Systematic desensitization Health Article

Definition

Systematic desensitization is a technique used to treat phobias and other extreme or erroneous fears based on principles of behavior modification.

Purpose

Systematic desensitization is used to help the client cope with phobias and other fears, and to induce relaxation. In progressive relaxation, one first tightens and then relaxes various muscle groups in the body. During the alternating clenching and relaxing, the client should be focusing on the contrast between the initial tension and the subsequent feelings of relaxation and softening that develop once the tightened muscles are released. After discovering how muscles feel when they are deeply relaxed, repeated practice enables a person to recreate the relaxed sensation intentionally in a variety of situations.

After learning relaxation skills, the client and therapist create an "anxiety hierarchy." The hierarchy is a catalogue of anxiety-provoking situations or stimuli arranged in order from least to most distressing. For a person who is frightened by snakes, the anxiety hierarchy might start with seeing a picture of a snake, eventually move to viewing a caged snake from a distance, and culminate in actually handling a snake. With the therapist's support and assistance, the client proceeds through the anxiety hierarchy, responding to the presentation of each fearful image or act by producing the state of relaxation. The person undergoing treatment stays with each step until a relaxed state is reliably produced when faced with each item. As tolerance develops for each identified item in the series, the client moves on to the next. In facing more menacing situations progressively, and developing a consistent pairing of relaxation with the feared object, relaxation rather than anxiety becomes associated with the source of their anxiety. Thus, a gradual desensitization occurs, with relaxation replacing alarm. Several means of confronting the feared situations can be used. In the pre-computer era, the exposure occurred either through imagination and visualization (imagining a plane flight) or through actual real-life — or so-called in vivo — encounters with the feared situation (going on an actual plane flight). More recently, during the 1990s, virtual reality or computer simulated exposure has come to be utilized in lieu of in vivo exposure. Research findings indicate that mental imagery is the least effective means of exposure; in vivo and virtual reality exposure appear to be indistinguishable in terms of effectiveness.