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Exploring the mechanisms of emotional problems which occur from to the ability to manipulate language

Tomu Otsuki
Assistant Professor, Faculty of Human Sciences, Waseda University

Tempered through clinical training as a university student

Why do human beings become depressed or uneasy simply by imagining things which have not actually occurred? Research conducted over the past twenty years has revealed that our ability to manipulate language and images is a major reason for such emotional instability. While high level cognitive abilities such as language and recognition have expanded our possibilities, such abilities sometimes also torment our hearts. I conduct research to determine how language and recognition abilities influence emotional problems such as psychiatric disorders. My research includes both theoretical fundamental research and applied research performed through clinical practice.

Ever since I was a high school student, I had been vaguely interested in the occupation of psychiatric counselor. I enjoy conversing with people to the extent that I even thought of becoming a radio personality. Acting upon my interests, I entered a university where I could study psychology. When the time came to select a major during my second year at university, I chose the field of psychosomatic disorders. The major included many practical training courses and was based on the academic field of behavioral analysis. I was able to explore effective methods of guidance and support for autistic children and children who caused trouble at school. While still a student, I was quickly thrust into administering actual psychiatric care. I still remember how the other therapists would get mad at me. However, the experience toughened me and made me into the professional that I am today. Through actual experiences in psychiatric work, I developed an interest in behavioral analysis.

Upon entering graduate school, I delved even deeper into practical training while also conducting theoretical study. I participated in an "adaptation workshop" where I supported special classes for truant children and went camping with the children. During these activities, I conversed with children, supported children who had trouble joining their friend during free time and tried to serve as a good example. I became good friends with the children while acting together.

For example, in the case of a child who often spends time alone, methods of interaction and support will differ depending on the reason for solitary behavior. Why does the child spend time alone? Does the child want to rest because interacting with others is tiring? Does the child really want to interact with others but is too shy? If a child doesn't understand how to establish relationships with others, I help the child become familiar with interpersonal exchanges by forming a relationship with the child. Put simply, I use a variety of approaches based on analysis of each individual situation.

In actuality, a child's emotional condition is created through a complicated interaction of various factors. In order to link practical knowledge with research and to utilize research findings in practical application, it is necessary to refine and extract the important elements of such conditions and conduct further research. At first, when confronted with a complicated case, I had absolutely no idea of which elements to extract. However, as I have gained experience, I have gradually developed an intuitive understanding regarding core elements and the variables which need to be extracted in order to form a theoretical connection.

Expectations for the spread of cognitive behavioral therapy

Oral presentation at an academic conference in Italy (2011)

The scope of "behavior" included in the field of behavioral analysis is extremely broad. In addition to physical actions, it covers all psychological activities of human beings, including thinking and speaking. Cognitive behavioral therapy gives special attention to behavioral aspects associated with recognition. This field has gradually become more prevalent in Japan.

Cognitive behavioral therapy postulates that each individual's habits of understanding and recognition have great influence on the feelings and emotions of uneasiness or depression. Based on an assessment of that individual's recognition habits, treatment is conducted to create a more flexible understanding and way of viewing matters. This type of therapy is said to be highly effective for patients suffering from general uneasiness or depression. It is expected that the application of such therapy will spread in the future.

Furthermore, in recent years, the framework of behavioral analysis has been used to conduct detailed research on the aspect of "recognition" within cognitive behavioral therapy. As a result, there are expectations for further theoretical advances. As a specific example, I will give a brief introduction of what recognition mechanisms influence the behavior of human beings. Let's assume that there are three different words spelled as CUG, XZW and KDU. Individuals are taught that CUG is greater than XZW and that KDU is smaller than XZW (KDU<XZW<CUG). Now, suppose that XZW is defined as 10,000 yen and individuals are asked if they want CUG, KDU or XZW. Normally, people will answer that they want CUG because it is bigger than XZW.

Now, suppose that XZW is defined as the pain of being punched in the face. Individuals will now prefer KDU, since they assume that it will hurt less. The important point of these examples is that even though no specific explanation is given for CUG or KDU, human beings can indirectly create an image of the value or contents based on magnitude relations. This kind of language and recognition ability is unique to humans and cannot be found in animals. Actually, this cognitive ability is deeply related with psychopathological disorders in human beings.

How does this phenomenon apply to actual daily life? For example, assume that a child was scolded by Teacher B and has become afraid of the teacher. The child hears from his friends that Teacher A is even stricter, but that Teacher C isn't so bad. This information alone will cause the child to develop a fear of Teacher A. Even though the child has never actually been scolded by Teacher A, he or she will avoid the teacher. Despite never confirming whether or not Teacher A is truly a scary teacher, the child will avoid contact in advance. A buildup of such worries will cause the child's range of activities to shrink. It may even lead to problems such as truancy.

Such problems would not occur if human beings didn't possess the ability to manipulate language, which is essentially the ability to establish relationships between different things. It is also said that there is no particular requirement for necessity between the things which are correlated. For example, why is a pen called a pen? There is actually no need to use this name. However, assigning the name "pen" is convenient because it enables communication with other people. This ability to establish unnecessary and arbitrary correlation forms the basis of the cognitive abilities in human beings.

From the time that we are small children, human beings are trained through daily life in a variety of relationships such as equal relationships, opposite relationships, consequential relationships and temporal relationships. Understanding of such relationships is acquired as the ability to manipulate language and recognition. We now understand that this ability to create correlations is related to cognitive ability. Even animals are capable of assigning correlations in physical dimensions. For example, suppose that there are two sticks. A dog is repeatedly trained that it will receive food when it brings the long stick. The dog will remember that the long stick will lead to food. In other words, the dog is capable of selecting the "longest" in a physical dimension. In contrast, human beings also possess the ability to establish arbitrary correlations between things which do not exist in physical dimensions. The aforementioned example of the relationship between the object "pen" and the name "pen" is a quintessential example.

Cognitive behavioral analysis assesses what correlations have an effect on the patient's recognition. Therapy is used to remedy any correlations which lead to negative emotional conditions. Or, even if such negative correlations exist, many problems can be remedied by decreasing the influence of associated words. In order to conduct direct experiments regarding this ability to arbitrarily manipulate language, researchers use fairly meaningless symbols such as the aforementioned three-letter alphabet strings. Through such experiments, researches explore the basic mechanisms of human thought and develop methods for practical application to treatment.

Teaching veteran professionals with onsite experience

Despite producing highly effective results, there are many psychological treatments for which theoretical reasons of effectiveness have not yet been clarified. This is also true for cognitive behavioral analysis. We do not yet understood the conditions and mechanisms through which effective treatment is composed by changing recognition, creating flexible ways of thinking, and reducing the influence of certain words.

A variety of research has been conducted during the past twenty years, and an academic theory known as "relational frame theory" has been developed regarding the characteristics of human language and recognition that are discussed in this article (see Figure 1). Although this theory is not yet well known in Japan, it was developed through repeated fundamental research performed mainly by researchers in Ireland and America. If it is possible to advance the theorization of correlation, I believe that relational frame theory will enable the development of methods for promoting the development of recognition in children. Based on this expectation, I am actively engaging in international research exchange. I visited Ireland two years ago in order to conduct research exchange, and I also recently exchanged information with fellow researchers at an academic conference held in Italy. Actually, an international research conference was scheduled to be held in Japan but was postponed due to the Great East Japan Earthquake. The conference has been rescheduled for March of next year.

Figure 1: Point of relational frame theory (RFT)

Regarding the unknown stimuli A, B and C, assume that subjects directly learn that A and C are alike while B and C are opposites. In such a case, we human beings automatically understand the relationship between A and B even without direct learning (secondary stimuli relation). Furthermore, assume that subjects directly encounter A, have a positive experience and develop a liking for A. In such a case, despite never having directly encountered B or C, we human beings will develop an aversion to B (because it is the opposite of A) and a liking for C (because it is similar to A). RFT postulates that this kind of human ability is the essence of language and recognition.

In terms of education, I teach a one-year nighttime course at the graduate school for working professionals (Master's Program of the Clinical Education Course at the Graduate School of Human Sciences). Through the course, students can acquire certification as a school psychiatrist or a clinical development psychiatrist. Many of the students taking the seminar are in charge of child-raising support or work as school teachers. Many students enroll in the seminar because of concern for children who are truant, possess developmental disorders, or suffer from other conditions which prevent them from adapting to a school environment. Students enter the course due to personal motivation, and I deeply respect their passion and high level of consciousness. The greatest merit of professionals studying at a graduate school is that they will become able to diagnosis the mechanism related to why children show symptoms of maladaptation. This enables them to provide more appropriate guidance. In addition to onsite experience, students acquire the ability to think scientifically and theoretically, thus making it possible to offer more effective and flexible support for children under their supervision.

Actually, all of my seminar students are older than me. There is not a single student who is younger than me! Since my students are veteran professionals with onsite experience, I feel pressure to present realistic and pertinent material. Still, instructing such students has taught me a lot. I am working my hardest to provide students with techniques which can be immediately used at their workplace tomorrow and with knowledge for understanding the theoretical background of problems held by children.

Research exchange in Ireland

Tomu Otsuki
Assistant Professor, Faculty of Human Sciences, Waseda University

Graduated from the College of Human Sciences, Tsukuba University, in 2002. Completed the Master's Program at the Niigata University Graduate School in 2004. Completed the Doctoral Program at the Hiroshima International University Graduate School in 2007. Holds a PhD in clinical psychology. After serving as a psychological counselor at Yugakukan, became an Assistant Professor at the Faculty of Human Sciences, Waseda University, from April 2008. Assumed his current position in April 2010. Areas of expertise include behavior analysis and research in cognitive behavioral therapy. Current research themes include relational frame theory, clinical behavioral analysis, behavior therapy and school education clinical research.