LEARNING AND

BEHAVIOR MODIFICATION
Dr. Mohamed Elhassan Khalid
Assistant Professor and Consultant Psychiatrist
■Is mind born with ideas and/ or knowledge,
or the mind is completely blank at birth ?

There is Much debate about the answer of this question

and many philosophies and theories tried to answer it:-
1.Blank slate theory and empiricism.
2.Innatism and Instinct theory
Blank slate theory
■ According to blank slate theory, the mind is
completely blank at birth and humans are shaped
entirely by their experiences and not by any preexisting
biological mechanisms.
■ This theory is being challenged and soundly trounced
(defeated) by the cognitive, neural, and genetic sciences.
Empiricism
■ In philosophy, empiricism is a theory  states that
knowledge comes only or primarily from 
sensory experience. 
■ Empiricism emphasizes the role of empirical evidence in
the formation of ideas, rather than innate ideas or 
traditions. 
■ Historically, empiricism was associated with the "blank
slate" , according to which the human mind is "blank" at
birth and develops its thoughts only through experience.
■ Empiricism in the philosophy of science emphasizes that
"knowledge is based on experience" and
"knowledge is tentative ( not fixed) and
probabilistic, subject to continued revision and 
falsification“,-alteration and changing and often
used by natural scientists.
■ Empirical research, including experiments and
validated measurement tools, guides the 
scientific methods.
Innatism
■ Innatism is a philosophical and epistemological( theory of
knowledge) doctrine holds that the mind is born with
ideas/knowledge, and therefore the mind is not a "blank slate" at
birth, as early empiricists such as John Locke claimed.
■ Innatism asserts that not all knowledge is gained from experience
and the senses. 
■ Plato and Descartes are prominent philosophers in the
development of innatism and the notion that the mind is already born
with ideas, knowledge and beliefs.
■  Both philosophers emphasize that experiences are the key to
unlocking this knowledge but not the source of the knowledge
itself.
■ Essentially, no knowledge is derived exclusively from one's
experiences as empiricists like John Locke suggested.
INSTINCT
■ It is an inborn impulse or motivation to action, typically performed
in response to specific external stimuli.
■ Today instinct is generally described as stereotyped, apparently
unlearned, genetically determined behavior pattern.
■ Therefore Instinct is innate, meaning that instinctive behaviors
and responses are present and complete within the individual at
birth.
■ In other words, the individual does not have to undergo any
experience to acquire such behaviors.
■ It is fairly easy to identify innate behavior when an animal
exhibits it at birth, but in some cases innate behavior manifests
only later in life.
 
 
 
 

■Instincts are goal-directed innate patterns of behavior that are not the
result of learning or experience.
■All organisms are born with innate biological tendencies that help them to
survive.
■Instincts are different from reflexes in that reflexes are simple reactions to
stimuli, whereas instincts involve much more complex sets of behavior.
■Instincts exist across a wide range of human and non-human species.
Migration, hibernation, eating, drinking and sleeping are examples of
instinctual behaviors.
■Like all animals, humans have instincts, genetically hardwired behaviors
that enhance our ability to cope with vital environmental contingencies. Our
innate fear of snakes is an example. Other instincts, e.g. including denial,
revenge, escape, defensive maneuvers,aggression, self- preservation, sex
and socially tribal loyalty .
 
What is learning?

Learning is the process of acquiring new understanding,

knowledge, behaviors, skills, values, attitudes, and
preferences. The ability to learn is possessed by humans and
animals.
What is the difference between Instinct and learning?
The distinction between instinct and learning revolves around the
question of whether an animal, in responding to a specific situation,
is acting on the basis of experience or instead is guided by instincts
"hardwired" within its brain ( a permanent behavior or belief).
Plenty of gray area exists between pure instinct and genuine
learning, and within that gray area is a fascinating concept known
as imprinting. 
■What is IMPRINTING:
Imprinting is a form of learning in which a very young animal fixes its
attention on the first object with which it has visual, auditory , or tactile
experience and follows that object. Such behavior occurs at a critical period
early in life, and becomes permanent.
■ Lorenz, who first developed the theory of imprinting, noted that newly
hatched geese learn to walk by following their parents, but he wondered how
they distinguished their parents from all other objects in their environments.
■ He discovered that if he removed the parents from view the first day after the
goslings hatched and if he walked in front of the young geese at that point,
they would follow him.
■ In Humans imprinting can occur with other human beings shortly after birth or
within the few months of life – most commonly with parent, though care
givers can also be imprinted upon. Imprinting behavior is also thought to
play role in development – even in language development .
■ There are many theories of learning but we are going to
concentrate mainly on Behaviorism theory of learning and
Social leering theory.
■ Social Learning Theory ; integrated behavioral and cognitive
theories of learning in order to provide a comprehensive model
that could account for the wide range of learning experiences that
occur in the real world.

■ Also these theories have many clinical applications in psychiatry

and behavioral modification.
 Behaviorism Theory - Behavioral Psychology
■ Behaviorism is the theory of learning based on empiricism and
accordingly believes that all behaviors are acquired through
conditioning.
■ Conditioning occurs through interaction with the environment.
■ In the behaviorist model of learning and behavior modification,
internal states, subjective impressions, and unconscious
processes are not relevant.
■ All that matters is the objective data, i.e., only what can be
seen, observed, and measured.
■ According to behaviorism theory learning is relatively
permanent change in behavior, not due to drugs, or
maturation.
 Behaviorism learning paradigms
■ The two main types of learning paradigms are:
1. Classical conditioning.
2. Operant conditioning.
Classical Conditioning (Pavlovian) Conditioning
(UCS) Unconditioned Stimulus (sight of food) →
(UCR )Unconditioned response (salivation)
(CS)Conditioned Stimulus (bell) → (CR) Conditioned response
(salivation)
 Classical Conditioning (Pavlovian) Conditioning

1. In classical conditioning, the conditioned response is elicited by

the conditioned stimulus after repeated pairings of the UCS and
CS.
a) The Pavlovian experiment paired the ringing of a bell(CS) with
the bringing of food(UCS) so that, eventually, the sound of the
bell elicited the salivatory response, which previously occurred
only with the sight of the food.
b) Example in clinical practice: a patient receives chemotherapy
(UCS), which induces nausea (UCR). Eventually, the sights and
sounds of the hospital alone (CS) elicit nausea (now the nausea
become a CR).
2. A new stimulus elicits the same behavior. Note that the triggering
stimulus (CS) occurs before the response.
3. Stimulus generalization: In case of nausea due
to chemotherapy, generalization will have occurred
if any hospital, or even meeting a physician, comes
to elicit nausea from the patient.
4. Extinction: after learning has occurred, for
example, breaking the pairing between
chemotherapy and the medical setting by giving
chemotherapy at home. The nausea-eliciting
properties of hospitals will be extinguished.
Operant or Instrumental Conditioning

■ Operant conditioning (sometimes referred to as ( 

instrumental conditioning) is a method of learning that occurs through
rewards and punishments for behavior.
■ Through operant conditioning, an association is made between a behavior
and a consequence for that behavior.
■ In the Skinner experiment, pressing a lever resulting in the delivery of food.
After receiving food, the bar-pressing behavior increased. Because it
changed behavior, the food is a reinforcing event.
■ Another example using reward and punishment, when a lab rat presses a
blue button, it receives a food pellet as a reward, but when it presses the
red button it receives a mild electric shock as a punishment. As a result, it
learns to press the blue button but avoid the red button
.
Operant conditioning is not just something that takes place
in experimental settings while training lab animals; it also
plays a powerful role in everyday learning.
Reinforcement and punishment take place almost every day
in natural settings as well as in more structured settings
such as the classroom or therapy sessions.

A reinforcer is defined by its effects. Any stimulus is a

reinforcer if it increases the probability of a response.
Types of reinforcers:
A positive reinforcer:
is a stimulus that, when applied following an operant response,
strengthens the probability of that response occurring.
■Examples: (i)increased pay leads to increased work from an employee
(ii) increased complaining leads to increased attention from the
nursing staff.
B. A negative reinforcer:
is a stimulus that, when removed following an operant response,
strengthens the probability of that response occurring.
Examples:
(i) a child learns that he can stop his parents’ nagging by cleaning
up his room.(You engage in an action in order to avoid a negative result).
(ii) Aversive stimuli such as a loud noise, bright light, shock, can often
be negative reinforcers.
C. Positive and negative do not imply good and bad, respectively. Both positive
and negative reinforcement lead to an increase in response frequency or strength.
D. Punishment, like negative conditioning, usually uses a noxious stimulus.
(i) However, this stimulus is imposed to weaken response.
(ii) physical punishment of a child will suppress naughty behavior, but may
fade when the punishment is removed and may be a model of aggressive
physical behavior for the child.
E.Extinction refers to the disappearance of a response when it is no longer being
reinforced.
Examples
(i) a nurse who is bombarded by constant complaints from a patient stops
paying attention to the patient whenever he complains.
(ii) a child is ignored by the parents when he throws temper tantrums.
If not paying attention and ignoring is successful, the unwanted behavior will stop.
Reinforcement schedules:
1. Continuous reinforcement: every response is followed by a
reinforcement.
(i) Results in fast learning acquisition.
(ii) Results in fast extinction when reinforcement is stopped
2. Intermittent (or partial) reinforcement: not every response is
reinforced
i. Learning is slower
ii. Response is harder to extinguish
iii. If the parents after a long spell of ignoring, they attend
to the child tantrums and they are putting the child on an intermittent
reinforcement schedule they will find it harder to extinguish the tantrums.
iv. Extinction of intermittent reinforcement often requires a
change back to continuous reinforcement.
Spontaneous recovery:
after extinction, the response occurs again
without any further reinforcement.
Secondary reinforcement:
a symbol or a token gains reinforcement value
because of its association with a real reinforcer
(e.g., money is not valuable in itself but because of
what you can do with it).
Modeling, Observational, or Social Learning
Social Learning Theory( SLT)is integrated behavioral and
cognitive theories of learning in order to provide a
comprehensive model that could account for the wide range of
learning experiences that occur in the real world.
key basic principals of Social Learning Theory :-
■Learning is not purely behavioral; rather, it is
a cognitive process that takes place in a social context.
■Learning can occur by observing a behavior and by
observing the consequences of that behavior (vicarious
reinforcement) i.e. indirect.
■ Learning involves observation, extraction of information
from those observations, and making decisions about the
performance of the behavior (observational learning
or modeling).
■ Reinforcement plays a role in learning but is not entirely
responsible for learning.
■ The learner is not a passive recipient of information.
Cognition, environment, and behavior all mutually
influence each other (reciprocal determinism).
 Applications of social learning
1. Criminology
■Social learning theory has been used to explain the emergence and
maintenance of deviant behavior, especially aggression.
■criminal behavior is learned in both social and nonsocial situations
through combinations of
a) direct reinforcement,
b)vicarious( indirect) reinforcement,
c)explicit instruction,
d)observation ( modeling).
2. Developmental psychology
Both moral development and gender-role development are
important areas of research within social learning theory.  Social learning
theorists emphasize observable behavior regarding the acquisition of these two
skills.
For gender-role development, the same-sex parent provides only one of many
models from which the individual learns gender-roles.
3. Entertainment-Education (EE) is a communication strategy that aims to
alleviate a social issue or educate the public through a custom-tailored piece
of entertainment that is to say Creating social change with media.
■ Entertainment education is symbolic modeling can help viewers learn socially
desired behaviors in a positive way from models portrayed in these programs.
4.Media violence
■ Principles of social learning theory have been applied extensively to the study
of media violence. Many research studies and meta-analyses have discovered
significant correlations between viewing violent television and aggression
later in life.
5. School psychology
Many classroom and teaching strategies draw on principles of social learning to
enhance students' knowledge acquisition and retention.
 BEHAVIOR THERAPY AND BEHAVIOR
MODIFICATION

■ Focus on treating symptoms directly rather than

changing underlying internal conflicts.
■ Behavioral modification is a type of behavioral therapy in
which principles of operant conditioning ( reinforcement,
punishment , etc. ) are used to eliminate some type of
unwanted, maladaptive, behavior.
Learning based therapies:-
1. Based on Classical Conditioning
2.Based on Operant Conditioning
1. Based on Classical
Conditioning
1. Systematic Often used to treat anxiety and phobias
desensitization Step 1: Hierarchy of stimuli: least to most feared.
Step 2: Technique of muscle relaxation taught.
Step 3: Patient relaxes in presence of each
stimulus on the hierarchy.
Works by replacing anxiety with relaxation, an
incompatible response

2. Exposure (also: Simple phobias treated by forced exposure to the

flooding or implosion) feared object. Exposure maintained until fear
response is extinguished

3. Aversive conditioning Properties of the original stimulus are changed to

produce an aversive response. Can help reduce
deviant behaviors.(spoiled meat for Pavlov dog —
Antabuse for alcoholism).
2. Based on Operant
Conditioning
Shaping Achieves target behavior by reinforcing successive approximations of the
desired response. Reinforcement gradually modified to move behaviors
from general responses to the specific responses desired. ( treatment of
autistic child to vocalized the desired sounds)
Extinction Discontinuing the reinforcement that is maintaining an undesired behavior.
(stopping attention to much complaining patient and “Time out” with
children).
Stimulus control a person’s eating behavior is tied to a particular stimulus, such as
television watching. Reducing the time watching television should
reduce the amount eaten.

Biofeedback Using external feedback to modify internal physiologic states functions of

ANS e.g. HR, BP, body temp. Often uses electronic devices to present
physiologic information, e.g., heart monitor to show heart rate. Works by
means of trial-and-error learning and requires repeated practice to be
effective.
Fading Gradually removing the reinforcement: 1. without the subject discerning
the difference
2. while maintaining the desired response Example: Gradually replacing
postoperative painkiller with a placebo and smoking cessation by reducing
nicotine content.
References for further reading:

1 -USMLE_Step_1_Lecture_Notes 0n Behavioral science social

science 2016
2. WWW.encyclopedia.com/science/instinct-and-learning.
3.https://en.wikipedia.org/wiki/
Social_learning_theory#Creating_social_change_with_media