Should punishment play any role in therapy?

Should punishment play any role in therapy?

I've said no. There's been enough of that IRL and if it appeared in therapy I would be out of there. I think though that this may turn into an interesting discussion - thanks CE

Could you elaborate on this question with an example or situation? I want to answer "no", but I'm not exactly sure what you mean by "punishment".

Punishment as in the kind you uhh....want....and are....ummm...ahhhh.....willing to pay for (really no puns intended) or something else?

P.S. I like you CE and don't want to see you unhappy (ref: your other thread) -- so yeah, I'm all for you getting help.

P.P.S. Gin and Amaretto are a dangerous combination for me (cue multiple edits).

Some might say therapy is punishment.

Eta: my mind also went in the direction ay's did.

I'm not sure about what you mean by punishment. I see lots of things my T does as punishment but he insists thety are boundary tightenings on his side.

I hesitated between "no" and "it depends," because I want to say no but then I think about how if I promise my T I won't and then I do, she should hold me accountable. But I answered no because she can hold me accountable without punishing me, whether that be through guilt or termination or whatever. If she did punish me somehow, that ultimately would harm me and she wouldn't be a good T for that.

not sure... i think positive and negative reinforcement work. there are abusive and other ways of doing those things though

I am an adult. My therapists treat me with adult respect. They may discuss natural consequences of my actions with me -- for instance, if I am not minding my sleep hygiene, they will remind me that the natural consequence of that for me is that lack of sleep can throw me into hypomania which can start an episode that, in my case, almost inevitably leads to a crash into serious depression. That isn't punishment. That's just an adult conversation about actions and natural consequences. They might encourage me to call my pdoc for sleep meds to cut the cycle off before it gets set in motion, but there is no punishment involved. I can't think of an instance where they "punished" me for something that I did or didn't do. I wouldn't have continued to see them if they did; I'm not a child.

my ex therapist certainly thought so. if i didnt do what she wanted, if i didnt stick to my meal plan (i was anorexic) etc, she would refuse to meet with me (she knew i really valued my time with her), she would refuse to talk to me,etc. She treated me like a rebellious child (i was not- i always tried to cooperate). At the time. i thought she was right. Now i know better

I want to say absolutely not, as someone who was raised by a narcissistic parent, where I couldn't (and still can't) seem to do anything right.

However, as a psych and social work student, I have a slightly different answer.

Not punishment in a cruel way, ever. But, for someone who never had an appropriate parent child relationship, some punishment can be good. I hesitate to use that word, tho, and lean more toward consequences.

Sometimes, therapy turns into a parent child relationship. It is where people learn how to properly navigate life and the relationships in it. If they never had proper consequences, either too lenient or too harsh, getting consequences from a T can be really beneficial.

This is why some Ts set rules on contact btwn appts, for instance. Without set boundaries or expectations, consequences don't have the desired effect.

Pushing boundaries is often a way to see if the T will react the way the parent(s) did/would. Sometimes, people in therapy need someone, anyone, to stand up and say "I will not allow that." Often, the only person they have that is capable of that is their T. It is, technically, modelling healthy boundaries and behavior.

I think setting and maintaining healthy and appropriate boundaries is totally different than punishment though. Boundaries setting is, well, healthy and appropriate, while punishment in therapy is not okay at all. In my opinion anyway.

Punishment scares me.

Correction with understanding and guidance is different. I never knew that growing up.

I'm learning different ways to see things and process things. To me that is correction.

I agree, but to some people, the word punishment is synonymous with consequence. Punishment is a different word for a negative consequence, in psychology. I think, though, the severity of the punishment itself may be more what is in question here.

(Also, I seem to think there is a poll attached to this thread. I almost never get on PC on a computer. Always on Tapatalk, and I cannot see a poll in this thread. Is there one?)

Absolutely not! Even with my children I have never seen any reason to punish them. I generally think that when one person punishes the other (be this other an adult or a child) then the reason is always that this person just cannot handle the situation.

ETA: To me a punishment is very different from natural consequences or healthy boundaries.

If it's ok, may I ask for someone to give a definition of punishment as apposed to correction? That's a big thing with me right now. I didn't grow up knowing what correction was without punishment.

I think I would want to say no. But as others have said, it depends what you would label as "punishment", and the therapist and the client might have different perceptions of this.
For example, I think that in DBT, the T will usually speak to the client by phone outside of session if needed, but if the client harms themself, then the T will not speak to the client for a certain amount of time (I think a few days).
This could be seen as something cruel, and a "punishment", and the client might perceive it that way.
But the reason given is that DBT is to help people stop using harmful impulsive behaviour such as SI, because that will be better for them and for their life and their future. And so if the therapist spoke to the client on the phone straight after SI, they might be inadvertently rewarding a way of the client communicating upset through SI, whereas the therapist is trying to help them learn new patterns and healthier ways of communicating their pain.
I've never done DBT therapy, SI is not usually an issue for me, but a few times when it did happen, my T didn't refuse to speak to me. And if he had, I think I would certainly have perceived that as a punishment.
But on the other hand, in the cold light of day, I can understand why DBT therapy would work that way, and it makes sense. I don't think therapists would frame it as a punishment, but rather that they need to be careful to avoid reinforcing unhealthy patterns.

I think responsibility yes, but punishment no. Responsibility, as in, my actions might have consequences and it's my responsibility to accept that and own it. I think punishment might do the opposite, take ones power away from the real situation. Instead of facing the reality of your actions, you become more invested in the punished-punisher relationship dynamic.

I punish myself all the time

Psychological definition of Punishment (which is what I was using in my post)

"In operant conditioning, punishment is any change in a human or animal's surroundings that occurs after a given behavior or response which reduces the likelihood of that behavior occurring again in the future. As with reinforcement, it is the behavior, not the animal, that is punished."

In psychology, punishment can be negative or positive, just like reinforcement.

Punishment is used to change a behavior, reinforcement to keep it. Negative means to take something away, and positive means to add something.

I was using this definition when I gave my long answer.

The beginning of my post, when I said I want to say no, I was going with the laymen definition of punishment, as being a bad thing and not pleasant.

I wanted to explain, because if a T or psychologist or psychiatrist uses the term, one might need to ask for clarification...

Thank you for explaining this.

So I'm interested to know - in the DBT example I gave in my post, is that punishment in the psychological sense, do you think?

Yes. The T is taking away the crisis call, for a period of time, because the client acted in a behavior that they have been working on not doing. It's not meant to make the client feel bad for doing it, it is to not reinforce the behavior further. If the T takes the call, the client may see the conversation as more of a sympathizing than a skills training. DBT is skills training first, not really process oriented.

No. I think fantasies of punishing the other can inform the therapy or even be explored together to find meaning, but it shouldn't be acted out. I can't imagine that ever being therapeutic. I think it would be abusive no matter who is hypothetically doing the punishing.

On the other hand, couldn't the therapist not taking the call amplify the feelings that led to the self injury in the first place, leading to more self injury?

I've never done that kind of self harm, and am not that informed about it as others, so I'm wondering if you've considered that possibility.

There's also controversy as to what helps with DBT and certain conditions and what doesn't; things later proven to be more harmful. Hospitalizations for one. Well, depending on your source...

I read about operant conditioning in the book Skinner's Box; it really freaked me out, so I couldn't help but make a comment about it. It's what's used for rat experiments. Not sure it's safe for humans.

I don't think punishment, no matter how you define it, should play a role in therapy. I'm an adult and do not need to be punished by someone else (I do enough self-punishment as it is). I think that therapy should be built on mutual respect and understanding. Punishment kind of implies a power imbalance with the therapist holding power over the client. Personally, I would never work with a therapist that wanted to hold power over me.

I understand the use of punishment in operant conditioning and even with that definition - something added or removed which makes a behavior less likely to occur - I just don't see how it could be effective in therapy. I think that a therapist pointing out potential consequences can be helpful and respectful. A therapist taking it upon themselves to add an aversive or remove something of value to make a behavior less likely to occur has a huge potential to backfire spectacularly when dealing with someone with a mental illness.