- ior too). In fact, so much behavior is occurring in any given moment that there’s simply no way any of us can maintain conscious awareness of all of our behaviors, let alone all of the influences on our behavior. The result is a kind of chaos—­not in the sense of disorder, but in the sense of complexity to such a degree that it often defies mechanistic understanding. This is the medium of psychology. ALL BEHAVIOR HAPPENS IN THE MOMENT A feature of behavior is how often we slip away from contact with or awareness of the behavior that is happening in the moment. Here’s an example that will be familiar to most psychotherapists: you ask a client what he’s feeling, meaning what’s happening in his body right now, and he simply says “bad,” or “I feel like I can’t get anything right.” These are, of course, conventional, sensible responses. Yet notice that they put the client at a distance from what’s actually happening: that his body is feeling a certain way, that he isn’t breathing very much, that he isn’t noticing the tension in his shoulders or the way he’s clasped his hands around his knees. In particular, he isn’t noticing that he’s having the thought I can’t get anything right or I feel bad, which is quite distinct from the sensations he is actually experienc- ing. He might live much of his life in this way, wrapped up in generalized thoughts about what is happening, yet rarely in contact with the momentary play of events flowing through him and how this behavior is shaped and shapes itself. In a similar way, as therapists we might talk about clients having a personality disorder, being resistant, having a transference reaction, being psychopathic, being depressed, or having a certain attachment style. Yet if we stop at such terms or labels, it’s difficult if not impossible to locate, in time and space, the concrete behaviors we’re referring to. Unless we provide more information, we’re obligating others to guess what we mean or, worse, to make blind assumptions that they know exactly what we mean. If another therapist tells you, clinician to clinician, that a client she’s refer- ring to you is depressed, you might have some general ideas about what’s happening, and you might know what sorts of questions to ask to get more specific information about the client, but you don’t know any of the specifics. This person might be an insomniac who obsesses about suicide but has no notable feelings of sadness, only a ringing emptiness. Or this person might spend eighteen hours a day in bed consumed by grief and bouts of crying. At best, the other therapist’s description orients you toward what sorts of questions could be helpful to ask the client. That’s very useful indeed, but it’s only the beginning of an assessment. Of course general labels aren’t inert. They shape how we relate to the person we’re labeling. The client who labels himself a failure stays at a distance from himself and treats himself unkindly. We react with distrust or disgust to the client labeled a psychopath. Labels form a basis for judg- ments and discriminations. And insidiously, these labels can steer our behavior even when we aren’t deliberately being pernicious or judgmental. Because the flow of behavior is the medium of psychology, and because we often lose track of that flow in ways that distance us from ourselves and what matters, the first and most basic step in the CBS perspective is to orient ourselves to seeing behavior as the flow of events it really is. Relating to the flow of events in this way is about humane, connected, and empathetic understanding—­staying close to the story of what is actually happening rather than our stories and labels about those events. It’s about getting in touch with what is actually happening here and now—­and whatever we wish to change. Here are some of the fundamental behaviors we orient ourselves to in psychotherapy: • Actions • Thoughts • Utterances • Images • Urges • Sensations • Feelings • Questions BEHAVIORS ARE STEERED BY CONSEQUENCES The experiential foundation of CBS is noticing what’s happening in the moment. We aim to notice, with some level of precision and mindfulness, how judgments may cloud our view of what’s happen- ing. In turn, that in-­the-­moment awareness allows us to begin to notice how our behavior is shaped—­ steered this way or that way—­by the consequences it creates. In other words, the CBS perspective is about making sense of the flow of experience in terms of some basic principles of learning. Again, there are really only a few principles that are especially useful to understand: • Some behavior functions to increase contact with certain things. • Some behavior functions to reduce contact with certain things. • When a behavior functions to get a payoff, a person will be more likely to repeat that behavior in the context where he or she received that payoff. • When a behavior doesn’t get a payoff, or it incurs a cost, a person will be less likely to repeat that behavior in the context where he or she didn’t receive that payoff or incurred a cost. In the sections that follow, we’ll take a closer look at each of these ideas. Some Behaviors Function to Move Us Toward Things There are certain things or states or situations in the world that we tend to move toward. When we are thirsty, we drink water. When we are lonely, we seek social contact. Often we move toward things that feel good or meet some biological need or give meaning. The things that we move toward are referred to as appetitive. It’s important to not assume that the thing itself is intrinsically appetitive, because what is appe- titive for us depends on the situation we are in (for example, whether we are thirsty or lonely) and, to some greater or lesser extent, who we are and our particular history. Many people like donuts and will move toward them, but after a few donuts, the donuts are no longer appetitive. In turn, in any large crowd of people, there will be a variety of different purposes, sets of values, tastes, and so on—­in other words, different things that are appetitive. The flow of behavior tends to move us toward what we find appetitive. What were the things your behavior functioned to move you toward today? As you read this book, what does your behavior move you toward? Some Behaviors Function to Move Us Away Conversely, sometimes the function of our behavior is to reduce contact with or move away from something. Things that we move away from are referred to as aversive. The first three donuts were appetitive. The fourth donut—­the one that makes us sick—­becomes aversive. We push away certain thoughts or feelings because they are painful. We react against certain statements from others. The Payoffs of a Behavior Can Reinforce That Behavior Sometimes behavior gets a payoff: it moves us toward an appetitive thing that we enjoy or away from an aversive thing that causes us harm or distress. When we have these experiences, learning happens: When our behavior successfully moves us toward an appetitive thing or moves us away from an aversive thing, we become more likely to repeat the behavior in the same or similar situations in the future. This is called reinforcement, the process by which the probability of behavior in a given setting increases. The Costs of a Behavior Can Decrease That Behavior At other times, behaviors have costs: they take us farther away from the appetitive thing or bring us closer to the aversive thing. When this happens, another type of learning, called punishment, occurs: those behaviors become less likely to recur in similar circumstances in the future. As with aversive and appetitive stimuli, whether a given consequence will actually be reinforc- ing or punishing can’t be determined in advance. You have to wait and see how the consequences affect the behavior. When you stand back and observe the flow of behavior, you can begin to see more clearly the different ways that consequences influence behaviors. For example: • When there is a strong payoff coming, or you have a strong sense of the payoff for a behavior in the moment, it is easier to endure the aversive things that might happen along the way. • When there is no sense of payoff, it is more difficult to persist in the face of aversive things. • One of the most desperate places to get stuck is when you know that a behavior is important because of its long-­term consequences, yet you constantly get derailed while pursuing it because of the pain involved, or because numerous other appetitive “shiny gold objects” draw you away. Function Is Active CBS doesn’t take the view that humans are passive agents or automatons who are pushed around by the world and are at the mercy of their environment. Central to the principles we’ve just outlined—­about how behavior functions—­is the notion that humans are actively operating on the environment around them. Every aspect of human behavior is an active, ongoing, mutual interac- tion with the world. The CBS perspective considers how behavior is shaped by context and the ways behaviors create or perpetuate context and the situations people find themselves in. This interdependent relationship is the central meaning of the word “function.” How does this behavior produce consequences in the world? What consequences has the behavior produced in the past that have shaped it, making the behavior worth repeating now? PROBLEMS WITH LEARNING The behavior we engage in now, in this situation, reflects the history of consequences we received in similar situations in the past. Because we are always bringing past experience to the present moment (that’s what learning is), the past is always present. At the same time, what worked and was reinforced in the past does not always work well in the present. Said another way, the influence of historic consequences doesn’t always steer us well in the long run. One form of this breakdown involves limited contact with the future. We could call it the problem of “consequences now matter more than consequences later.” For instance, when people are addicted to cigarettes, they are excessively under the influence of the immediate results of smoking (for example, relief from tension and withdrawal symptoms), despite the fact that the long-­ term consequences can be deadly. Or consider how this dynamic plays out for Mark, whom we mentioned earlier. He learned to avoid expressing his needs to the important people in his life because, due to early life experiences, it makes him anxious to do so. In the short term, he avoids the anxiety of making requests, but in the long term he stands a good chance of feeling more disap- pointed or resentful because his needs aren’t met. In these kinds of situations, behavior is too heavily constrained by its short-­term results, despite the fact that being constrained in this way doesn’t work well in the long run. This pattern happens in interpersonal contexts all the time. We avoid raising a difficult issue in the moment because we don’t want to feel uncomfortable in the short term. Yet that avoidance leads to ongoing dissatisfac- tion and a bigger problem later. Or we gossip, complain, or attack because it feels satisfying in the moment, even though a few hours later we feel ashamed, and in the long run we undermine trust and closeness. Another form of the breakdown of learning involves the past. In this case, behavior that func- tioned well in the past can persist into the present even though it no longer functions very well. We could call it the problem of “past learning is out of touch with the present.” Consider Gillian, who avoids expressing her wishes because she was consistently punished for doing so as a child. She may persist in this behavior even though her current partner is eager to understand her and respond compassionately toward her. Behavior that’s been met with such painful consequences in the past can be especially problematic because the person now avoids the situation or behavior that prompted the pain, as is the case for Gillian. In fact, she may feel fear simply at the thought of expressing her wishes. When people avoid such situations, they deprive themselves of opportunities for new learning. As a result, Gillian loses the chance to learn that expressing her wishes will actually produce positive consequences. Because of her avoidance, she remains under the influence of old learning and is less effective in her current context. This kind of avoidance can persist for decades. If psychological problems occur when past learning excessively controls our behavior, more effective behavior often occurs when people balance being guided by the past with being respon- sive to what seems to be working best in the present. In other words, we benefit from past learning but remain able to flexibly adapt our behavior to the present moment. Similarly, if problems occur when short-­term consequences excessively control our behavior, such that we cause long-­term problems, more effective behavior typically occurs when we build a capacity to tolerate whatever short-­term consequences are necessary to achieve our long-­term aims; more effective behavior also occurs when we are able to find a clearer sense of the long-­term value of our actions here and now in the present. Or in other words, when we have a vivid sense of the purpose or goal behind our actions, we become much more able to tolerate frustrations and discomforts and forgo easy dis- tractions in favor of persevering toward what matters to us. CBS terms these capacities, taken together, as psychological flexibility. In turn, taking the CBS stance—­being able to see our behavior clearly and see the ways that it gets stuck—­tends to help us become more psychologically flexible. LANGUAGE: A VERY SPECIAL KIND OF BEHAVIOR Notice how much of the CBS stance is about learning to “see,” that is, observe and label behaviors and how behaviors function. All of this involves language—­and language, like everything else people do, is behavior. Not surprisingly, then, language plays a very special role in the CBS frame- work. In humans, language is an important behavior that allows us to operate in and be shaped by social interactions. By and large, therapy is a process of language. On the flip side, sometimes lan- guage can powerfully curtail our flexibility, such as when people decide, based on past experience, that they know exactly what’s going on and, as a result, miss what’s really happening. In our treatment of language in this book, we’re guided by relational frame theory (RFT; Hayes, Barnes-­Holmes, & Roche, 2001), an empirically established CBS account of language and cogni- tion. Briefly, RFT posits that the behavior at the core of language is the behavior of relating. For instance, we relate objects and words to one another, such as when we relate the verbal label “tree” to an actual tree. Similarly, we can relate words to each other; for example, we say, “Blue is a color.” We can relate things in many ways. For instance, “blue is a color” is a relation of hierarchy, given that color is a category that contains several things, one of which is blue. Another type of relation is that of opposition: day is not night. These are very fundamental relations. The analysis of RFT has allowed us to break the operation of language down into these fundamental pieces of behavior. These relations, in turn, influence how we respond to the things we’re relating to. For example, “This apple is good” or “This apple is bad” steers our behavior. As for language operating naturally in a mature human being, that’s what happens when you take these very simple relations, multiply them by a trillion, then put them in a blender, along with other people and massive chunks of the world, and run that blender at high speed for several decades. The result is a very complex soup of relations and influences and an ability to engage in the present-­moment behavior of relating a whole bunch of things that aren’t in the here and now to whatever is present. Again, these relations influence how we respond to the things to which we’re relating. Remember when we warned in chapter 1 that labels are not neutral? For instance, if you relate your child’s teacher and “stupid,” thinking to yourself That teacher is stupid, you’ll respond to him differently than if you relate other words to him. Similarly, some clients may come to therapy with all sorts of thoughts about how they should interact with you—­without having any prior experience with you, or perhaps with therapists in general. Part of what we do carefully in therapy, then, through the process of functional analysis and our therapeutic relationship, is influence how people relate to themselves and their behavior and the world around them. From the CBS perspective, this is no doubt a “common factor” across any form of therapy. If you’re interested in learning more about RFT and this common factor, we encourage you to check out Learning RFT (Törneke, 2010) or Mastering the Clinical Conversation (Villatte, Villatte, & Hayes, 2015). In this book, our presentation of FAP is strongly influenced by RFT; however, we won’t invoke RFT directly beyond this point. THE CLIENT IS RIGHT: DON’T ASSUME, ASSESS If you’re having the thought that learning is incredibly complex, you’re right. When we study behavior, we’re studying something of marvelous complexity. As therapists, we must witness the ongoing flow of this complexity and bring great humility and appreciation to our attempts to influ- ence it. This is of course what we all know as clinicians. CBS echoes this wisdom. As Skinner said, “Behavior is a difficult subject matter, not because it is inaccessible, but because it is extremely complex. Since it is a process, rather than a thing, it cannot easily be held still for observation. It is changing, fluid, and evanescent, and for this reason it makes great technical demands upon the ingenuity and energy of the scientist” (1953, 15). Of course, for mental health therapists, we typi- cally have only one hour per week with a given client, so this difficulty is greatly compounded: it’s like trying to watch a parade through a pinhole. This complexity and inaccessibility of behavior has direct implications for how we must venture to understand it from a CBS perspective. Beware of any tendency to dismiss or distort clients and their experience in service of preserving a case conceptualization or other theory about how things should be. Instead, listen and watch and see what works. An anecdote from the early science of behaviorism illustrates this concept: A famous scientist reached the end of some grueling and fastidi- ous experiments with rats and found that one of his well-­considered hypotheses didn’t seem to hold up to reality. But he accepted this, saying, “The rat is always right.” In other words, clients might not behave as we think they should, but they are nevertheless behaving exactly as they ought to. The good news is that we don’t need to know everything in order to be helpful. The goal is not to be right; it’s to be helpful. We can take a pragmatic approach and focus on knowledge that works. A large component of the art of behavior therapy is knowing how much factual information and specificity is necessary in order to focus treatment without making it unnecessarily compli- cated or inflexible. We don’t need to find the “best” way or the “right” way. After all, there are numerous ways to describe clinical phenomena and a variety of paths to behavior change. Our task as clinicians is to find one path that works. WHY IT’S IMPORTANT TO UNDERSTAND LEARNING AND FOCUS ON FUNCTION Hopefully everything you’ve read in this chapter has underscored that CBS is an intrinsically com- passionate way of understanding and working with clients. At its core, CBS is about seeing behav- ior and seeing the influences of learning in the present so we can become more flexible and effective in the present. Everyone has a history that makes up the meaning of this moment. And yet that history is invis- ible to us, as observers. So it is so easy to misunderstand people, to miss the meaning of their actions. In psychotherapy especially, in which our job is to create change in behaviors, we need ways to see that invisible context of learning and function. Social psychology research on what’s called the fundamental attribution error (Jones & Harris, 1967; Gilbert, 2002) has nicely captured our view on this point. On the one hand, we tend to explain our own mistakes and failings through an appeal to context; for example, “I wasn’t lazy. I had a lot on my plate this week. I was stressed and needed to rest.” We can make these kinds of generous inter- pretations of our own behavior because, in part, we have access to the contexts that shaped us. Furthermore, we tend to provide similarly generous interpretations for the behavior of those we care about. On the other hand, we aren’t as generous with strangers, as we can’t see beyond their appear- ance and their history is invisible to us. The same is true of people whom, for whatever reason, we dislike. We’re much more likely to judge them based on their supposed intrinsic qualities as people. The attribution error we make in these cases is that we blame people’s attributes for their behavior, rather than imagining that, within their context, their behaviors make sense, as we do for ourselves. Another way to say this is that we tend to see people’s behavior in its context when we’re at our most compassionate. In a sense, seeing someone’s behavior in context is simply another way of describing empathy and understanding. And likewise, we are much more likely to feel understood by someone who takes a generous view of our actions and more likely to be open to that person’s influence. CBS is about developing that generous stance of seeing action in context. In fact, CBS researchers (Hooper, Erdogan, Keen, Lawton, & McHugh, 2015) recently showed that training in perspective taking decreases the chance that people will commit the fundamental attribution error. Not surprisingly, for many people seeking psychotherapy, one way they’ve gotten stuck is by failing to see their own actions in context. They’ve become bogged down in negative and general- ized self-­attributions: “I’m a loser,” “I’m unlovable,” and so on. By helping them see their behavior in context, we can help them achieve a more self-­compassionate stance. And as we said in the previ- ous chapter, when you deeply understand someone and care for her, then what’s good for her—­her growth—­will naturally become appetitive for you, so you’ll tend to nurture or reinforce more of that. Perhaps this is what a skilled listener does, even without noticing it. And given how central social connection is to well-­being for humans, as discussed in chapter 1, it should come as no sur- prise that a close relationship can be such a subtle and sensitive instrument for behavior change. CBS helps us get below appearances in order to investigate the deeper functions of behavior and to build a deeper kind of empathy and understanding and, therefore, influence. In turn, we seek to see a client’s problematic behaviors as they happen, respond in ways that evoke new and more effective behaviors, and reinforce those behaviors so they take root, not only in the client’s rela- tionship with us but in other contexts as well. In the next chapter, we turn to more concrete ways in which we put the CBS perspective to work in the therapy relationship using functional analysis. SUMMARY • The psychological perspective at the root of FAP is contextual behavioral science (CBS). • The CBS perspective involves a small set of basic assumptions, including • everything people do is behavior, including thinking, feeling, sensing, and so on; • behaviors are events happening in time and space; and • behavior is steered by its consequences. Some consequences cause the behavior to increase in frequency; other consequences cause the behavior to decrease in fre- quency. “Function” is what a behavior achieves in terms of these consequences. • There are problems that result from learning through consequences. Behavior can become too constrained by past experiences and therefore be out of touch with the present. It can also become too influenced by short-­term consequences, even if it leads to long-­term costs. • The influences on behavior are complex. You won’t be able to gain a definitive under- standing of them, but you can attain a good enough understanding to exert influence. • Understanding function and learning history is a road to empathic, compassionate understanding—­to making sense of the contexts and experiences that lead people to behave as they do.