Al entrar al curso de “Psicología del Aprendizaje” lo que más se quedó en mi memoria fue el condicionamiento clásico y operante y en variadas oportunidades me pregunté si la modificación de la conducta podía ayudar a la mejora de ciertos trastornos mentales y no sólo a lograr que un can se siente o que una rata apreté una palanca (como pensaba en mis momentos malos tras la llegada del taller de condicionamiento). Después de avanzar en el curso me di cuenta que el conductismo es de mucha ayuda para los trastornos de ansiedad, alcoholismo, entre otras enfermedades.
La Terapia de conducta es un conjunto de métodos de tratamiento psicológico basados en el aprendizaje y dirigidos a sustituir las conductas inadecuadas por otras más adaptadas. Éste se centra en la conducta observable y objetiva, usando técnicas derivadas de la teoría del aprendizaje. Busca mejorar exclusivamente los síntomas del paciente sin preocuparse de las causas del problema.
Aquí tienen algunos ejemplos sobre las técnicas utilizadas en dos tipos de trastornos de ansiedad, la Fobia Específica y el TOC.
Fobia específica
La terapia conductista más utilizada en éste trastorno es la exposición, la cual puede ser real o imaginaria. La exposición real implica que el paciente entre en contacto físico con el estimulo fóbico, mientras que la segunda técnica consiste en descripciones del terapeuta y la imaginación del paciente.
La terapia in vivo puede ser gradual, donde se va aumentando paulatinamente la los acontecimientos anisogenos para el paciente, por lo que se parte de lo menos estresante a lo más estresante. Asimismo, está la exposición no gradual, la que consiste en una exposición inmediatamente más estresante.
La terapia no suele utilizarse sola, sino también con ayuda de fármacos para personas que tienen un trastorno fóbico que incluye de crisis de angustia.
Trastorno obsesivo compulsivo (TOC)
En éste trastorno, la terapia conductual tiene dos elementos los cuales son procedimientos de exposición para minimizar la ansiedad asociada a las obsesiones o a la necesidad de confrontar los temores obsesivos y las técnicas de prevención de la respuesta que tratan de reducir la reiteración de los rituales o pensamientos obsesivos. Las técnicas de exposición van desde la exposición imaginaria breve hasta la prolongada y real a los estímulos que generan los rituales que causan malestar en el individuo. La técnica de exposición tiene como objetivo menguar la molestia asociada a los estímulos responsables a través de la habituación.
Otra técnica muy utilizada es la prevención de la respuesta, que consiste en exponer al paciente, por ejemplo a la suciedad, sin dejarle que se lave las manos o tolerando sus dudas, como por ejemplo “cerré la puerta antes de salir” sin dejar que la persona lo compruebe.
La terapia es más efectiva si se combina con otras técnicas de éste mismo enfoque, como por ejemplo la exposición con la prevención de la respuesta. Combinando éstas técnicas hasta el 75% de los sujetos que realizan rituales y que desean y pueden someterse al tratamiento mejoraran significativamente.
Fuente: “Guía de trastornos de ansiedad”, escrito por Eric Hollander
Saludos
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