‘Why?’ is a very common word in the therapy room. Often clients come to a therapist after experiencing ongoing ‘dysfunctional’ patterns of behaviour, which have led to unpleasant feelings and prevented them from living the life they want. These repeat behaviours, which can include things like substance abuse, unhealthy partner choices or using a passive communication style, might not make sense to the client, and when they examine their own choices in hindsight, they might not always understand the reasons they engaged ‘irrational’ behaviours. When clients feel like this, it is only natural to ask ‘why?’. For many clients, the ‘why?’ question is driven by feelings of anxiety and fear – fear that something is ‘wrong’ with them, anxiety about continuing to repeat these patterns of behaviour in the future, and worry about being unable to control their own actions or emotions.
The reasons for patterns of unhelpful behaviour are different for every client, and depend on the person’s current environment, attachment style, family background, beliefs, personality temperament and the consequences the repeat behaviours usually have for them. Therapists know almost nothing about a client when they attend their first session, and they are not mind readers! So, it is unlikely that they will be able to fully answer the ‘why’ question immediately. However, therapists still have tools to assist clients in better understanding their own patterns of thinking and behaviour. Without having these tools, clients will be much less able to make helpful changes.
Functional behaviour analysis is one essential tool many therapists use in order to better understand what drives and maintains their clients’ behaviour patterns. Also known as an ‘ABC’ chart, it breaks these patterns down into Antecedents (what happens before the behaviour), Behaviours (what exactly they do in these situations) and Consequences (what happens soon after the behaviour is performed). Many clients find this an overly simple way of viewing their problems, however, once they start to use it, they are often amazed at how much insight and self-awareness it gives them.
For example, a client who expressed high levels of anger about minor stressors might, through functional behaviour analysis, reflect on the fact that growing up, she was never given the skills to communicate her discomfort with a situation - yelling was the main way that people in her family expressed their unhappiness. In her current relationship she also found that, if she did not yell, her partner would avoid the issues, so the consequence of not yelling would usually be that the issue was not resolved, but if she yelled, he would be frustrated with her but would also listen. Her partner also often used hugs to calm her down after the interaction, which meant that it often ended in a very comforting way.
The immediate consequences of a behaviour (what happens right afterwards) tend to be the most reinforcing, so even if many unpleasant consequences occur after a behaviour is performed, if the immediate consequences are pleasant (e.g. hugs, relief, avoidance of a difficult situation), then this is often enough to have the behaviour repeat in future. For the person in the example above, the long-term consequences of her behaviour were guilt, relationship difficulties and lowering self-esteem, as well as the belief that there was something ‘wrong’ with her because she often overreacted to minor stressors.
Functional behaviour analysis is a tool I have used with many clients and most have found it extremely helpful. As a result, they better understand themselves and the factors influencing their behaviour, which then assists both of us in identifying what skills they might benefit from learning (e.g. communication and stress management skills, for the client in the above example). It also makes them aware of the conditions that usually give rise to the behaviour, so they can be more mindful when these conditions arise in the future and not allow the dynamics of the situation to shape their behaviour. In other words, it empowers clients to make changes to behaviours that may have previously felt automatic and unchangeable.