The contours of my interior sculpture have acquired new characteristics over the course of three years of psychological studies. I approached this “brave new world” with the enthusiasm of a newcomer in search of knowledge and recognition. It was not difficult to get used to the new building of the College of Philosophy, the house of the psychology division, in the part of the city where the heart of Belgrade was pulsating. Even now, when I close my eyes, I sense the energy of this enormous building, which, with its architectural style and size, stands out from the environment in which it grew up like a solitary leave of grass from the asphalt of the city. The numerous students who came from all over Yugoslavia produced a contagious chatter that overwhelmed me every time I entered. I slowly walked up the stairs to the third floor where psychology classes took place in a quieter setting. I felt like I belonged there. Without a bit of nervousness and equipped with a sharp mind, I had the vitality of youth that pushed me full steam ahead.
Psychology of learning
Slavoljub Radonjić was an imposing figure, that invoked fear and trepidation in the students. He was characterized by high intelligence, precision in teaching, and confidence that the topic of his teaching was the foundation of the scientific approach to psychology. There was no way of pulling a fast one on him. We had to respond on the basis of the material he presented to us, without the speculative discourse that characterized the postmodern culture fostered in academia at the time. He insisted on the importance of the experimental method, the observable behavior and the measurability of the changes. From him, I learned behaviorism, a school of thought in psychology that operated at the same time as psychoanalysis but built on completely different foundations. In psychoanalysis, the analysis of the subjective experience and the unconscious part of the psyche is the basic unit on which its theoretical tower is built. In contrast, behaviorism places emphasis on establishing a connection between a stimulus and behavior, under strict experimental conditions. To explain any behavior (adaptive or maladaptive) or personality as a whole, it is important to know the laws of learning. And that's what Professor Radonjic pointed out in his lectures. If we are serious about becoming psychologists and practicing the discipline in the right way, we must know the principles of learning. He was not referring here to the traditional understanding of the concept of learning, which implies that it is a conscious and deliberate activity, for the purpose of acquiring knowledge or skills. If we consider the wider meaning of the concept, to which Professor Radonjić was referring, learning is a permanent or relatively permanent change in an individual created through the influence of the environment or experience. * In this sense, learning happens by itself, involuntarily, automatically, according to principles that we must know.
Do you remember Ivan Pavlov and his dogs? He is considered the father of behaviorism because he was the first to establish the principle of learning known as the conditioned reflex or classical conditioning. While he was working at the Institute of Experimental Medicine in what was then Russia, and later the Soviet Union, and researching the function of the stomach in dogs, he noticed that dogs tend to salivate before the food actually enters their mouths. As soon as it saw food or smelled it, the dog would start to secrete gastric juice and saliva. Pavlov's genius was that after a series of experiments he found that other stimuli not directly associated with food, such as the ringing of a bell, could lead to the same response if initially timed with feeding. Thus, the principle of learning using a conditioned reflex consists of connecting two stimuli, natural such as food (which is also called an unconditioned stimulus) and neutral, such as the ringing of a bell. Learning (classical conditioning) is when a neutral stimulus takes on the characteristics of a natural one and thus acquires the ability to elicit the same response.
This type of learning is automatic, unconscious and present not only in dogs and other animals but also in humans, especially in early childhood. Americans quickly realized the importance of classical conditioning and began experimenting with humans. John Watson, who developed the method of emotional conditioning, which is of great importance for understanding the origin of phobias, stood out in this regard. His most famous experiment was with a nine-month-old boy, known as Little Albert. In the first part of the experiment, the researchers brought him various animals, with which Albert played with no fear. After a few days, they brought the same animals back to him but made an unpleasant hammer noise every time Albert came near the animal. He reacted to the sound by crying. After that, Albert showed fear toward all the animals that were shown to him, as well as toward the objects that resemble them, without the unconditioned stimulus, i.e. the loud noise. The conclusion was that this type of learning, called emotional conditioning, is quickly and easily acquired, slow and difficult to extinguish, and simply and broadly generalized. This experiment was done over 100 years ago and did not raise any ethical questions at the time, but I am sure it would not be permitted today.
Professor Radonjić cited it as an example that classical conditioning is not only important for physiological functions but also for psychological functions, such as emotions, and in this way he wanted to demonstrate that a lot of psychopathological phenomena are not the unconscious expression of an inner conflict or an unsatisfied desire, but the result of erroneous learning. This simple experiment with Little Albert left a deep impression on me. Professor Radonjić continued to give lectures on a number of other experiments, mainly on animals, with detailed and relentless precision. His style and personality were different from the casual approach of some other professors. He was feared by many students, and as a result, they tended to freeze on exams and even quit college. But this didn’t bother me. He demonstrated the importance of a different approach in psychology and its relevance for clinical work. That’s what I valued. With the help of experimental psychologists and behaviorists, the development of behavioral therapy took place. Enviable results have been achieved in the treatment of not only phobias and other anxiety disorders, but also addictions, sexual disorders, psychosomatic conditions, and behavioral problems. Behavioral therapy has a much broader application and a shorter period of treatment in comparison to the exclusivity of psychoanalysis, which is very demanding, costly and time-consuming.
Systematic desensitization is an example of one of the effective behavioral therapies I have frequently used in my work with patients.** It is a type of counter-conditioning based on the hypothesis that if a patient with any phobia learns to relax, and is then gradually exposed to stimuli that trigger a reaction of fear, from the mildest to the strongest, either “in vivo” or in imagination, the cure is achieved in up to 90% of cases. The principle of learning through classical conditioning is thus turned upside down, in that the conditioned response of fear is inhibited in the presence of an incompatible response (relaxation) to the conditioned stimulus, say flying in an airplane.
So far I have written only about one type of learning because of its importance in understanding the formation of beneficial or maladaptive behavioral habits. The formation of associations is related not only to classical conditioning but also to other forms of learning such as instrumental learning in which behavior is modified by reward or punishment. This type of learning, popularized by Skinner, is based on the natural tendency to repeat behaviors that lead to pleasure and avoid behaviors that are accompanied by pain. In this learning, the consequences of behavior determine future behavior. This type of learning has less clinical usefulness but has been applied in education, schooling and animal training.
Now let's summarize. In classical conditioning, the S-R scheme is the unit of analysis in which S stands for a stimulus and R stands for a response. In instrumental learning, there is only R the organism spontaneously emits, and depending on the outcome (positive or negative), R is enhanced or inhibited. Pretty simple. The concepts of consciousness and introspection are not needed. This behavioral psychology takes behavior as its subject and objective methods of observation as its methodology. Professor Radonjić was satisfied. But not all other behavioral psychologists who did not want to completely renounce higher cognitive functions, so they added to the original theory the research of internal states, mediators between S and R, being careful not to fall into the trap of subjectivism. The so-called neo-behaviorists had as a unit of analysis S-O-R where O represents a “black box” about which we know nothing except that it exists. This trend was followed by neo-neo-behaviorists who identified internal states ("black box") as complex thoughts and emotions and thus laid the foundations of cognitive psychology and therapy, which I will not discuss in this text.
Professor Radonjić and his course have helped me understand the importance of applying the scientific method of experimentation and objective observation in the analysis of psychological phenomena. The learning processes he taught serve as an adequate explanation for some forms of behavior, but certainly not for all. The primary objections of behaviorism are simplification and reductionism due to the generalization of animal behavior to humans, radical determinism that abolishes freedom of choice, and neglect of the complexity of higher cognitive processes.
Personality psychology
And now something quite different in Professor Boško Popović's person and work. He looked like a young Freud to me. In my mind’s eye, I see him walking around the classroom, enthusiastic, passionate, interactive, and interested in the students' opinions. The subject of his class was the totality of all that is considered to be the characteristics of an individual's personality, from the cradle to the grave. He told us that personality is a set of psychological traits and mechanisms within an individual that is organized and relatively permanent and that influence the interactions and adaptations of the individual to the intrapsychic, physical and social environment. With admiration and fascination, I listened and learned about the hall of fame psychologists who offered various theories of personality in which they inevitably integrated their own personal experiences and characteristics. Then I became acquainted with Freud and Jung in a deeper way, especially Jung, who was preferred by my good teacher, as well as many other well-known personality theorists.
But the most important gain for me was getting to learn about the so-called third force in psychology, the humanistic one. Unlike psychoanalysis, which created a theory of personality based on the treatment of patients, and behaviorism, which generalized the experimental work with animals to humans, humanistic psychology deals with the healthy personality, emphasizing human uniqueness, potential, creativity, altruism, and rationality. One of the main exponents of this trend was Gordon Allport. That's why we studied his book Pattern and Growth in Personality. *** He developed an eclectic theory of personality. He emphasized the uniqueness of each individual and the importance of the current context for understanding personality. What particularly sticks in my mind is the functional autonomy of motives, a concept considered central to his theory of personality. Functional autonomy of the motives tells how some specific activity that had the function of satisfying a certain motive can become an end in itself. It thus becomes autonomous in relation to the original need it served. The example I remember is related to the activity of a fisherman. The original motive of that activity was related to the use of caught fish as food. For some people that motive changes and gains autonomy when fishing becomes a hobby and purpose in itself. According to Allport, this concept has far-reaching consequences and explains the emergence of interests, values, attitudes, and intentions that help the individual achieve a higher level of authentic maturity and growth. He writes: “A person is mature to the extent that his behavior is functionally autonomous.” *** Allport linked maturity with mental health. For him, a healthy personality accepts responsibility for his life and develops in his own unique way. He identified six basic traits of a mentally healthy person. These are: an expanded sense of one's own self, emotional security and a positive opinion of oneself, a warm connection with others that implies intimacy and compassion, an objective assessment of others, the ability of insight which enables an individual to better understand oneself, and unique life philosophy with a meaningful value system.
Abraham Maslow is the most influential humanistic psychologist. His most famous and long-lasting contribution is related to the hierarchy of human needs. They are composed of five groups, visually arranged in the shape of a pyramid, in which the basic needs are at the bottom of the pyramid and the most exclusive ones are at the top. Let's discuss them from bottom to top. Physiological needs are: the need for food, water, air, sleep, and sex. Safety needs include: personal, emotional and financial security. Love and Belonging needs relate to: friendship, family, and sexual intimacy. Esteem needs consist of: self-esteem, success, respect of others, and recognition of success. At the top are Self-actualization needs such as: morality, creativity, spontaneity, problem-solving, lack of prejudice, and acceptance of facts. **** The basic premise is that the higher needs in this hierarchy become relevant only after all lower-level needs are met. Also, when a need is met, the importance of its motivational role decreases, and another rapidly takes its place.
The need for self-actualization is the ultimate goal of individual development. When an individual satisfies that need, it means that he has achieved the complete development of his capabilities, talents, and potentials. According to Maslow, there are a small number of people who have achieved complete self-actualization. That small group of the chosen have similar characteristics. They: treat life's difficulties as problems that require solutions; have healthy personal relationships and only a few close friends; are comfortable being alone; focus on problems outside themselves; have a clear sense of what is true and what is false; are spontaneous and creative; and are not too strictly bound by social conventions. Maslow used the term metamotivation to describe self-actualized individuals who are motivated beyond their basic needs to explore and reach their full human potential. These are people who are guided by a calling, a mission, or a purpose in life and not by survival needs.
At the end of this review of humanistic psychology, I want to mention Carl Rogers, not because of his humanistic, existentialist and phenomenological theory of personality, but because of the psychotherapy that has had and continues to have an important influence. ***** It is called non-directive or client-centered therapy. It facilitates the tendency to grow and fulfill the potential for self-actualization. His treatment approach was very beneficial for me because I personally cherished the main principles of this therapy. Rogers claims that the most important factor in successful therapy is the therapist's relationship with the client, characterized by the therapist's transparency without hiding behind a professional or personal facade; unconditional positive regard demonstrated by attentive listening without interrupting, judging, or giving advice; and empathy, the therapist's sincere desire to understand and appreciate the client's perspective. He believed that the answers to problems lie with the client, not with the therapist. Accordingly, the therapist's role is to create a supportive, accepting environment in which clients can discover the answers by themselves and experience a transformation that leads to growth and development. The interesting fact is that during the 1970s my wife's parents went to Carl Rogers in California, where they took part in the Human Potential Movement, formed around the concept of extraordinary potential which is untapped in most people. The program was intended to develop this human potential, through which people would live a life of happiness, creativity and fulfillment. But this is not the end of it. It was thought that graduates of the program would direct their actions in society to help others unleash their potential. Both my mother and father-in-law appear to have learned from Carl Rogers, and my experience with them is testimony to this end.
When I think about this subject now, I can freely say that it was the closest to my heart during my three-year studies in psychology because I readily identified with the humanism of both humanistic psychology and its teacher, Professor Popović. He demonstrated this not only in the classroom and at the exam (in my experience he was the only one who had the courage to admit the mistake and correct my grade from nine to ten), but also at conferences aimed at a broader audience. I clearly recall the moment when an attendee in a room full of interested people stood up and began to insult Professor Popović in an incoherent manner. He listened to him calmly, even though a large number of those present shouted and wanted to cast this unfortunate individual out of the room. Our professor opposed it because he realized that the man's behavior was a product of mental disturbance and that an empathic, non-judgmental, Carl Rogers-style approach would be more useful. I admired the professor's ability to remain calm and true to his calling, with the desire to help even at the moment when he was exposed to such an unprovoked outburst of verbal aggressiveness. He was the real deal.
Additional teachings
The three years went by rapidly because they were filled with interesting and enriching topics of study. Whether it was statistics, psychometrics, general psychology, childhood and adolescent psychology or general psychopathology, I was interested in everything. I was like a dry sponge with the will and ability to absorb water/knowledge from this flowing “liquid” environment in which I found myself.
There was another important person I met frequently during those years. His name was well known at the time due to his father, the famous professor of philosophy Veljko Korać, and later on, at the end of the last century and the beginning of this century, because of his prominent political engagement and position. This was none other than Žarko Korać, who was even briefly the president of the country. His signature appears in several places in my student booklet, proof that our paths often crossed. At the beginning of my studies, he was still an assistant professor. He obtained his master's degree in 1976 with the thesis “Empirical-theoretical foundations of ecological psychology” and was promoted to an associate professor. I remember him as a favorite amongst students, usually smiling and communicative, accessible and like us students in clothes and manners. Only one time he lost control, and it was at a club interested in learning more about the new primal scream therapy. The club was run by a psychologist passionate about this therapy who lived and worked in Niš and came to Belgrade to popularize this type of therapy among psychology students. I was in the room when Žarko Korać walked in. The moderator of the club called him, in a rather provocative way, to express himself on this therapy, which he regarded as the solution to all psychological problems. Žarko Korać responded defensively and left the room angry, leaving behind the unpleasant confusion of everyone present. Many years later, while I was already living in America, I learned that he had come to visit a nearby American state. I wanted to see him, but he was already on his way to another destination. Our paths never crossed again.
In the end, I shall mention the only psychiatrist who taught at the College of Philosophy, the famous Professor Milan Popović, known and recognized worldwide for his numerous activities. He was educated at the famous Tavistock Clinic in London, and in many ways contributed to the modernization of psychiatric services in Serbia and Yugoslavia. For me, he was a teacher of General Psychopathology. I remembered him for the elegance of a gentleman, the restraint of a psychoanalyst and the gentle smile that never left his face. He was measured in speech and manners, always patient to explain the psychopathological phenomena present in patients at the Institute of Mental Health where he worked as head of the Center for Psychotherapy and Sociotherapy. It was my first and only encounter with patients during my psychology studies. It will always be remembered for Professor Popovic's ability to demonstrate delusions, hallucinations, thought and speech disorders, physical and psychological symptoms of depression and the unbridled energy of a manic state. In passing his exam with the highest grade, I completed my career as a psychology student in the best possible manner.
Contributions of psychology
My sculpture of a psychiatrist was greatly fashioned through those “psychological” years. I experienced the closeness of kindred spirits, a treasure trove of knowledge that opened before my eyes, an alternative model of understanding the mind that is not based on pathological manifestations, a positive and optimistic look at human nature, and a research methodology applied in a novel way in psychology domain. I am forever grateful to all the teachers and students who accepted me under their wing and thus facilitated my studies of psychology. Understanding the language of psychology has allowed me to successfully collaborate with psychologists and other mental health professionals in my long career as a psychiatrist with ease and appreciation for working together for the betterment of the people who come to us for help.
* Psihologija učenja, Slavoljub Radonjić, Zavod za udžbenike i nastavna sredstva, 1985
** Behavior Therapy Techniques, by Joseph Wolpe and Arnold Lazarus, Oxford: Pergamon Press Ltd., 1996
*** Sklop i razvoj ličnosti, Gordon Olport, Kultura, 1969
**** Maslow, Abraham H. (1943). "A theory of human motivation". Psychological Review. 50 (4): 370–396.
***** Client-Centered Therapy: Its Current Practice, Implications and Theory, by Carl Rogers, Constable, 1951
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