Behavioral Control Theory

To CSGnet.

Would CSG please challenge a theory I've developed?

I developed behavioral control theory, BCT, as a
psychiatrist-psychoanalist treating psychiatric patients. The theory
seemed to work--the patents got well and went on to lead normal lives.
So I then I applied it to normal people--It seemed to work there also
People were able to resolve their conflicts more effectively. I am quite
excited by my theory and eager to present it to CSG in the hope they
will challenge it and so give me a chance to try to defend it. I� m not
so concerned, at this point, in comparing BCT to PCT, rather merely to
find out where my theory is wrong, or right, in the eyes of CSG.

                               Behavioral Control Theory

Behavioral control theory [BCT]] suggests methods of doing things. It
is based on a medical doctor�s need to do things to his patients to
relieve their pain--for example, to mend a broken leg, or stop a heart
attack.

To survive a person must do things--seek food, shelter, safety,
companions, sexual partners. Furthermore he must control what he does.
Submitting to control by other people, or to his passions, or to his
conscience leads to dissolution of his �self,� mental disorder and
death. To �do� something means to cause an effect in the person�s
environment, particularly in people in his environment.

Everyone knows that people like to decide for themselves what to do and
resent being told. For example, � a 46 year old patient says about her
mother, �She has control of me of course, total control. The only way I
could get even would be to kill my self.�

Disagreement and conflict occur constantly in human relationships,
particularly intimate relationships. It is not generally known that, as
my theory holds, a person�s mental health, even his sanity is at stake
in such conflicts. Many people fear the responsibility incurred by
deciding for themselves and prefer to let others decide for them.
Submitting endlessly to control by others ultimately leads to mental
disorder, according to my theory. Deciding for one�s self maintains
mental health. One of the more difficult actions a person takes in his
daily life is to oppose someone he loves and depends on. Doing so annoys
and may alienate the loved one, but he must do so to stay sane. My
theory shows that autonomy is necessary to both preserve mental health
and �love.�

To prove a theory it must be shown that it works. My proof that it
works are the clinical records of 35 psychotic patients and over 200
patients with less incapacitating mental disorders. Furthermore my
patients continue to show me daily that BCT works.

BCT works also for normal people resolving interpersonal conflicts.
I cannot offer direct proof that it works for normal people . However
in medicine, normal is often discovered by study of abnormal. For
example, study of liver disease led to understanding normal liver
function. Similarly study of mental disorder leads to knowledge of
normal mental function, namely to control behavior.

I hope CSG will focus their challenges on BCT�s interpretation of
clinical facts and specific therapeutic actions on my part. Also I hope
CSG will challenge both the theory and proof offered of the theory�s
validity.

Yours

John Appel

···

From: John Appel <jappel21@op.net>
Date: 2/2/'99 1800

[From Rick Marken (990203.2210)]

John Appel (2/2/'99 1800) --

I developed behavioral control theory, BCT, as a psychiatrist-
psychoanalist treating psychiatric patients. The theory seemed
to work--the patents got well and went on to lead normal lives.

The problem with evaluating a behavioral theory in terms of
theraputic success (I think) is that virtually _all_ theories
seem to work in the hands of a competent therapist; psychoanalysis,
group, gestalt, primal scream, behavior mod, PCT, eclectic, etc.
I know of no case where the developer of a theory that served as
the basis for a therapy abandoned the theory because the therapy
failed.

I hope CSG will focus their challenges on BCT�s interpretation
of clinical facts and specific therapeutic actions on my part.
Also I hope CSG will challenge both the theory and proof offered
of the theory�s validity.

I'll be happy to try but I have to know more about BCT. What
are the basic assuumptions of the theory. How does the theory
work? How do I make prediction based on the theory? How do I
determine whether or not the clinical facts support the theory?
What clinicial facts would contradict the theory?

Best

Rick

···

--
Richard S. Marken Phone or Fax: 310 474-0313
Life Learning Associates e-mail: rmarken@earthlink.net
http://home.earthlink.net/~rmarken

Rick Marken wrote:

[From Rick Marken (990203.2210)]

John Appel (2/2/'99 1800) --

> I developed behavioral control theory, BCT, as a psychiatrist-
> psychoanalist treating psychiatric patients. The theory seemed
> to work--the patents got well and went on to lead normal lives.

The problem with evaluating a behavioral theory in terms of
theraputic success (I think) is that virtually _all_ theories
seem to work in the hands of a competent therapist; psychoanalysis,
group, gestalt, primal scream, behavior mod, PCT, eclectic, etc.
I know of no case where the developer of a theory that served as
the basis for a therapy abandoned the theory because the therapy

To CSGnet.

Reply to Rick.

Thanks for your challenging reply to my presentation of Behavioral
Control Theory

As I said in an earlier post, I developed behavioral control theory,
BCT, as a psychiatrist-psychoanalist treating psychiatric patients. The
theory seemed to work--the patents got well and went on to lead normal
lives. So I then I applied it to normal people--It seemed to work there
also People were able to resolve their conflicts more effectively. I am
quite excited by my theory and eager to present it to CSG in the hope
they will challenge it and so give me a chance to try to defend it. I’
m not so concerned, at this point, in comparing BCT to PCT, rather
merely to find out where my theory is wrong, or right, in the eyes of
CSG.

                                                         Behavioral
Control Theory

Behavioral control theory [BCT] suggests methods of doing things. It is
based on a medical doctor’s need to do things to his patients to relieve
their pain--for example, to mend a broken leg, or stop a heart attack.

People do, or try to do what makes them feel good. They remember actions
which made them feel good, or bad and repeat, or avoid repeating them.
They thus build up a repertoire of adaptive behaviors. They, themselves,
control what they do. They anticipate the consequences of their actions
and choose accordingly.

To survive a person must do things--seek food, shelter, safety,
companions, sexual partners. Furthermore he must control what he does.
Submitting to control by other people, or to his passions, or to his
conscience leads to dissolution of his “self,” mental disorder and
death. To ”do” something means to cause an effect in the person’s
environment, particularly in people in his environment.

Everyone knows that people like to decide for themselves what to do and
resent being told. For example, a 46 year old patient says about her
mother, “She has control of me of course, total control. The only way I
could get even would be to kill my self.”

Disagreement and conflict occur constantly in human relationships,
particularly intimate relationships. It is not generally known that, as
my theory holds, a person’s mental health, even his sanity is at stake
in such conflicts. Many people fear the responsibility incurred by
deciding for themselves and prefer to let others decide for them.
Submitting endlessly to control by others ultimately leads to mental
disorder, according to my theory. Deciding for one’s self maintains
mental health. One of the more difficult actions a person takes in his
daily life is to oppose someone he loves and depends on. Doing so annoys
and may alienate the loved one, but he must do so to stay sane. My
theory shows that autonomy--control-- is necessary to both preserve
mental health and “love.”

Proof that BCT works is behavioral and measurable. For example, Leslie,
the patient I told about above, stopped assaulting nurses, stopped
banging her head and started talking to me,--a change to more adaptive,
rewarding behavior. She learned what to do to make herself feel good.
This change was the result of treatment. In our therapeutic interaction
I rewarded her autonomous actions by responding in the way she sought.
For example, when she asked questions I answered her. When she talked, I
listened. This is why she said, ”It’s so amazing that you listen to
me..It’s the most wonderful thing that has happened in my life.”

When she lost control of what she did, as when she assaulted nurses I
had her placed in full physical restraints: arms, legs, head. I thereby
took control of her behavior, though not of her decisions. This is why
she said, “It feels so good to struggle as hard as I want, yet know I
can’t hurt myself or anybody else.”

Well Rick, the above is for starters. I can go on at much greater
length. Am I presenting BCT and evidence for it, according to your
criteria? Shall I proceed, or do you have challenges to the above?

Yours

John Appel

jappel21.vcf (61 Bytes)

···

failed.

> I hope CSG will focus their challenges on BCT’s interpretation
> of clinical facts and specific therapeutic actions on my part.
> Also I hope CSG will challenge both the theory and proof offered
> of the theory’s validity.

I'll be happy to try but I have to know more about BCT. What
are the basic assuumptions of the theory. How does the theory
work? How do I make prediction based on the theory? How do I
determine whether or not the clinical facts support the theory?
What clinicial facts would contradict the theory?

Best

Rick
--
Richard S. Marken Phone or Fax: 310 474-0313
Life Learning Associates e-mail: rmarken@earthlink.net
http://home.earthlink.net/~rmarken

[From Rick Marken (990206.1900)]

John Appel (000206) --

   Behavioral Control Theory
...

People do, or try to do what makes them feel good. They remember
actions which made them feel good, or bad and repeat, or avoid
repeating them.

The problem here is that it is typically impossible to produce
the same result (whatever made you "feel good", in this case) by
repeating the actions that produced that result in the past.
This is because the world changes; things are different each time
you try to produce some result. For example, the action that makes
my coffee perfect is different each morning depending on how much
coffee is in the cup. If I did the same pouring action each morning
I wouldn't consistently get the result (tan colored coffee) that
makes me feel good. I have learned to control the lightness of my
coffee (the result that makes me happy) by varying my actions
(the duration of my pours) as necessary to produce the "feel
good" result (tan colored coffee).

They anticipate the consequences of their actions and choose
accordingly.

They might _anticipate_ the consequences of their actions
(like "tan colored coffee") but they won't _experience_ those
consequences if they "choose actions accordingly". People can't
know, in advance, what the actual consequences of their actions
will be. According to PCT, people vary their actions while
continuously monitoring the state of the result ("coffee color")
so as to bring that result to the desired state ("tan colored")

To survive a person must do things--seek food, shelter, safety,
companions, sexual partners.

Are sexual partners really a "must" for indiviual survival? I
don't think so.

Submitting to control by other people, or to his passions, or to his
conscience leads to dissolution of his �self,� mental disorder and
death.

I don't quite see how that follows from anything you're said. What
if what makes a person feel good is "submitting to control by other
people"? That is, what if the person controls for "submission".
Nothing you've said explains why this would necessarily lead to
dissolution of his �self,� mental disorder and death.

Everyone knows that people like to decide for themselves what to
do and resent being told.

I don't know that. I have delt with people who seemed genuinely
happy to have someone else decide something for them.

Many people fear the responsibility incurred by deciding for
themselves and prefer to let others decide for them.

Ah. So you've met such people too. So now it's everyone - 2 (you
and me) who knows that people like to decide for themselves;-)

Submitting endlessly to control by others ultimately leads to mental
disorder, according to my theory.

What does it mean to "submit to control"? What is being submitted?
What is being controlled?

My theory shows that autonomy--control-- is necessary to both
preserve mental health and �love.�

The concept of control does, indeed, seem fundamental to your
theory. What is "control"? How do I know when a person "has it"
(other than by observing that they are mentally healthy)?

Am I presenting BCT and evidence for it, according to your
criteria?

Sort of. I am still not really sure what the theory is. It
sounds like a puzzling combination of reinforcement theory (people
repeat actions that produce results that feel good) and humanism
(people are autonomous controllers). I base this conclusion on
comments like this:

In our therapeutic interaction I rewarded her autonomous actions
by responding in the way she sought.

It sounds like you are saying that you trained Leslie to be
autonomous by rewarding her autonomous behavior (by "responding
in the way she sought"). It seems to me that if you are the one
selecting her behavior by rewarding it then you are the autonomous
one (controlling for Leslie's "autonomous behavior"), not Leslie.
Maybe we are thinking of different things when we think of "autonomy".

Shall I proceed, or do you have challenges to the above?

As you can see, I have some questions. I don't mean them to be
challenges. But you said you wanted to "find out where my theory
is wrong, or right, in the eyes of CSG." I guess I have pointed
out some of the things that seem wrong to me about the theory.
But maybe theose things are right and I just don't understand.
So feel free to proceed in any way you like.

Best

Rick

···

--

Richard S. Marken Phone or Fax: 310 474-0313
Life Learning Associates e-mail: rmarken@earthlink.net
http://home.earthlink.net/~rmarken/

[from Tracy Harms (19990207.0700)]

John Appel (6 Feb 1999 11:38:28 -0500) --

To CSGnet.

[...] I am
quite excited by my theory and eager to present it to CSG in the hope
they will challenge it and so give me a chance to try to defend it.
I'm not so concerned, at this point, in comparing BCT to PCT, rather
merely to find out where my theory is wrong, or right, in the eyes of
CSG.

I, for one, am quite enthusiastic about turning a critical eye toward
psychiatric theories and practices.

    Behavioral Control Theory

Behavioral control theory [BCT] suggests methods of doing things. It is
based on a medical doctor's need to do things to his patients to relieve
their pain--for example, to mend a broken leg, or stop a heart attack.

Even in the context of your elaborations I find it difficult to be
confident whether BCT "suggests methods of doing things" to the
*psychiatrist*, to the person *attended* by the psychiatrist, or both. I'd
suppose that it is primarily the first of these, for if it is to serve as
an aid to the practice of the psychiatric profession then I'd think it is
the psychiatrist who could be expected to study it for his or her
professional betterment. I'll operate on that presumption unless I'm
contradicted.

The next sentence is much more interesting. You say that BCT is based on a
medical doctor's need to do things to his patients to relieve their pain.
Now it seems to me that any theory is valuable only in the context of a
problem to be solved. As you indicate, medical doctors face problems such
as helping injuries to heal. True also, help necessarily involves taking
action. In PCT terms, the attitude "help is appropriate" indicates a
disruption is present, and behavior flows from this in an attempt to lessen
the disruption of the applicable perception.

If Behavioral Control Theory is an attempted solution to a problem faced by
medical doctors, I'd like to better understand what that problem is. Are
physicians beset by a general difficulty when it comes to a "need to do
things to his patients"? I've heard not a peep indicating that such
trouble exists.

To be frank, I suspect that the key problem at hand is something which
faces psychiatrists alone, not M.D.s in general, and that the "needs" of
general practicioners has been invoked out of a hope to obtain something
that those doctors have which psychiatrists lack. That "thing", I propose,
is a relative lack of moral complications arising in the things they do to
people in their professional role. This will not be found by extrapolating
from activities such as bone-setting and heart-attack-interruption. The
important difference is that routinely the people who do these things do so
with the willing cooperation of the person whose body they act upon,
whereas the fundamental predicament of psychiatrists is that they routinely
are involved with persons who are hostile to their involvement.

This difference will not be erased by examining "helping" actions: Any
action counts as helpful (or not) only by reference to the person who is
allegedly helped. Turning to PCT once more, actions are only behavior if
they are produced to correct perceptual error. Consider an example of an
action, providing a sedative: we can only evaluate it behaviorally in
regard to whose perceptions are being corrected. A host of alternative
possibilities might apply. If the person provided the sedative is
exhausted but frantic with pain or similar discomfort, and has sought the
doctor's assistance in obtaining relief from this conflict, this action on
the doctor's part is a fulfillment of that person's behavior because it is
in accord with their intention. Yes, the doctor's actions are also
behaviors *of the doctor*, but I want to emphasize the manner in which they
are behavior *of the patient*. If I am exhausted by frantic with pain, I
behave in order to perceive the good things which are noticeably lacking.
If I set as a goal the perception of relaxation, then the steps I take
toward that goal are behavioral. Even if I go to another man and say "I'd
like you to help me acheive restfulness" then, if he does help me
accomplish my goal, his action is part of my behavior.

In contrast, if something is done to my body which is not the result of any
attempt on my part to make my life in some regard as I prefer, it is not my
behavior. If it moreover *disturbs* some aspect of my perceptual norms, it
is (prima facie) a problem which I will attempt to remove by means of
behavior. It is then the exact opposite of help.

The infamous difficulty of psychiatry is that it often involves impositions
on one person or another, and the accounts of these impositions are
systematically dishonest. The main difficulty psychiatrists face is in
making plausible the claim that something is helpful when it is opposed by
those who are alleged beneficiaries. The solution to this problem, to my
mind, is to renounce all such attempts. We should we mend our ways; start
calling a spade a spade. This may well result in a division of psychiatry
into two fields, one of which coerces some people for the benefit of other
people, another which strives cooperately with a person for obtaining
benefits for themselves.

Since I recieve only the digest version of CSGnet postings, if I am copied
directly on replies I can respond more rapidly than if I must wait for the
morning compilation. My address is harms@bendnet.com

Tracy Harms
Bend, Oregon

"T. Harms" wrote:

[from Tracy Harms (19990207.0700)]

John Appel (6 Feb 1999 11:38:28 -0500) --

>To CSGnet.
>
>[...] I am
>quite excited by my theory and eager to present it to CSG in the hope
>they will challenge it and so give me a chance to try to defend it.
>I'm not so concerned, at this point, in comparing BCT to PCT, rather
>merely to find out where my theory is wrong, or right, in the eyes of
>CSG.

I, for one, am quite enthusiastic about turning a critical eye toward
psychiatric theories and practices.

Good! I think your experience with and observation of psychiatrists in action
must give you convincing reasons to criticize them with enthusiasm

> Behavioral Control Theory
>
>Behavioral control theory [BCT] suggests methods of doing things. It is
>based on a medical doctor's need to do things to his patients to relieve
>their pain--for example, to mend a broken leg, or stop a heart attack.

Even in the context of your elaborations I find it difficult to be
confident whether BCT "suggests methods of doing things" to the
*psychiatrist*, to the person *attended* by the psychiatrist, or both. I'd
suppose that it is primarily the first of these, for if it is to serve as
an aid to the practice of the psychiatric profession then I'd think it is
the psychiatrist who could be expected to study it for his or her
professional betterment. I'll operate on that presumption unless I'm
contradicted

The next sentence is much more interesting. You say that BCT is based on a
medical doctor's need to do things to his patients to relieve their pain.
Now it seems to me that any theory is valuable only in the context of a
problem to be solved. As you indicate, medical doctors face problems such
as helping injuries to heal. True also, help necessarily involves taking
action. In PCT terms, the attitude "help is appropriate" indicates a
disruption is present, and behavior flows from this in an attempt to lessen
the disruption of the applicable perception.

If Behavioral Control Theory is an attempted solution to a problem faced by
medical doctors, I'd like to better understand what that problem is. Are
physicians beset by a general difficulty when it comes to a "need to do
things to his patients"? I've heard not a peep indicating that such
trouble exists.

I may have misled you by using the word, "need." The word "responsibility"
would be more accurate. As a doctor I am "responsible" for doing something to
relieve a patient's pain.

To be frank, I suspect that the key problem at hand is something which
faces psychiatrists alone, not M.D.s in general, and that the "needs" of
general practicioners has been invoked out of a hope to obtain something
that those doctors have which psychiatrists lack. That "thing", I propose,
is a relative lack of moral complications arising in the things they do to
people in their professional role. This will not be found by extrapolating
from activities such as bone-setting and heart-attack-interruption. The
important difference is that routinely the people who do these things do so
with the willing cooperation of the person whose body they act upon,
whereas the fundamental predicament of psychiatrists is that they routinely
are involved with persons who are hostile to their involvement.

I couldn't 't agree more. Many psychiatrists find themselves primarily
involved in relieving, not the patient's pain, but some else's, usually that
of a distraught family member who has dragged the patient to the
psychiatrist's office, or to a locked mental hospital in which the
psychiatrist works, One can sympathize with the family member up to a point;
but to lock up a patient primarily for the family member's convenience is not
only immoral it is malpractice. Even more shocking is for a psychiatrist to
inject psychotropic medication into an unwilling patient in order to subdue
the patient and make him easier to control.

Just as a doctor must frequently hold down a struggling, screaming infant to
examine it., the psychiatrist must frequently lock up a patient for the
patient's his own good; for example to prevent the patient from killing
himself, or killing someone else. Doing so is not immoral; it is the
psychiatrist 's responsibility. Failure to do so is malpractice and subject to
legal suit. As a psychiatrist , I'll confess it is not always easy for me to
know who is doing what for whom.

This difference will not be erased by examining "helping" actions: Any
action counts as helpful (or not) only by reference to the person who is
allegedly helped.

Look out for people who claim they want to help you. They are dangerous

Turning to PCT once more, actions are only behavior if
they are produced to correct perceptual error. Consider an example of an
action, providing a sedative: we can only evaluate it behaviorally in
regard to whose perceptions are being corrected. A host of alternative
possibilities might apply. If the person provided the sedative is
exhausted but frantic with pain or similar discomfort, and has sought the
doctor's assistance in obtaining relief from this conflict, this action on
the doctor's part is a fulfillment of that person's behavior because it is
in accord with their intention. Yes, the doctor's actions are also
behaviors *of the doctor*, but I want to emphasize the manner in which they
are behavior *of the patient*. If I am exhausted by frantic with pain, I
behave in order to perceive the good things which are noticeably lacking.
If I set as a goal the perception of relaxation, then the steps I take
toward that goal are behavioral. Even if I go to another man and say "I'd
like you to help me acheive restfulness" then, if he does help me
accomplish my goal, his action is part of my behavior.

In contrast, if something is done to my body which is not the result of any
attempt on my part to make my life in some regard as I prefer, it is not my
behavior. If it moreover *disturbs* some aspect of my perceptual norms, it
is (prima facie) a problem which I will attempt to remove by means of
behavior. It is then the exact opposite of help.

The infamous difficulty of psychiatry is that it often involves impositions
on one person or another, and the accounts of these impositions are
systematically dishonest. The main difficulty psychiatrists face is in
making plausible the claim that something is helpful when it is opposed by
those who are alleged beneficiaries. The solution to this problem, to my
mind, is to renounce all such attempts. We should we mend our ways; start
calling a spade a spade. This may well result in a division of psychiatry
into two fields, one of which coerces some people for the benefit of other
people, another which strives cooperately with a person for obtaining
benefits for themselves.

Since I recieve only the digest version of CSGnet postings, if I am copied
directly on replies I can respond more rapidly than if I must wait for the
morning compilation. My address is harms@bendnet.com

Tracy Harms
Bend, Oregon

yours

John Appel

jappel211.vcf (62 Bytes)

Rick Marken wrote:

[From Rick Marken (990203.2210)]

John Appel (2/2/'99 1800) --

> I developed behavioral control theory, BCT, as a psychiatrist-
> psychoanalist treating psychiatric patients. The theory seemed
> to work--the patents got well and went on to lead normal lives.

The problem with evaluating a behavioral theory in terms of
theraputic success (I think) is that virtually _all_ theories
seem to work in the hands of a competent therapist; psychoanalysis,
group, gestalt, primal scream, behavior mod, PCT, eclectic, etc.
I know of no case where the developer of a theory that served as
the basis for a therapy abandoned the theory because the therapy
failed.

I certainly agree proving my theory on he basis of therapeutic success
is insufficient.. I need to show how and why re patients got well. I
will attempt to do so..

jappel212.vcf (62 Bytes)

···

> I hope CSG will focus their challenges on BCT’s interpretation
> of clinical facts and specific therapeutic actions on my part.
> Also I hope CSG will challenge both the theory and proof offered
> of the theory’s validity.

I'll be happy to try but I have to know more about BCT. What
are the basic assuumptions of the theory. How does the theory
work? How do I make prediction based on the theory? How do I
determine whether or not the clinical facts support the theory?
What clinicial facts would contradict the theory?

Best

Rick
--
Richard S. Marken Phone or Fax: 310 474-0313
Life Learning Associates e-mail: rmarken@earthlink.net
http://home.earthlink.net/~rmarken

John Appel said: Submitting to control by other people, or to his passions,
or to his conscience leads to dissolution of his �self,� mental disorder and
death.

DMG: How does this happen within BCT? What is the proposed mechanism?

John Appel said: One of the more difficult actions a person takes in his
daily life is to oppose someone he loves and depends on. Doing so annoys and
may alienate the loved one, but he must do so to stay sane. My theory shows
that autonomy is necessary to both preserve mental health and �love.�

DMG: Teaching a person how to appropriately assert oneself is a common
strategy in many therapies.

Learning how to resolve interpersonal conflicts, especially with a loved
one, is also a commonly taught therapy stategy.

The unique aspect of BCT seems to be the strong claims you are making about
the harmful impact on a person of allowing himself/herself to be controlled
by another person.

If you could specify how these harmful effects occur, then maybe there would
be more to talk about. In the words of Peggy Lee song: "Is that all there
is?"

···

From: David Goldstein
Subject: Re: Behavioral Control Theory (From: John Appel
Date: 2/2/'99 1800)

[from Tracy Harms (19990208.1140)]

John Appel (7 Feb 1999 16:45:15 -0500)

Good! I think your experience with and observation of psychiatrists in action
must give you convincing reasons to criticize them with enthusiasm

Actually, my criticism largely arises from written study. I have very
little direct experience with or observation of psychiatrists in action.

I may have misled you by using the word, "need." The word "responsibility"
would be more accurate. As a doctor I am "responsible" for doing something to
relieve a patient's pain.

Only if you have accepted a patient's request for pain relief. If a
so-called "patient" has in fact not retained you to serve them in this
manner, you have no such responsibility whatsoever. An auto-mechanic has
no responsibility to tinker with anybody else's car unless this is part of
an agreed arrangement. Indeed, nobody has either the responsibility *or*
the *opportunity* to provide aid to a person, in body or soul, without that
person's consent.

I couldn't agree more. Many psychiatrists find themselves primarily
involved in relieving, not the patient's pain, but some else's, usually
that of a distraught family member who has dragged the patient to the
psychiatrist's office, or to a locked mental hospital in which the
psychiatrist works.

I'm glad you appreciate the basic thrust of my concerns.

One can sympathize with the family member up to a point;
but to lock up a patient primarily for the family member's convenience is not
only immoral it is malpractice.

I go much further. I generally refuse to accept locking up *anybody*
against their will except as part of due processes of criminal prosecution.
(I can think of exceptions, but they may be too obscure to elaborate in
this forum.)

Even more shocking is for a psychiatrist to
inject psychotropic medication into an unwilling patient in order to subdue
the patient and make him easier to control.

This is very bad indeed. But I will not condone this if the psychiatrist
merely has a different *motive*. Even if it is done with the very best of
intentions, since it is a violation of the most intimate aspect of the body
of an unwilling person, that person is a victim--not a patient at all.

Just as a doctor must frequently hold down a struggling, screaming infant to
examine it., the psychiatrist must frequently lock up a patient for the
patient's his own good; for example to prevent the patient from killing
himself, or killing someone else. Doing so is not immoral; it is the
psychiatrist 's responsibility.

No. It *is* immoral. A doctor has no need to "hold down a struggling,
screaming infant to examine it", much less do so "frequently". That too is
immoral. Citing one species of atrocious misbehavior provides neither
explanation nor relief from culpability regarding the other pattern of
offense.

Failure to do so is malpractice and subject to
legal suit.

The legal standards are in error for holding anybody irresponsible, in a
professional capacity, for failing to provide something to people who have
not willingly contracted for professional services.

As a psychiatrist , I'll confess it is not always easy for me to
know who is doing what for whom.

I find this statement entirely credible. It very often must involve a
hideous tangle of intentions and incentives.

Look out for people who claim they want to help you. They are dangerous

I'll take your word for it, John.

Tracy Harms
Bend, Oregon

"T. Harms" wrote:

[from Tracy Harms (19990208.1140)]

John Appel (7 Feb 1999 16:45:15 -0500)

>Good! I think your experience with and observation of psychiatrists in action
>must give you convincing reasons to criticize them with enthusiasm

Actually, my criticism largely arises from written study. I have very
little direct experience with or observation of psychiatrists in action.

>I may have misled you by using the word, "need." The word "responsibility"
>would be more accurate. As a doctor I am "responsible" for doing something to
>relieve a patient's pain.

Only if you have accepted a patient's request for pain relief. If a
so-called "patient" has in fact not retained you to serve them in this
manner, you have no such responsibility whatsoever. An auto-mechanic has
no responsibility to tinker with anybody else's car unless this is part of
an agreed arrangement. Indeed, nobody has either the responsibility *or*
the *opportunity* to provide aid to a person, in body or soul, without that
person's consent.

>I couldn't agree more. Many psychiatrists find themselves primarily
>involved in relieving, not the patient's pain, but some else's, usually
>that of a distraught family member who has dragged the patient to the
>psychiatrist's office, or to a locked mental hospital in which the
>psychiatrist works.

I'm glad you appreciate the basic thrust of my concerns.

>One can sympathize with the family member up to a point;
>but to lock up a patient primarily for the family member's convenience is not
>only immoral it is malpractice.

I go much further. I generally refuse to accept locking up *anybody*
against their will except as part of due processes of criminal prosecution.
(I can think of exceptions, but they may be too obscure to elaborate in
this forum.)

>Even more shocking is for a psychiatrist to
>inject psychotropic medication into an unwilling patient in order to subdue
>the patient and make him easier to control.

This is very bad indeed. But I will not condone this if the psychiatrist
merely has a different *motive*. Even if it is done with the very best of
intentions, since it is a violation of the most intimate aspect of the body
of an unwilling person, that person is a victim--not a patient at all.

>Just as a doctor must frequently hold down a struggling, screaming infant to
>examine it., the psychiatrist must frequently lock up a patient for the
>patient's his own good; for example to prevent the patient from killing
>himself, or killing someone else. Doing so is not immoral; it is the
>psychiatrist 's responsibility.

No. It *is* immoral. A doctor has no need to "hold down a struggling,
screaming infant to examine it", much less do so "frequently". That too is
immoral. Citing one species of atrocious misbehavior provides neither
explanation nor relief from culpability regarding the other pattern of
offense.

If you were a doctor, what would you do if a mother brought you an crying infant
with a bad earache? The infant resisted and screamed when you tried to place an
otoscope in her ear? Also, remember the patient, Leslie, when physically
restrained: arms, legs, head all strapped down, said, "It feels so good to
struggle as hard as I can, yet know I can't hurt myself or anyone else." How do
you explain her saying that? I suggest that being unable to control herself, she
welcomed control by me and the nurses who strapped he up

>Failure to do so is malpractice and subject to
>legal suit.

The legal standards are in error for holding anybody irresponsible, in a
professional capacity, for failing to provide something to people who have
not willingly contracted for professional services.

Leslie was brought to me, struggling violently in the firm grasp of her father.
He dragged her to see me because she had inflicted a deep, long cut in her arm
and kept threatening to kill herself. What would you have done if you were me?
Sent her and her father away?

jappel213.vcf (62 Bytes)

···

>As a psychiatrist , I'll confess it is not always easy for me to
>know who is doing what for whom.

I find this statement entirely credible. It very often must involve a
hideous tangle of intentions and incentives.

>Look out for people who claim they want to help you. They are dangerous

I'll take your word for it, John.

Tracy Harms
Bend, Oregon

[From Rick Marken (990209.0830)]

Tracy Harms (19990208.1140) --

No. It *is* immoral. A doctor has no need to "hold down
a struggling, screaming infant to examine it", much less do
so "frequently". That too is immoral.

John Appel (9 Feb 1999)

If you were a doctor, what would you do if a mother brought
you an crying infant with a bad earache? The infant resisted
and screamed when you tried to place an otoscope in her ear?

I think the important point to note here is that it's the
doctor himself who determines whether or not there is a
need to "hold down a struggling, screaming infant to examine
it". The need is not dangling out there in the environment;
rather, it exists as the state of a reference signal in the
doctor. This reference signal is presumably set in the
service of other systems inside the doctor that are
controlling other, higher level perceptions.

So it is not _really_ immoral (or moral) to "hold down
a struggling, screaming infant to examine it". Tracy gives
the impression that doing this is obviously immoral; John
implies that Tracy would find doing this to be moral if
Tracy were the doctor. But, from a PCT perspective, John
and Tracy are just describing the preferred state of the
perception of a recalcitrant infant being examined by a
doctor; Tracy prefers to see no coercion of the child;
John implies that coercion is the right thing to do in
this case.

The fact is that only right wing Republicans know what's
_really_ right and wrong;-) The rest of us must struggle
to do the best we can with all we've got: our own reference
signals, against which we compare what we are perceiving to
what these reference signals say we _should_ be perceiving.
So it is really the doctor him/herself (actually, his/her
control hierarchy) who decides, based on the principles
s/he controls for, whether the perception "hold down a
struggling, screaming infant to examine it" is right or wrong.
It is right if the doctor finds it necessary to set a
reference for that perception in the service of controlling
some higher level perception (like the perception of "being a
good doctor"). It's wrong if the doctor finds it unnecessary
to set a reference for that perception.

The point, again, is that the doctor is completely responsible
for whether or not the perception "hold down a struggling, screaming
infant to examine it" occurs -- whether the
doctor wants to "take" responsibility for it or not.

Leslie was brought to me, struggling violently in the firm
grasp of her father. He dragged her to see me because she
had inflicted a deep, long cut in her arm and kept
threatening to kill herself. What would you have done if
you were me? Sent her and her father away?

That's a tough call. But whatever anyone does (whatever
perception they select for themselves -- from the
perception of Leslie bound and gagged to the perception
of Leslie screaming away from the hospital with her father)
they do it because that is the perception demanded by
their existing hierarchy of goals. At least, that's what's
going on according to PCT.

Best

Rick

···

----
Richard S. Marken Phone or Fax: 310 474-0313
Life Learning Associates e-mail: rmarken@earthlink.net
http://home.earthlink.net/~rmarken

[From Bruce Gregory (990209.1200 EST)]

Rick Marken (990209.0830)

That's a tough call. But whatever anyone does (whatever
perception they select for themselves -- from the
perception of Leslie bound and gagged to the perception
of Leslie screaming away from the hospital with her father)
they do it because that is the perception demanded by
their existing hierarchy of goals. At least, that's what's
going on according to PCT.

In the past I fell back on, "It seemed like a good idea at the time."
Now that I know something about PCT I say, "It must have reduced total
system error."

Bruce Gregory

David Goldstein wrote:

From: David Goldstein
Subject: Re: Behavioral Control Theory (From: John Appel
Date: 2/2/'99 1800)

John Appel said: Submitting to control by other people, or to his passions,
or to his conscience leads to dissolution of his “self,” mental disorder and
death.

DMG: How does this happen within BCT? What is the proposed mechanism?

"I" am what I do. If I don't do, I cease to exist "There is no more me."
Identity depends on self directed action. Action directed, or decided by some
one else does not cause a sense of identity. This is because person does not
feel responsible for consequences of doing what someone else "made" him do. The
same apples to doing what his conscience told him. "Don't blame me. I was just
doing my duty." Also if he loses his temper, he doesn't feel responsible for
what he does. Same with fear. If fear overcomes him and he runs away like
coward, he can say "I couldn't help it," same with lust; date -rape-- "I got
carried way."

Isolation tank experiments show a person promptly begins to lose orientation
for time place and person and soon develops illusions and even delusions, hears
"voices." He returns promptly to his senses when removed from the isolation
tank and restored to his usual sights an sounds and social interactions A
person needs constant interaction with his environment to stay sane. He must
constantly "do things," Otherwise he experience dissolution of identify.

I elaborated BCT somewhat in a recent separate message to CSG, replying to
challenges by Rick. I also gave a sample of my clinical; evidence for the
above.

John Appel said: One of the more difficult actions a person takes in his
daily life is to oppose someone he loves and depends on. Doing so annoys and
may alienate the loved one, but he must do so to stay sane. My theory shows
that autonomy is necessary to both preserve mental health and “love.”

DMG: Teaching a person how to appropriately assert oneself is a common
strategy in many therapies.

Deciding for oneself what one does is not h same as pushing others aound.

Learning how to resolve interpersonal conflicts, especially with a loved
one, is also a commonly taught therapy stategy.

The unique aspect of BCT seems to be the strong claims you are making about
the harmful impact on a person of allowing himself/herself to be controlled
by another person.

If you could specify how these harmful effects occur, then maybe there would
be more to talk about. In the words of Peggy Lee song: "Is that all there
is?"

Tell Peggy this is enough.

Yours

John A

jappel214.vcf (62 Bytes)

Rick Marken wrote:

[From Rick Marken (990206.1900)]

John Appel (000206) --

> Behavioral Control Theory
> ...
>
> People do, or try to do what makes them feel good. They remember
> actions which made them feel good, or bad and repeat, or avoid
> repeating them.

The problem here is that it is typically impossible to produce
the same result (whatever made you "feel good", in this case) by
repeating the actions that produced that result in the past.
This is because the world changes; things are different each time
you try to produce some result. For example, the action that makes
my coffee perfect is different each morning depending on how much
coffee is in the cup. If I did the same pouring action each morning
I wouldn't consistently get the result (tan colored coffee) that
makes me feel good. I have learned to control the lightness of my
coffee (the result that makes me happy) by varying my actions
(the duration of my pours) as necessary to produce the "feel
good" result (tan colored coffee).

Defense of BCT: A hungry man feels better after he eats even if his meal
is not perfect . A person outside in the cold feels better if he comes
inside, even if it's only somewhat warmer inside.

They anticipate the consequences of their actions and choose
> accordingly.

They might _anticipate_ the consequences of their actions
(like "tan colored coffee") but they won't _experience_ those
consequences if they "choose actions accordingly". People can't
know, in advance, what the actual consequences of their actions
will be. According to PCT, people vary their actions while
continuously monitoring the state of the result ("coffee color")
so as to bring that result to the desired state ("tan colored")

Defense: A hungry person can predict that he will feel better if he eats.

>To survive a person must do things--seek food, shelter, safety,
> companions, sexual partners.

Are sexual partners really a "must" for indiviual survival? I
don't think so.

Defense: Touche. Sex partners are necessary for survival of species. I do
believe, however a person is more eager to survive if has sexual a
partner, or partners. Surviving is then moe enjoyable.

Submitting to control by other people, or to his passions, or to his
> conscience leads to dissolution of his “self,” mental disorder and

Defense: Your challenge is correct . I have not yet presented my theory
of how and why control by other people leads to dissolution of "self" So
here goes: "Plato, or was it Sophocles? I always forget which,. said, 'To
do is to be." The other sage said, "To be is to do." Sinatra said '"Do be
do be do." I came upon this idea treating psychotic patients such as
Leslie, who's case I presented in a previous post. You may remember she
was nor only "mad" [mentally disordered] , but "mad' [angry--really in a
killing rage] at her parents whom she accused of both neglecting her and
"making decisions for her" and never "listening" to her. This clinical
observation led to the idea that underneath her rage was fear of losing
her "self", or identify. The greatest fear a person can experience is
dissolution of identity.

Rick, are you with me? The next step is to ask why and how identity is
endangered by domination and neglect? And here Plato reenters the
dialogue. To "be" one must "do." To "be" means to exist, to have a
"self." To "do" means to "act." To "act" means to cause an effect in the
environment, particularly in people in the person's environment. But
still what what does "do" mean? Was Leslie doing something when she tried
to strangle the nurse? When asked why she did it? She said, "I didn't
do it" Emma did it" [Emma was an name she sometimes used for herself].
When asked why Emma did it? She replied, "Because the Black Lord told him
to." [Emma was a male] So here is a double denial of responsibility;
neither Leslie nor Emma had tried to strangle the nurse, and even Emma
could not be blamed, because the Black Lord had told him to. BCT explains
these statements by saying Leslie was not in control of what she did. She
was not autonomous, and so unable to choose or decide what she did. She
was controlled by the "Back Lord,"or by her rage.

Perhaps this enough for now. Your challenges were excellent . Have I
defended my theory thus far? I will return to defense in a later post.

Yours

John A.

jappel215.vcf (62 Bytes)

···

[From Rick Marken (990210.0800)]

Me:

it is typically impossible to produce the same result...by
repeating the actions that produced that result in the past.

John Appel (9 Feb 1999 16:32:22) --

Defense of BCT: A hungry man feels better after he eats
even if his meal is not perfect.

According to your model:

People do, or try to do what makes them feel good. They
remember actions which made them feel good, or bad and
repeat, or avoid repeating them.

My point is that, in general, it is impossible to repeat
a result by repeating the action that produced that result.
Eating a large meal at 7 PM may be the action that made
a hungry man feel better yesterday. Eating exactly the same
meal at 7 PM today (after he has been snacking all day)
will make him feel worse; same action, different result.
I am suggesting that what appears to be a fundamental
assumption of BCT -- that people repeat "actions that made
them feel good" -- is not valid.

I do believe, however a person is more eager to survive
if has sexual a partner, or partners. Surviving is then
moe enjoyable.

I'm with you there!

why and how identity is endangered by domination and
neglect? And here Plato reenters the dialogue.
To "be" one must "do."

I was hoping for an explanation derived from your theory (BCT),
rather than from Plato. Also, I would like to know exactly
what you mean by "submitting to control by other people".

Best

Rick

···

--
Richard S. Marken Phone or Fax: 310 474-0313
Life Learning Associates e-mail: rmarken@earthlink.net
http://home.earthlink.net/~rmarken

From John Appel

Rick Marken wrote:

[From Rick Marken (990213.1040)]

John Appel (990212) --

> BCT suggests that when a person does something to make him
> himself feel good, he also completes a feed back loop. He does
> something to evoke behavior in another person which he perceives
> and enjoys.

OK. Though I think it's not quite right to say that someone
"completes a feedback loop" when he acts to evoke a behavior
he enjoys. The feedback loop is always in place; the person in
this loop is acting to control a perceptual variable (in this
case, a variable aspect of someone else's behavior, such as the
degree to which that person is smiling).

> For example, he kisses a girl, looks into her eyes, feels her lips,
> smells her perfume, hears her gasps of pleasure, all of which make
> him feel good Loop one.

Actually there are several loops here because the lover is
apparently controlling several perceptual variables; the press
of the kiss, the sight of the eye, the feel of the lips, the
intensity of the scent of a woman, the sound of her sighs, etc.

> So he kisses her again, enthusiastically.

This suggests that the perceptions you mention above (the kiss,
the glance, the feel, the scent, the sighs, etc) _cause_ the
lover to kiss the girl again.

Defence of Behavioral Control Theory: No, BCT does not suggest the
perception of the girl's pleasure at being kissed _causes_ the man to
kiss the girl again. The man, himself, controls whatever he does. He
causes the results. His perception of the the girl's pleasure merely
offers him an incentve to kiss the gorl again
   According to BCT no one can _force_ anyone to do anytjing A person
normally learns in childhood that no one, not even its mother can _make_
it do anything. It can always refuse. For example, "No," it says, and
refuses go eat its spinach The child may even spit ithe spinach out,
if its mother puts the spinach in the child's mouth.. Learning it can
always say no, enables the child to choose whether to comply or oppose
control by another person.

The lover kisses in order to produce and maintain the perceptions he

wants; his kisses are not really caused by the perceptions he gets.

Defence: BCT quite agrees; although BCT would suggest somewhat
different wording: he kisses with the intent of causing the girl to
smile again.

Again, actions are not caused; they are part of a control of input
loop.

Defence: BCT and PCT may differ fundamentally abouit causation. BCT is
based on the idea that to do something means: to cause an effect on the
envirronment, partcularly on other people in the person's environment.
It is difficult to conceive of a person, or a world in which nothing
causes anything

I think you have to learn how a control loop works. I, of course,
recommend my demos at http://home.earthlink.net/~rmarken/demos.html.
I think the most important concept for you to understand is the
concept of a _controlled variable_. The actions of a person in a
control loop are not _caused_ by perceptions; they keep variable
aspects of the environment (the aspects of the environment that
are _perceived_) under control. The aspect of the environment
that is controlled by a control loop is called a _controlled
variable_.

Defence of Behavioral Control Theory: Perhaps I was wrong suggesting
that BCT has a feed back loop; certainly I was wrong in terms of PCT.
But at this point I am primarily interested in defending againsr
challenges to BCT. I note Rick's challenges are primarily from the view
point of PCT. .Perhaps Rick, and CSG are only interested, if they are
interested at all, in challenging BCT in terms of PCT. But both BCT and
PCT are theories, not facts. Bye the way, what is the criterion for
proof of PCT?

Yours

John A.

John W Appel , M.D.
University of Pennsylvania. E-mail jappel21@op.net

jappel211.vcf (62 Bytes)

[From Bruce Gregory (990221.1720 EST)]

John Appel 0221

Defense: BCT and PCT may differ fundamentally about causation. BCT is
based on the idea that to do something means: to cause an effect on the
environment, particularly on other people in the person's environment.
It is difficult to conceive of a person, or a world in which nothing
causes anything

In PCT, people act the environment to maintain or alter their perceptions.
This presumably is that you mean by "cause". When I turn up the setting on
my thermostat, I "cause" the furnace to come on, but only because the
thermostat is controlling its input (the temperature). The same is true when
I kiss someone. If I kiss Rick, he may respond differently that my wife
would, for example. But both are attempting to control their inputs.

Defense of Behavioral Control Theory: Perhaps I was wrong suggesting
that BCT has a feed back loop; certainly I was wrong in terms of PCT.
But at this point I am primarily interested in defending against
challenges to BCT. I note Rick's challenges are primarily from the view
point of PCT. .Perhaps Rick, and CSG are only interested, if they are
interested at all, in challenging BCT in terms of PCT. But both BCT and
PCT are theories, not facts. Bye the way, what is the criterion for
proof of PCT?

As you know, you cannot prove a model. The only way to test a model is to
compare its predictions with data. It may be that PCT and BCT predict the
same things, but without a quantitative model of BCT it is very difficult to
tell.

Bruce Gregory

[From Rick Marken (990222.0950)]

John Appel (990221) --

I hope you will agree that Bruce Gregory (990221.1720 EST) and
Tracy Harms (990222.0800) gave some very helpful answers to
your post. I just have a couple of things to add. First,
you say:

both BCT and PCT are theories, not facts.

Actually, much of what we call PCT is not theory; PCT also
describes the _fact_ of control and the _fact_ that purposeful
behavior _is_ control. This (non theoretical) aspect of PCT
is described in the first chapter of my book "Mind Readings".
This chapter is available on the net at:

http://home.earthlink.net/~rmarken/Chapter1.html

Bye the way, what is the criterion for proof of PCT?

The criterion for proof of PCT is the scientific criterion;
experimental test. If the model and the system modeled respond
to experimental manipulations in exactly the same way then
we accept (provisionally) the model as an accurate
representation of the functional characteristics of the system.
But the model is always provisional; if we do experimental
tests where the model and system unquestionably respond
differently to experimental manipulation then we have to be willing to
revise the model.

Best

Rick

···

--
Richard S. Marken Phone or Fax: 310 474-0313
Life Learning Associates e-mail: rmarken@earthlink.net
http://home.earthlink.net/~rmarken