Feedback and anxiety

Imagine a child who suffers from social anxiety. He fears contact with others for he worries that he will be evaluated negatively. His anxiety, his fear, causes him to avoid social contact. Avoiding contact means that he is deprived of opportunities to have positive social experiences. With a good deal of his attention on the impression he is making and worry about how to act, he comes across awkward, stilted, perhaps ungenuine. In response, others feel uncomfortable and avoid contact with him. This means that the feedback this child receives is consistent with his anxieties. He doubts he will be evaluated positively, which in turn causes him to act in the very manner than brings about negative evaluations. Often referred to as a self-fulfilling prophesy, this situation is known as a positive feedback loop. In a positive feedback loop, the system responds by altering its function so as to increase or promote the situation that caused the feedback. An example of a natural positive feedback loop is the onset of contractions in childbirth labor. The occurrence of a contraction induces the release of oxytocin, which stimulates stronger and more frequent contractions.

Once we frame the problem of anxiety in terms of feedback, the solution becomes obvious: break the feedback loop by intervening to alter the feedback. Imagine now a socially anxious child who, has an interaction with someone who is trained to respond with warmth and acceptance despite the child’s awkwardness. This interferes with the positive feedback loop. The child gets a taste for being accepted regardless of his stilted behavior. Now the child may feel just a bit less anxious. Feeling more comfortable and more confident, he becomes less awkward and more socially appealing, which in turn invites more positive evaluations, which bring about greater comfort and confidence and so on. Notice that we have traded one positive feedback loop (an unfavorable one) for another (a favorable one).

Cognitive-behavioral therapy (CBT) is a very commonly used approach to treating anxieties and its focus is on altering thoughts associated with anxiety provoking situations. An individual faced with a social situation would be asked to question why they are feeling anxious, what they fear, etc., and then are taught how to transform these thoughts so that they provoke less anxiety. Though it is not typically expressed in terms of feedback, CBT essentially amounts to altering feedback. It is important to realize that feedback is not absolute. In other words, it is every bit as open to interpretation as anything else that we perceive. CBT amounts to altering how one appraises feedback from the environment from more to less threatening. Its tight interweaving of feedback and behavior is likely one of the reasons for its success.

But I would like to suggest that we can go much further. As I depicted in the scenario above, involving the child, I think that systematically altering the environment so as to provide particular types of feedback can be a very effective way to bring about reduced anxiety. Essentially what I am proposing is to construct situations in which the individual can practice behaviors and receive the right kind of feedback. This is something that just can’t happen naturally due to the dastardly power of the positive feedback loop.