What is a behavioural experiment?
A behavioural experiment is a tool used in cognitive-behavioural therapy (CBT) to test how realistic or not a thought, idea or belief is. Thoughts and beliefs are powerful mental events with the capacity to cause emotional distress, especially when the content of the thought is unrealistic and unhelpful. Behavioural experiments aim to challenge these upsetting thoughts by directly testing their reality with an experiment.
We have a multitude of thoughts every day, but many of them are just not true. However, we tend to take them as if they were real. For example, you may have a thought that says that you need to wear a lot of make-up in order to be liked on dates. You may want to test this idea by going on several dates without any makeup to see if that thought turns out to be true. What if it is not true, and you are spending hours and hours making up for no reason? What if people like you with or without make-up? No better way to prove the thought wrong than by exposing yourself to the fear and analysing what happens in reality.
Behavioural experiments can be used to test any type of idea, including worry thoughts (e.g., if I don’t overprepare I won’t make a good presentation at work), o thoughts that make us sad (e.g., I won’t pass this exam) for example. They are used often in therapy for OCD, CBT for bulimia, social anxiety, panic disorder, and other mental health problems.
- Overestimate the probability that bad things will happen to us. We are constantly thinking that there is a danger around the corner.
- Amplify how bad things will be. We think of worse-case scenarios that often never happen.
- Underestimate our capacity to cope and deal with problems
- Disregard other factors in the situation which suggest that things will not be as bad as we are expecting.
As a result of these negative, unrealistic, and extreme predictions we may engage in unhelpful behaviours that can provide us with short-term relief but that are harmful in the long term:
- Avoidance: we may stay away from the feared situation thinking that it will be worse than it would be in reality.
- Safety behaviours: these behaviours are a form of avoidance. They are anything we do that reduce the anxiety in the short-term, but that reinforce the fear. For instance, in social anxiety, a safety behaviour could be thinking of possible excuses we could use to leave a party early in case we feel anxious and want to leave.
- Escaping the situation: we may face the situation but escape as soon as we feel uncomfortable.
These behaviours send the brain the idea that the risk is real, that there is a danger that needs to be taken care of. Also, they prevent us from testing if the risk is so high in real life.
For instance, if you have been invited to a job interview and your prediction is ‘I will blow this interview, I will make a fool of myself and they will think I am stupid’, you may avoid going to the interview. This will help you to reduce the anxiety briefly, however, it reinforces the idea that you can’t do job interviews, and any future job interview or similar situation will trigger anxiety again.
Steps to perform a behavioural experiment
Behavioural experiments can take many forms, like taking a survey to collect proof about whether other people hold a particular belief or facing fear and evaluating what is the outcome.
If needed, to avoid overwhelming the person, the client and therapist can break down a big experiment into smaller, more manageable ones. For example, a final goal may be testing the idea ‘if I go to the gym people will give me looks’, however going to the gym for a full hour can be very distressing at the beginning. This goal can be broken down into going to the gym for five minutes, ten, 20, etc.
These experiments usually involve testing a hypothesis and the process that the therapist and client follow is similar for all types of behavioural experiments. These are the steps:
- Identify the exact idea, thought, or belief the behavioural experiment will test. How strongly do you believe this? (e.g., if I go to the gym many people will give me looks and judge me. I believe this eight out of ten).
- Brainstorming ideas for the experiment and deciding what it will consist of. (e.g., going to the gym for five minutes. Using a machine and then leaving. Analyse other’s people reactions and see if they look at me).
- Writing down the predicted outcome/s (e.g., in these five minutes five people will give me looks and I will feel extremely embarrassed, like nine out of ten embarrassed).
- Predicting challenges and coming up with solutions. (e.g., it may be true that people give me looks. If that happens, I will remind myself that they are not necessarily judging me).
- Conducting the experiment. Remember to become aware of the results, including your thoughts, feelings, and behaviours.
- Analyse the results of the experiment and draw conclusions. What have you learned? (e.g., only two people gave me looks, and I felt a bit embarrassed. However, I was only five out of ten embarrassed, and it was manageable. I can’t know if the two people were judging me, but it didn’t feel that way and they only looked at me for two seconds.)
- Plan the next behavioural experiment if needed. (e.g., next time you can repeat the same experiment, or continue with the next slightly more difficult experiment, going to the gym for 10 minutes).
- Based on the results of the behavioural experiment/s rate how strongly you now believe in your original thought (0-10).
- Come up with an alternative thought, more realistic and accurate than the initial one. Based on the behavioural experiment, rate how much you believe the new thought. (e.g., some people but not everybody will look at me in the gym. I can’t know if they are having judging thoughts or not. However, the more I go to the gym, the more I get used to people looking at me, and I don’t feel so embarrassed anymore. I can go to the gym and work out without feeling too upset. I believe this nine out of ten).
Examples of behavioural experiments
Here we have some examples of behavioural experiments, as used in CBT:
- A businessman often gets very anxious when his emails pile up, thinking that ‘I need to answer every email asap, otherwise people will get angry at me’. He could try a behavioural experiment where he doesn’t reply in a few hours or a day on purpose and monitor how people react.
- A girl with social anxiety has difficulty talking to men, she thinks she will make a fool of herself, and they won’t want to talk to her. Her behavioural experiment consists of talking to five men every week and exploring if they are keen to talk to her.
- A boy with OCD checks multiple times that he has closed the door before going to work, as he fears that someone might break into his house. He could experiment by checking only once and then leaving to work and see if the worst-case scenario becomes real or not.
- A woman with depression doesn’t leave bed thinking that she has no energy to do any activity. Her behavioural experiment includes spending 10 minutes every day going out for a walk to test if she doesn’t have any energy.
- A man wants to challenge himself and put himself in an uncomfortable situation. He thinks he will feel extremely embarrassed and wants to test that. He plans to go on the bus and shout the next station out loud to see if he feels as bad as predicted.
- A boy with body dissatisfaction avoids going to the beach with his friends because of his fear of being judged. He tests his friends’ reactions by going to the beach with them and analysing their responses.
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