Systematic Desensitization

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Systematic desensitization is a behavioral therapy that is used primarily to treat phobias (fears). The technique was developed developed by Joseph Wolpe (1966); and it involves learning how to relax while gradually being exposed to a feared object or situation. Common phobias include fear of various animals, heights, blood, enclosed spaces, flying, and water, and systematic desensitization can be applied with any of these fears.

Treatment of the phobic client involves

  1. training in a relaxation techniques such as progressive muscle relaxation, relaxing imagery, or medication;
  2. the client’s creation of an anxiety hierarchy, which is a list of feared situations, ordered from least fear inducing to most fear inducing; and
  3. pairing the relaxation with the feared situations, beginning with the least fear inducing and gradually ending with the most fear inducing.

The idea is that after treatment, the client will have a relaxation response when encountering the formerly feared object or situation rather than a fear response.

Suppose a client is afraid of snakes. First, the client will be trained to relax. Next, s/he will produce an anxiety hierarchy, which might look something like the following:

  1. I’m in a room that has an aquarium against the far wall. A snake is inside the aquarium. (least feared)
  2. I’m in the room with the snake in the aquarium, and the snake is hissing.
  3. I’m watching a documentary about snakes.
  4. I’m watching the scary scene in True Grit (a John Wayne movie in which a character gets bitten by a rattlesnake).
  5. I’m inside my house and saw a huge snake outside.
  6. I’m outside, and a snake slithered within a few feet of me.
  7. My cat brought what appears to be a dead snake into the house.
  8. A snake is loose in the room in which I am sitting.
  9. A snake slithered over my foot.
  10. A snake is crawling on my neck. (most feared)

After constructing this hierarchy, the following procedure is implemented. The client is instructed to relax. Then, the client is exposed to situation 10 (least feared) on the anxiety hierarchy.

This exposure can be real or in vivo (imagined). If the client is exposed to situation 10 and remains relaxed, the therapist will instruct him to move to situation 9. If the client becomes anxious at any point, s/he self-induces relaxation, or the therapist may induce relaxation.

With each success, the client moves up the hierarchy toward situation 1 (most feared). Systematic desensitization may be of short duration, involving only 6 or so sessions, or longer lasting, up to 100 or more sessions, depending on the severity of the phobia, the number of phobias from which the client suffers, and other factors. This therapy is an effective treatment for phobias and is associated with improvement in most sufferers (Wiederhold & Wiederhold, 2005).

See also:
  1. Wiederhold, B.K., & Wiederhold, M.D. (2005). Specific phobias and social phobia. In M.D. Wiederhold & B.K. Wiederhold, Virtual reality therapy for anxiety disorders: Advances in evaluation and treatment (pp. 125 – 138). Washington, DC: American Psychological Association.
  2. Wolpe, J., & Lazarus, A. A. (1996). Behavior therapy techniques: A guide to the treatment of neuroses. London: Pergamon Press.