The Role of Extinction in Psychology & Behavior Change

Key Insights

14 minute read
  • Extinction in psychology refers to the weakening or disappearance of learned behaviors.
  • It involves neural plasticity, absence of triggers, and cognitive interventions, leading to reduced responses to learned associations.
  • Techniques like exposure therapy & CBT use extinction to treat anxiety, phobias, & behavioral issues by reducing conditioned responses.

Extinction in PsychologyThe role of extinction in psychology has been discussed by researchers for more than 100 years and remains vital and relevant in understanding our learning and mental health (Milad & Norrholm, 2023).

As a psychology lecturer working with students, I typically describe “extinction” as lowering or stopping a response to a stimulus (Woolfolk, 2021; Eysenck & Keane, 2020).

Consider this example of a possible outcome of extinction: If we issue a command not recently used in training, our four-legged canine friend may look confused and forget how to respond.

On the other hand, in therapy, extinction is typically associated with a positive outcome. As a result of treatment, the client may learn how to manage their fear of flying or reduce anxiety in social gatherings.

This article explores extinction in psychology, uncovering its causes, influences, myths, positive uses, and potential for supporting our clients.

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What Is Extinction in Psychology?

Extinction in psychology can have subtle differences in meaning and is found in various applications. Therefore, there is no single extinction definition in psychology.

It’s been described as “a simple phenomenon with a complex machinery” (Milad & Norrholm, 2023, p. 11). With that in mind, let’s explore several of the most common uses of the term and identify the features they share.

Extinction in classical conditioning

Classical conditioning takes us back to the early 1900s and eminent psychologist Ivan P. Pavlov (Milad & Norrholm, 2023).

The term refers to a process of learning involving the association of two things that happen together, either simultaneously or within moments of one another. For example, if a dog is regularly presented with food when a bell is rung, they will start to drool upon hearing the bell, even when no food is offered (Woolfolk, 2021).

The food is referred to as the unconditioned stimulus (UCS), as it makes the dog drool, known as the unconditioned response (UCR), without any learning.

The conditioned stimulus (CS) is the bell. It doesn’t cause the intended response on its own; it requires learning through association to cause drooling, which becomes a conditioned response (CR).

If the food (UCS) is no longer offered at the same time or soon after the bell is rung, the drooling (CR) disappears. It is extinguished (Woolfolk, 2021; Eysenck & Keane, 2020).

This helpful video from Khan Academy explains classical conditioning and describes extinction in psychology.

Classical conditioning: Extinction, spontaneous recovery, generalization, discrimination

Extinction in operant conditioning

Operant conditioning goes further. One of its leading advocates, B. F. Skinner, suggested that learning is based on the consequences of actions (Woolfolk, 2021).

For example, when a pigeon presses a lever (behavior), it receives some grain (reinforcer or reward).

Positive reinforcement occurs because the pigeon is encouraged by receiving the food to press the lever again. Over time, it is conditioned (Woolfolk, 2021; Eysenck & Keane, 2020).

However, if the reward (the grain) is persistently withheld, the pigeon will not continue the behavior indefinitely. This is also extinction.

Extinction in cognitive psychology

Cognitive psychology uses the term extinction when a patient with a head injury fails to detect a stimulus.

Extinction in therapy

Behavioral extinction in psychology can also refer to the therapeutic technique involving reducing or eliminating unwanted behaviors by limiting the reinforcement that previously maintained these behaviors (Abramowitz, 2013).

Extinction in psychology is often discussed in relation to exposure therapy for anxiety disorders. “The aim of exposure therapy is to facilitate extinction — reduction in the conditioned anxiety/fear response associated with the feared stimulus” (Abramowitz, 2013, p. 549).

One common use of extinction is for treating individuals with anxiety disorders. Individualized strategies and techniques are used to help control or overcome the dysfunctional thinking associated with an event, situation, or object (Milad & Norrholm, 2023).

The common theme across all types of extinction in psychology is that it involves the gradual weakening or disappearance of a learned and often unwanted behavior (Woolfolk, 2021; Abramowitz, 2013).

Why Does It Occur? 3 Causes & Theoretical Explanations

Neural mechanismsWe’ve already seen that extinction in psychology takes several forms. As a result, there are various causes and factors involved.

Let’s consider some of the mechanisms that initiate and impact extinction along with other closely related human abilities, namely forgetting and learning (Caravà, 2021; Eysenck & Keane, 2020; Milad & Norrholm, 2023).

Neural mechanisms

Our brains’ neuroplasticity (its capacity to change and adapt), along with altered neurotransmitter levels and blood flow, accompanies the transformations that result from learning, therapy, and behavioral extinction (Ballesteros, 2022; Milad & Norrholm, 2023).

Neuroimaging identifies that the brain’s response to fear and anxiety extinction is also associated with lowered activity in the amygdala, the part of the brain involved in processing emotions and threat responses (Milad & Norrholm, 2023).

Behaviorism

As with forgetting, extinction in psychology may result from the absence of appropriate cues. Without specific stimuli or triggers, a response or behavior does not occur (Eysenck & Keane, 2020).

For example, if a dentist suggests flossing as a valuable habit, placing the floss on the bathroom sink becomes a helpful reminder. However, if the floss is moved elsewhere (and without an appropriate stimulus or trigger), the individual may gradually stop this valuable habit. The absence of the trigger leads to the extinction of the habit (Eysenck & Keane, 2020).

Cognitive

Extinction in therapy is more complex. After all, it is unlikely that the client has forgotten the response or behavior that brought them to counseling in the first place. Instead, through working with the therapist using interventions, they have become capable of making informed choices regarding their thoughts, beliefs, and reactions (Abramowitz, 2013).

For example, exposure therapy supports the client by helping them modify or challenge their dysfunctional beliefs through repeated exposure to the stimuli they fear. In time, the environmental change reduces their conditioned response to fear (Abramowitz, 2013).

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What Influences Extinction? 14 Factors

There are many factors influencing successful extinction in psychology and therapy that are closely aligned with achieving a positive therapeutic outcome, including the following (DeAngelis, 2019; Kanatouri, 2020):

Building and maintaining a positive therapeutic alliance

Extinction in psychology, specifically therapy, appears to be influenced by the quality of the underlying therapeutic bond. As a result, it is essential for therapists to (DeAngelis, 2019):

  • Create an environment of mutual trust, respect, and empathy where the therapist and client work together as equal partners
  • Treat clients as individuals with specific needs based on gender identity, cultural background, personality traits, etc.
  • Repair breakdowns in communication to support a stronger alliance
  • End therapy as part of the overall therapeutic process, following open and honest discussion

Ongoing, appropriate, and timely support

Online and digital tools offer tailored techniques to promote the possibility of extinction in psychology (Kanatouri, 2020).

  • Timing and frequency can be more flexible, meeting the clients’ needs.
  • Sessions can be arranged before a known trigger (such as an exam) or soon after an incident.
  • Sessions can be organized individually or in groups to offer therapist-to-client or peer-to-peer support.
  • Exposure therapy can be performed within the context of the challenging environment to ensure relevance and identify and understand critical triggers.

Therapeutic approach factors

The following factors are valuable to extinction and closely related to the alliance formed between therapist and client. The therapist should (Ardito & Rabellino, 2011):

  • Be skilled in active listening and capable of using powerful questions, prompts, and activating language.
  • Be able to reach an agreement with clients on their goals, tasks, and working capacity.
  • Display understanding while considering the client’s needs and urgency for change.

Client factors

Research recognizes the importance and impact of client factors in achieving positive outcomes, such as the extinction of an unwanted or harmful behavior.

They include the clients’ (de la Prida, 2021):

  • Expectation of success, which is linked to their hope for improvement
  • Trust in the therapeutic alliance, the treatment credibility, and the therapist’s skills
  • Degree of resistance and reactance toward the treatment

Other factors identified by research as potentially causing or influencing extinction include sleep, sex hormones, stress, exercise, and age (Milad & Norrholm, 2023).

4 Behavioral Extinction Examples & Scenarios in Therapy

Eating disordersBehavioral extinction involves therapeutic interventions for clients experiencing fear or anxiety, and “deliberate, planned, and repeated exposure to what is feared, including objects, situations, memories, images, and body sensations” (Smits et al., 2022, p. 203).

There are many examples of extinction scenarios in clinical contexts in psychology. The process typically forms an essential part of the treatment for clients presenting with various health issues, such as (Smits et al., 2022):

1. Asthma

“Patients with asthma commonly present with panic, generalized anxiety, and health anxiety directly related to fear of asthma” (Smits et al., 2022, p. 186). Medications such as antidepressants are sometimes prescribed to people with asthma at twice the rate of the general population.

Cognitive behavioral therapy (CBT) and exposure therapy have both been combined with behavioral extinction to reduce patients’ fear associated with the bodily sensations that accompany asthma.

Teaching children how to cope with stressful situations and events can remove or reduce negative feelings about asthma. Helping young people handle triggers can significantly improve asthma management and health outcomes.

2. Pregnancy

Pregnancy, particularly delivery, can be a daunting prospect for many women. Studies suggest that 15% of pregnant women have an anxiety disorder. However, appropriate treatment is not always available, and research is limited (Smits et al., 2022).

Therapeutic practices, such as CBT, involving behavioral extinction have proven effective in managing anxiety and reducing stress and depression among pregnant women.

Treatment is performed in both individual and group settings, though the latter may invoke social anxiety, so it must be appropriate to the patient. Online therapy has been shown to increase access and reduce costs; however, further research is required to identify its benefits and limitations (Smits et al., 2022).

3. Anxiety in children

For many, whether as a result of genetic predisposition, brain chemistry, environmental factors, or insecure attachment to caregivers, childhood can be an anxious time. Children experiencing low self-efficacy and anxiety disorders can benefit from cognitive restructuring (Smits et al., 2022).

Behavioral therapy has been used for many decades with children, helping to reduce their fear of objects, situations, or events through repeated and controlled exposure. Each therapy session is planned and adapted to the child, their family, and their living situation.

4. Eating disorders

Eating disorders can take various forms, including binge eating, self-induced vomiting, restricting food intake, avoiding feared food, and using laxatives (Smits et al., 2022).

Despite their various forms, most treatments emphasize the importance of nutrition stabilization.

Exposure therapy has proven successful at treating eating disorders and their related symptoms. Treatment must be carefully planned and consider clients’ specific needs and environments (Smits et al., 2022).

Advantages & Disadvantages

The role of extinction in psychology is closely linked to the treatment model used, such as exposure therapy and CBT. It is typically associated with taking control of the fear or anxiety that is limiting their life experiences.

Here, we explore some of the advantages and disadvantages of extinction in therapy (Abramowitz, 2013; Milad & Norrholm, 2023).

Advantages

  • Extinction is often successful. Exposure therapy is recognized as the “most effective psychological intervention for people with anxiety disorders” (Abramowitz, 2013, p. 548).
  • The treatment is backed up by a wealth of research across various populations.
  • Protocols are well established and documented for a range of conditions, including obsessive-compulsive disorder (OCD), panic disorder, and specific phobias.

Disadvantages

  • Clients may argue that the risks of confronting the objects, events, and situations causing anxiety are too high.
  • Therapists may be unwilling or ill-prepared to implement extinction protocols due to the need to induce fear or anxiety in their clients.
  • Relapse can occur following treatment. However, this can be reduced by ensuring that therapists thoroughly understand the underlying principles.

5 Common Misconceptions About Extinction

conditions with which exposure therapy helpsSeveral misconceptions are associated with treatments involving exposure to feared stimuli and the extinction of unwanted behaviors.

We briefly introduce five such inaccuracies and the response from the research below (Spencer et al., 2023).

  • Success results from habituation alone
    Fact: Successful treatment of anxiety, fears, and phobias is not all down to the individual reacting less to the repeated stimulus (habituation). New learning can help them recognize situations as nonthreatening and, in some cases, beneficial.
  • Extinction violates client expectations
    Fact: The client is not tricked or taken by surprise in confronting their fears. Instead, they are made aware of what will happen and how their treatment will likely progress. While some emotional reactions are inevitable, they are not unexpected.
  • Extinction involves removing memories
    Fact: Treatment does not attempt to hide or erase previous memories, even if they have a negative effect on the client. Instead, a successful outcome involves reducing the conditioned response to a particular stimulus. In doing so, they learn to confront and manage their fears.
  • Medication is the first line of treatment for OCD, fears, and anxiety
    Fact: CBT and exposure therapy are drug-free, and due to their high degree of effectiveness, they are often recommended as a starting treatment.
  • There is a lack of evidence for extinction in psychology
    Fact: Repeated studies confirm that anxiety, fear, and phobias can be successfully treated through therapy where extinction of unwanted behaviors occurs, resulting in the reduction or stopping of unwanted behaviors.

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Helpful Resources From PositivePsychology.com

We have many resources for therapists to support individuals and groups wishing to stop unwanted thoughts and behavior.

Our free resources include:

  • Questions for Challenging Thoughts
    This powerful list of questions helps the client challenge unwanted or unhelpful thoughts.
  • Reward Replacement Worksheet
    Identify existing behavior, its negative consequences, goal behavior, and its potential benefits.

More extensive versions of the following tools are available with a subscription to the Positive Psychology Toolkit©, but they are described briefly below:

  • Habit tracker
    A habit tracker is a tool used to record desired behaviors and provides a visual reminder that supports the repetition and maintenance of new behaviors.

Try out the following steps:

    • Step one: Understand and reflect on the importance of tracking the small choices made over days, months, and years.
    • Step two: Identify the habits to track and add them to the habit tracker.
    • Step three: Perform each habit and track its progress by filling in the daily tracker.
  • The ABC model of helpful behavior
    The ABC model helps analyze why problem behavior occurs by exploring what triggers or reinforces the behavior.

Try out the following steps:

    • Step one: Understand the ABC model: Antecedents happen before a particular behavior occurs. The consequences are what happens after that behavior.
    • Step two: Describe a problem you recently dealt with by acting helpfully.
    • Step three: Describe that helpful action.
    • Step four: Identify and describe the triggers for that way of acting.
    • Step five: Reflect on the triggers, the actions, and their positive outcome.

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A Take-Home Message

Extinction in psychology has various uses across multiple contexts. Yet, they share a common theme: changing, reducing, or removing an unwanted response or a behavior.

Early psychologists exploring learning recognized that association and reinforcement can encourage or modify specific responses to an event, trigger, or environment.

However, when these are removed or not presented for a period, extinction occurs. The response or behavior reduces or stops entirely.

Extinction in therapy is more intentional and often has a clear goal in mind, yet it offers similar results.

Your clients may present with issues regarding anxiety, fears, or depression that are preventing or limiting their capacity to connect with their surroundings and peers. As a therapist, you can work with them to extinguish negative thoughts, feelings, or behaviors and help them overcome barriers to living a full life.

Extinction, in most cases, is closely linked to positive therapeutic outcomes. It suggests that we have supported our clients as they seek more control over their lives and create positive connections with themselves and others that support flourishing.

Ultimately, a clear understanding of the causes of extinction and the factors involved creates a therapeutic alliance where clients face the world with a manageable degree of fear and anxiety.

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Frequently Asked Questions

Extinction in psychology refers to the gradual weakening or complete disappearance of a learned behavior or response. It occurs either when a reinforcement is removed or during therapy when cognitive restructuring has occurred (Milad & Norrholm, 2023).

In classical conditioning, we can think of extinction as occurring when a conditioned response (for example, a dog salivating) weakens or disappears because the conditioned stimulus (a bell) is no longer paired with the unconditioned stimulus, food. (Woolfolk, 2021; Eysenck & Keane, 2020).

No, extinct behaviors may reappear. Spontaneous recovery can occur in specific situations after a period of rest (Milad & Norrholm, 2023).

Neither. Extinction is not positive or negative. It involves removing or reducing a reinforcement that maintains a behavior or reaction (Abramowitz, 2013).

  • Abramowitz, J. S. (2013). The practice of exposure therapy: Relevance of cognitive-behavioral theory and extinction theory. Behavior Therapy, 44(4), 548–558. https://doi.org/10.1016/j.beth.2013.03.003
  • Ardito, R. B., & Rabellino, D. (2011, September 28). Therapeutic alliance and outcome of psychotherapy: Historical excursus, measurements, and prospects for research. Frontiers. https://www.frontiersin.org/articles/10.3389/fpsyg.2011.00270/full
  • Ballesteros, S. (2022). Cognitive plasticity induced in older adults by cognitive training, physical exercise, and combined interventions. In G. Sedek, T. M. Hess, & D. R. Touron (Eds.), Multiple pathways of cognitive aging: Motivational and contextual influences (pp. 340–367). Oxford University Press.
  • Caravà, M. (2021). An exploration into enactive forms of forgetting. Phenomenology and the Cognitive Sciences, 20(4), 703–722. https://doi.org/10.1007/s11097-020-09670-6
  • DeAngelis, T. (2019). Better relationships with patients lead to better outcomes. Monitor on Psychology, 50(10). Retrieved September 12, 2024, from https://www.apa.org/monitor/2019/11/ce-corner-relationships
  • de la Prida, A. (2021, November). BACP. Retrieved September 12, 2024, from https://www.bacp.co.uk/media/14412/bacp-what-works-in-counselling-and-psychotherapy-relationships-gpac004-jan22.pdf
  • Eysenck, M. W., & Keane, M. T. (2020). Cognitive psychology: A student’s handbook. Psychology Press.
  • Kanatouri, S. (2020). The digital coach. Routledge, Taylor & Francis Group.
  • Milad, M. R., & Norrholm, S. D. (2023). Fear extinction: From basic neuroscience to clinical implications. Springer International Publishing.
  • Smits, J. A. J., Jacquart, J., Abramowitz, J., Arch, J., & Margraf, J. (2022). Clinical guide to exposure therapy: Beyond phobias. Springer International Publishing Springer.
  • Spencer, S. D., Stiede, J. T., Wiese, A. D., Guzick, A. G., Cervin, M., McKay, D., & Storch, E. A. (2023). Things that make you go HMM: Myths and misconceptions within cognitive-behavioral treatment of obsessive-compulsive disorder. Journal of Obsessive-Compulsive and Related Disorders, 37, 100805. https://doi.org/10.1016/j.jocrd.2023.100805
  • Woolfolk, A. (2021). Educational psychology. Pearson.

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