ESSAY

Trends in Psychology

Psychotherapy and the Pleasure Response:

By Robert DePaolo

Abstract

This article discusses the potential importance of the pleasure response as a therapeutic tool, particularly with respect to long term psychological adjustment. Parallels are drawn between underlying factors in psychopathology and the pleasure-pain continuum, as well as discussing cognitive aspects of pleasure that can be beneficial to clients.

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The history of psychotherapy has been typified by a stress-reduction model. Although Freud wrote about the pleasure principle and its primal importance in pre-civilized human epochs, even he espoused that pleasure is something to be compromised and modulated. Indeed he felt that was the primary task of the ego. Subsequent thinkers, including Carl Rogers delved into the positive-creative aspects of experience. Yet Rogers’ therapeutic approach was also pathology-based; his assumption being that the client must resolve conflicts in the form of self-image incongruities to restore psychic stability (1961). While some therapeutic methods went beyond the conflict resolution model, adding in vivo “homework” components to the counseling process (for example the rational and behavior therapies) few clinicians have actually viewed the pursuit of pleasure by clients as a prime focus of therapy.

That is perhaps due to the negative connotations of pleasure which implies risk, guilt and behavioral impropriety. Counselors might question the ethics involved in counseling clients on the pursuit of pleasure. Indeed, to the extent that by pleasure is meant pleasures of the flesh that might be the most prudent course to take. On the other hand the experience of pleasure goes well beyond that into areas that would be ego-syntonic, socially and morally appropriate. Before discussing those, it might be interesting to consider the role of pleasure in the broadest terms; as a staple of life and as a fulcrum in the evolutionary process

One of the more fascinating aspects of evolution involves the process of “symmetry.” For purposes of discussion symmetry refers to any trend, anatomical, behavioral or otherwise, that coincides with another trend to create a higher probability of survival and propagation, ie. fitness. One example of symmetry can be seen in lion’s mating habits. When a new male overthrows a previously dominant male he kills the offspring sired by that male. Whether or not he reasons his way to this behavior, eg… they’re not my cubs, why should I take care of them?... or simply acts on a primal impulse is hard to determine without either anthropomorphizing or underestimating a lion’s intelligence. Interestingly, in response to this the female goes immediately into estrus. It represents a perfect symmetry. She no longer has any cubs, he has the sperm to provide her with cubs so it stands to reason she would tend to ovulate, despite any misgivings she might have about his act of brutality.

As with the male, one could ask whether the lioness is actually deliberating. For example is she at best ambivalent about mating with someone who killed her cubs? is there any contemplation, moral apportionment or pragmatism at work among the neurons within her brain? While lionesses are bright and certainly family-oriented that is unlikely. If contemplation (which always includes more than one choice) were involved, there would be more variability in the mating decisions of lionesses. Some might conclude that this is the “lion-way” and in accord with hormonal dispositions, accede to the male’s advances. Others might reach the conclusion that, despite being in estrus the new male is a rather frightening creature and not her cup of tea. In such circumstances she might reject his advances and seek out another male.

There are numerous examples of symmetry in nature. For example some female frogs reproduce uni-sexually when males are not available. Some animals shift from an r selection pattern of parenting (which involves less attention given to a greater number of offspring) to a k selection pattern (typified by a more careful parenting approach with fewer offspring). Some of these animals can barely be said to be cognitive. They appear to behave in a primarily instinctive manner. Yet they change their behavior in response to conditions they might not even know exist. If these changes in behavior are not governed by cognition or by instinct, then what is the medium by which they change their behavior – more to the point how does symmetry occur?

One answer lies in a phenomenon that pervades all of nature; the pleasure response. It does not matter how big or small the animal’s brain or whether or not it has intelligence as we typically define it. In order to behave it simply needs to have a capacity to perceive and respond to pleasurable stimuli. It don’t have to know the environment is more or less prosperous or that the pride must re-populate at any cost. All that is required is for the environment to send signals to the organism, leading it to behave in ways that produce pleasure and avoid aversions.

The perception of pleasure and pain drives the animal kingdom. In a sense it also drives the evolutionary process. Notwithstanding inherited traits, it is ultimately an organism’s behavior that enables it to survive and propagate because traits must be enacted to be useful. Camouflage coloring in the lion’s coat, is only helpful if the lion crouches in the weeds, approaches its prey downwind etc. The peripheral vision of prey animals is only adaptive if it leads to a rapid escape from predators.

As Ciompi has written (1994) pleasure also drives cognition, perception and emotion, and thus has a universal presence in the formation of the personality. The next logical question is; what constitutes pleasure and pain, and as a corollary, how did the perception of pleasure and pain evolve? Research on the brains of primates and humans has yielded interesting results in that regard. Olds and Milner (1954) first discovered sections of the limbic system including the septum and hypothalamus that seem to regulate these sensations. Their landmark study created a template for modern neuroscientists regarding brain function. Based on their research one could assume (as many have) that pleasure emanates from specific brain circuits and is a localized function. On the other hand some creatures have no limbic brain, yet engage in sexual activity, self defense, socialization also respond to threats. Interestingly, Olds once issued an indirect critique of localization theory, in referring to the fact that organisms virtually without brains learn to approach pleasurable stimuli and avoid aversive stimuli. If indeed the correlation between pleasure and brain mass is weak, the question remains; where does the sense of pleasure and pain come from?

D.E Berlyne (1960) provided a possible answer, which incidentally is similar to the Freudian definition of pleasure and pain. Berlyne refers to the process of brain/body arousal as the prime unit of pleasure and pain. Specifically when a cluster of neurons (regardless of how few) is activated over an extended period of time or too intensely, it will tend create a sense of discomfort. If one thinks of the brain in homeostatic terms, as system with specific functional parameters like the heart, lungs and immune systems, then this makes sense. Prolonged high arousal is not a normal state in the brain or body. Therefore the organism will seek resolution through arousal-dampening mechanisms.

In that context, it appears pleasure is a temporal phenomenon. So too are pain and various states of discomfort. On the other hand when arousal is terminated quickly, such that it jumps rapidly from a state of tension to one of resolution, the neuro-behavioral effect is what we call pleasure. This pleasure response is referred to by Berlyne as an arousal jag. It is an up-and-down response. Since any creature with neurons can experience rapid activation/resolution sequences they can all experience pleasure. That provides a mechanism for learning and motivation in even the most primitive organisms.

Thus pleasure is the language of evolution - a universal prompt as it were - that appears to adhere to a simple paradigm; Whenever electrical activity in brain and body is activated beyond usual parameters of intensity and/or duration the organism is directed toward restoring stasis; not because it has cognition or a sense of “purpose” but because instability in the comparison between pre and post activation leads

to a response geared toward terminating that feeling of discomfort. By the same token, when activation occurs and the response terminates it abruptly, the brief (arousal jag) byproduct of that constitutes a pleasure response.

In applying this idea to psychopathology and treatment, one could conceive of various components of personality in terms of the arousal resolution concept, with the pleasure response being a motivational anchor point for human experience. Without refuting the importance of other phenomena, one could then assume that a prime purpose of the personality is to seek resolution of arousal levels, both to terminate aversions if of long duration or partake of pleasures, if abrupt. This is not a giant theoretical leap of faith with respect to clinical protocol, merely a re-statement of Freud’s idea that the mind, which is, in effect, a physiological organ operates like the other organs of the body. That invites discussion about psychopathology, treatment and the pleasure-pain duality.

Many forms of psychopathology can be seen as a manifestation of instability, or corrective action toward restoration of stasis (Selye 1950), (Lazarus 1966 ), (Keil 2004 ). Consequently, one of the traditional goals of psycho-therapy is to provide information to the client that restores stasis. Yet the question could be asked as to whether insight and/or schemata are sufficient. Such outcomes provide resolution for the client as well as new habits in thought and behavior. However, resolution does not necessarily correlate with pleasure. Since it typically occurs slowly and sequentially it might not provide the client with an affective benefit beyond the aha experience the client might get when he first comes to certain realizations about himself. Pleasure, according to the arousal jag concept is an abrupt phenomenon requiring a fairly rapid shift from high arousal to resolution. Such an experience can only be found in certain circumstances; for example during sex, gambling, and various forms of risk taking (provided they involve safety and closure).

If one believes normalcy consists of mere stability, with schemata and feelings all lined up in rational, functional terms and that periodic pleasure responses are not necessary to the healthy maintenance of the personality, then most current forms of counseling might seem sufficient. If on the other hand one believes that since the pleasure response has guided us through millions of years of evolution and has great significance in the priming of mind and the formation and maintenance of the personality, then perhaps it could be incorporated into current practice.

The question becomes; do we need to experience pleasure to function adequately? As discussed previously, pleasure has negative connotations. Yet it appears to have a very central role in the proper orchestration of the central nervous system – therefore of mind. Research evidence suggests not only that pleasure is crucial in terms of child development, but that deprivation of pleasure plays a role in the onset of psychopathology. Neurological research is particularly interesting in that regard. A study by Jacobs, Praag et al (2000) and Malberg, Eisch et al (2000) demonstrated that neurogenesis (an increase in brain cell growth and development that is rare for most brain sites) does occur in the dentate gyrus,

a brain site designated as a “pleasure center.” In the study, neurons in this section of the hippocampal/limbic structure proliferated with administration of antidepressant dopaminergic medications. Neural growth and innervations arising from pleasure have also been observed by Kempermann, Kuhn et al (1997) whose subjects sought pleasure through aerobic exercise. Thus there seems to be a positive feedback loop in which experiencing pleasure leads to a greater capacity within pleasure centers to experience subsequent pleasure.

The dentate gyrus has also been implicated in the development of long term pleasurable memories that by definition have a lasting impact on mood and the functions of personality. By the same token, a study by Gould, Tanapat et al (1998) demonstrated that the deprivation of pleasure blocks neural growth. Meanwhile Prescott (1975) found that subjects experienced more distress from pleasure deprivation than from short bursts of pain (Prescott 1975). Prescott also found a correlation between pleasure deprivation and violent behavior.

Perhaps even more interesting is the effect of pleasure deprivation on cognition. The limbic system has rich connections to the prefrontal lobes of the cortex. As a result, Ashby, Isen et. al (1999 ) have suggested that pleasure can be derived not on only from somatic processes such as sex and drug use, but through problem solving and other cognitive processes as well. The relationship between cognition and pleasure has significance with respect to the every-day functions of the personality, including the development of schemata, the use of defense mechanisms, attitudes and fortification of the self image. While the problem solving cortex and motivation-inducing limbic system serve different purposes, their manifest pleasure responses might be similar. The arousal jag concept, which involves a strong and abrupt arousal shift appears to operate throughout the brain and the soma. In light of that Ledoux has argued, like Olds, that use of the term “limbic system” might be somewhat unnecessary ((2003).

While idea of an arousal jag was initially proposed by Berlyne subsequent studies have demonstrated its relevance regarding pleasure and affect per se. For example In the Ashby study, rapid alternation of attention set shifts correlated with a feeling of elation. In addition Crikszentmihalyi (1990) found that elation resulted “when attention is invested and realistic goals and skills match the opportunity for action.” Thus the cognitive aspect of pleasure has something to do with shifting arousal levels that accompany attention to task followed by successful completion of the task.

The fact that pleasure is necessary for mood stabilization, can enhance productivity and creativity and by virtue of its cognitive access, can be aggressively pursued with less guilt than typically accompanies the pursuit of somatic pleasures makes it a potentially valuable treatment tool.

Traditional forms of psychotherapy have typically been geared more toward restoring emotional stability and social functioning than toward neuro-behavioral (hedonic) priming. That trend might be worth reconsidering in the future. In fact some, such as Jacobs & Praag (2000) have already begun to think in terms of pleasure-priming as a long term skill that might be just as important to client’s future adjustment as behavior change, rational thinking and self-awareness. To the extent that clients are guided therapeutically toward seeking pleasure in their lives – not through promiscuity, greed or excessive indulgence but through cognition via the active pursuit of challenges tasks and goals in a quest for personal development, the long term effects of psychotherapy might well be enhanced. Perhaps so too will society in general.

The avenues of exploration in counseling would be myriad. One might be Immersion in the arts in a participatory role where the arousal during performance could be relaxed by the immediacy of the audience response. (This also presents a logical argument for the implementation of psychodrama in mental health settings). Others could include a devotion or task focus in areas like astronomy or research and writing. Some clients might be encouraged to join a debating team, others to take appropriate risks via athletic and outdoor endeavors. Travel would be another. Obviously much of this would depend on available resources in the clients’ communities, and on the client’s financial assets. Yet a regular infusion of such experiences could hold promise for sustained mental health, with an effect on existential, social, dopaminergic and neurogenic factors

Would, or should this method replace more orthodox therapies? Probably not - though a comparison study might be interesting. However it could certainly (and comfortably) be incorporated into more traditional methods as a kind of prescriptive methodology for purposes of long term adjustment.

REFERENCES

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