In 1993, Murray Sidman wrote what I believe is one of the most important articles in the field of positive behaviour support. Entitled “Reflections on Behavior Analysis and Coercion” (Sidman, 1993) presents an argument for non-coercive behavioural interventions that is unrivalled. Sidman says that the only thing coercion and punishment teach is escape and avoidance. The difficulty, Sidman says, is that we live in a coercive culture with traffic laws promising punishment if we break the rules, and in most families coercion is used to manage the behavior of children. We grow up learning to use coercion to accomplish our goals.
In my own journey, I started teaching “Behavior Modification for Nurses” in 1982 at what is now Hawkeye Community College in Waterloo, Iowa. Looking back on what I taught, I am burdened by the knowledge that I was really good at coercion and the use of coercive language to teach and justify the use of force to gain behavioural compliance for the sake of safety.
When “Towards a new technology of non-aversive behavior support” (Horner et al, 1990) was published, I remember thinking that this won’t last. I was convinced that the tried and true methods of a mix of reinforcement and punishment coupled with physical and mechanical restraint as a “last resort” were absolutely the way to go.
In 1999 one of the individuals I supported needed to have a pacemaker put in, and I was told that he had to be maintained at a calm state, and absolutely could not be restrained, for 6 weeks. At that point, we could not go 6 days without using restraint, but I re-evaluated everything and made changes to his physical environment, the staffing ratios and the positive reinforcement schedule. To my surprise, we were able to go 6 weeks and then 6 months without using restraint, and I realised I had spent over 20 years of my professional career focusing on control and not support, on coercion and not on inviting behaviour change.
It took me several years to learn how to do Positive Behaviour Support (PBS), and longer to be able to integrate the concepts of Trauma into a PBS in a way that was not just trauma-informed, but trauma-centred. Understanding the neurobiological impact of trauma and how these experiences shape us has to be, in my opinion, at the centre of the discussion around behaviour change. Part of this move away from coercion is understanding the experiences of trauma as being central to the development of behaviours that begin as functional adaptive responses to dysfunctional environments, people and experiences. These behaviours serve as barriers against the harmful environments and people in the lives of children and adults. Over time, these barriers become the primary safety behaviours for the individual, and become dysfunctional, or challenging, or of concern, when the individual is in a safer environment, in safer relationships, and has safer experiences.
Every year I get better and better at moving away from coercion. Every year I get better and better at supporting people to improve their quality of life, not just the quality of their behaviour. Supporting people without the use of coercion requires a different way of thinking, and the word “invite” seems to be the most appropriate way of describing what we are doing, asking instead of telling, seeking cooperation instead of compliance. When we invite people to change their behaviour, they have the power to accept or reject the invitation. When the people we support have the power to accept or reject, coercion becomes difficult if not impossible to do.