Evaluation and Applicability of Counterconditioning in Fear

Extinction

Boris Kitanov

Melbourne School of Psychological Sciences, University of Melbourne

PSYC10003: Mind, Brain & Behaviour 1

Rayn Jamieson, A. (2023). Inventing The Egyptian State [PowerPoint slides].

University of Melbourne

28.04.2023

Word count:

Evaluation and Applicability of Counterconditioning in Fear

Extinction

In the ‘’Fear Extinction and Relapse: State of the Art’’ by (Vervliet et el., 2013) is provided a

thorough insight of the Pavlovian classical conditioning which is fundamental for treating

anxiety disorder and phobias. Of which the core idea is to avoid a relapse of an already

extinct fear or replace it with something that would erase the undesired feeling from the

context in which was acquisitioned. Although, environment (context) which is ‘’most

systematically investigated feature’’ (Vervliet et el., 2013, p. 220) could be difficult to be

modified as a trigger for it is in the core of the fear, which makes counterconditioning

suitable and effective when it comes to erasing the feeling associated with a certain context

by enhancing it with a pleasant stimulus. Hence, it plays a vital role in fear extinction as well

as avoiding unpredicted shifts and relapse in behaviour. However, fear extinction could take

time to remember, merely because the new memory is more recent while the memory of fear

has been there for longer period which makes it stronger and outweighs the novel modified
more pleasant one. Thus, there is a high chance of reoccurrence of the extinct response

(Pavlov 1927, as cited in Vervliet et el., 2013, p. 218). It is important because nowadays

thousands of people experience phobias, anxiety, and many other mental problems related to

fear, where counterconditioning suggest a more favourable outcome than classical

conditioning in fear extinction. In this essay, I argue that fear extinction can be most

effectively established in a patient’s brain and behaviour by examining and applying

counterconditioning. Where the context which triggers the fear is paired with a positive or

neutral stimulus to avoid relapse of the unconditioned fear stimulus and increase the chance

of long-term extinction.

The classical conditioning initially coined by Pavlov after conducting an example of a pre-

clinical trial on his dog. Where he establishes how different stimulus work such as

conditioned stimulus, unconditioned stimulus, and neutral stimulus where such modifications

in behaviour first were created in process called the synaptic plasticity. Which have a vital

role in fear extinction and the change of the behaviour of the stimulus. The control over the

stimulus is executed in series of clinical trials with the patient and exposure to US in the same

and different context until the fear response decreases or in very little number of cases it is

completely erased. To test the level of extinction, hence renewal test is presented in ABB and

ABA variations in which a few steps are followed (Vervliet et el., 2013, pp. 221-222). Such

test are initially done in pre clinical trials first trials with animals are executed mostly rodents,

which are done to establish the safety of the methods before applied on humans. For example,

Vansteenwegen et al., (2005, pp. 331-332) displays the charts and results from ABA and

AAA groups with four block tests M1-acquisition, M2-second acquisition, M3-extinction,

M4-test where the AAA group had a much higher CS+ score than the ABA which could lead

to increase in the chances of a relapse. Suggesting that relapse of fear is almost inevitable.

Furthermore, part of the pre-clinical trials in distinguishing some cognitive disorders such as
attention deficit hyperactivity disorder (ADHD), schizophrenia, and traumatic brain injury

AX and BX experiments are required.

Counterconditioning which is based on classical conditioning and many of the methods

mentioned above making it more effective due its enhancements in the methodology of fear

extinction. The concept of counterconditioning was first developed in the experiment called

the ‘’Little Peter” by Mary Cover Jones (1924) which was noted as the earliest behavioural

modification (Keller et al., 2020, p. 2). The term ‘’counterconditioning’’ was coined by

Joseph Wolpe in 1950 during the process of replacing anxiety and phobias response with

desirable feelings which was extracted from the model of classical conditioning (Mcleod,

2022, November 3). The core idea of counterconditioning (CC) is first to pair both stimulus

until a later phase of complete replacement of the unconditioned stimulus (US) negative

stimulus with US positive stimulus (e.g., food, music, favourite cloth, etc.) (Keller et al.,

2020, p. 2). This method aims to avoid what exposure therapy proposes ‘’ systematic

desensitization, individuals progress through increasingly more anxiety’’ (Craske et al., 2012,

p.2) while in the counterconditioning the anxiety is decreased. Thus, the counterconditioning

in clinical conditions would be conducted in the following order: person with phobia or fear

not only exposed to it as in the exposure therapy, but appetitive is introduced simultaneously

with it. Which is the main reason why it is suggested to be more effective. During the

appetitive phase where the prediction error system leads to dopamine release in the ventral

tegmental area (VTA) located at the back part of the brain through the Ventral Straitum to the

ventromedial prefrontal cortex (vmPFC) and regulation of expression is learned by an output

of the amygdala (Keller et al., 2020, pp. 5-6). In this lengthy looking process, the fear

extinction is reduced, in short ‘’the higher the dopamine, lower is the possibility of a

relapse’’. For instance, a person with fear of dogs is put in a room with a calm and friendly

dog while being given their favourite food which dominates the feeling of fear by releasing
dopamine through the reward system (explained above). Furthermore, the

counterconditioning suggests a less stressful and traumatising extinction with better

efficiency in manner of combing two different stimulus and solidifying the prediction error

response (Keller et al., 2020, p. 7).

According to Button (2004, p. 2) the ‘’saved’’ original learning would not be remembered as

well as during a counterconditioning process because the memory would be modified by the

appetitive presented in the specific context. Although, studies also suggest that

counterconditioning can be a lengthy process which is considered a drawback, while an

extinction should be short term treatment to ease the fears or phobias of a person, with an in-

depth focus on kids (Wolpe, 1956, pp. 236-239). Nowadays, it is used more often with kids

and animals, whereas for adults different methods are suggested.

On the other hand, counterconditioning is based on the release of a vital for our existence

chemical, the dopamine. Without the dopamine we would not be motivated to do anything

but with enough of it a person can not only overcome a fear or phobia but do much better in

life as suggested in the book The Molecule of More by Dr. Lieberman. As mentioned above

the key difference in the counterconditioning is that it uses this dopamine release as fear

‘’extinguisher’’. Furthermore, dopamine-based drugs could be used to stabilise fears and

phobias (Garcia, 2017), until extinction is reached. Finally, this method suggests one less

harmful, lengthier, and more natural manner of fear extinction, by the use of dopamine which

is part of our daily life and turned into medication by being manipulated in various ways.

Reference list:
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counterconditioning: Past and future directions. Behaviour Research and Therapy, 125,

103532. https://doi.org/10.1016/j.brat.2019.103532

Mcleod, S. (2022, November 3). Systematic Desensitization as a Counter-conditioning Process.

Simply Psychology. https://simplypsychology.org/Systematic-Desensitisation.html

Vervliet, B., Craske, M. G., & Hermans, D. (2013). Fear Extinction and Relapse: State of the Art.

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