Systematic Desensitization: 3 Steps of Desensitization CBT Psychotherapy and Methods

If at any time during the exercise the coping mechanisms fail or became a failure, or the patient fails to complete the coping mechanism due to the severe anxiety, the exercise is then stopped. When the individual is calm, the last stimuli that is presented without inducing anxiety is presented again and the exercise is then continued depending on the patient outcomes. For someone who is afraid of spiders, he is advised to close his eyes and imagine himself in a room alone with a huge spider. When he feels anxious, he is asked to practice the relaxation exercise, such as deep breathing or deep muscle relaxation.

These four worksheets describe specific methods for gradually exposing your client to aversive stimuli while countering anxiety by practicing relaxation. Systematic desensitization is a type of therapy that focuses on teaching you how to relax in the midst of your fears. Essentially, you’ll learn the skills and tools you need to navigate situations that would have previously felt unmanageable. Remember to stop and use a relaxation exercise when you feel anxious. The goal is to replace the anxious feeling with a relaxed state. You might have to try each step multiple times, and that’s OK.

  • The first fears to be presented are typically the weakest, moving to those that are scariest and hardest to deal with.
  • The problem with graded exposure is that rising anxiety may be experienced as intolerable, and the client may discontinue therapy.
  • In order to try desensitizing yourself to your fears, you first have to know exactly what you’re scared of.
  • Depending on the severity of someone’s phobia, it may require four to 12 sessions in order to meet treatment goals.
  • The most recent of these studies occurring in 1989 as most researchers have moved away from systematic desensitization, preferring exposure therapy.
  • There are a variety of meditation apps that contain guided meditations.

Was effective in reducing trauma-related symptom, the studies suffer methodological problems. The most recent of these studies occurring in 1989 as most researchers have moved away from systematic desensitization, preferring exposure therapy. These two approaches have much in common and emphasize the importance of understanding and working with the actual events of the trauma and the cognitive and emotional responses.

Systematic Desensitization: Why Facing Your Fears Reduces Anxiety

It involves pairing imaginal exposure with relaxation, so that the anxiety elicited by the confrontation with the feared stimuli is inhibited by relaxation. First, the patient is instructed in muscle relaxation exercises. When a state of relaxation is achieved, the feared stimuli are introduced, via imagined scenarios, in the most effective ways to fight alcohol cravings and urges a graded hierarchical manner, with the least anxiety-provoking scenarios presented first. When the patient begins to feel anxious, the instruction is given to erase the screen, focus on relaxation, and begin again. The scenario is repeated until it no longer elicits anxiety, at which point the next scenario is introduced.

With older children and college students, an explanation of desensitization can help to increase the effectiveness of the process. After these students learn the relaxation techniques, they can create an anxiety inducing hierarchy. For test anxiety these items could include not understanding directions, finishing on time, marking the answers properly, spending too little time on tasks, or underperforming.

systematic desensitization

For example, the first level of fear for someone fearful of crowded public spaces may be seeing a crowded public space on a television show. While using the meditation techniques learned, expose the individual to TV scenes of crowded public spaces. This exercise may need to be completed several times before the individual can view the scene and remain relaxed. If they are unable to remain completely relaxed, they should not move on to the next fear in the hierarchy. It typically takes four to six sessions of systematic desensitization therapy to be successful but can require twelve or more, depending on the severity of the phobia.

Relaxation Training

Those who experience improvements with this treatment usually need to complete several sessions led by a trained therapist. Lets learn about this often ignored emotion on this podcast episode. A specific phobia is an excessive fear of a certain object or situation that lasts at least 6 months. But many kinds of exposure therapy take their main principles from systematic desensitization, especially the creation of fear hierarchies. As you feel more at ease with the topic, they may ask you to look at photos of birds while you focus on breathing deeply or practicing another relaxation technique. VR can bridge the gap between imagining your fear and experiencing it in real life.

The process takes you from your imagination to real life exposure. The first phase typically involved deep muscle relaxation exercises. Wolpe assumed that one could not be both relaxed and anxious at the same time. The second phase was hierarchy construction where the client rank ordered stimulus features. The third phase was pairing the stimuli on the hierarchy with relaxation, beginning with the least feared stimulus, until that stimulus no longer produced fear. Then the patient was asked to relax in the presence of the next most feared stimulus.

Posttraumatic Stress Disorder

Previously, it took many years for individuals who experienced trauma, to heal and some were not able to heal at all. Numerous studieshave shown that EMDR therapy is an effective form of systematic desensitization for individuals dealing with mental or emotional trauma. The gradual exposure to stimuli, along with practicing PMR, makes people less afraid as they move to each stage in the hierarchy. If moving to a new stage increases anxiety, the client can return to a relaxed state at an earlier stage. Relaxation can be a part of systematic desensitization, but the more significant component of it is simply repeated exposure to the feared object or situation.

During the process the patient works on remaining calm through muscle relaxation, which helps keep symptoms of anxiety under control. The patient is trained in deep-muscle relaxation and breathing can alcoholics ever drink again? exercises, in order to be able to counteract physical effects of stress, such as a racing heartbeat and sweating. You counteract your anxiety with the relaxation techniques you’ve learned.

systematic desensitization

The therapist and client collaborate to produce a hierarchy of the client’s intensity of response to the stimulus at different levels of exposure to the stimulus. The technique is called systematic desensitization, as the counter conditioning graded exposure proceeds systematically through three phases. The American Psychological Association describes narrative exposure therapy as a treatment approach that helps patients develop a coherent life narrative in which to contextualize traumatic events.

If the patient were able to stay calm while completing the visualization exercise, they could move on to the next fears on the list. Somewhere in the middle of the hierarchy of fears, a step might include having the patient attempt to climb a ladder. If the patient successfully faced that anxious thought, they would then move on to their ultimate fear, for example, to stand on top of a skyscraper and look down. Once completing the entire hierarchy of fears, from visualizing heights to standing on a ladder, the person could tackle their last, biggest fear. The goal of the therapy is for the individual to learn how to cope with and overcome their fear in each level of an exposure hierarchy. The process of systematic desensitization occurs in three steps.

Part 12. Systematic desensitization

There are three distinct components within systematic desensitization treatment. In the first phase, the therapist teaches the client a deep muscle relaxation technique, also known as progressive muscle relaxation as well as breathing exercises. Therapists may teach their clients how to meditate, control their breathing, or how to lower muscle tension. Systematic desensitization has proven to be highly effective in treating anxiety disorders caused by a learned situation as well as specific phobias. It’s important to note that this type of therapy is not effective for treating mental health disorders like depression or schizophrenia. The “Systematic Desensitization” method is by Joseph Wolpe in the 1950s.

He used graded exposure to the stimuli to avoid overwhelming his patients and reinforcing their aversive responses. Systematic desensitization uses counter conditioning to teach a client a new response to the stimulus using relaxation techniques during graded exposure to the stimulus. In this way, the original fight-or-flight response of the sympathetic nervous system is replaced by the relaxation response of the parasympathetic nervous system . Because systematic desensitization involves exposure to fears, you may experience distressing emotions, anxiety, or even panic during the process. Working with a therapist to help you identify coping skills, list and rank your fears, and determine a plan for the best way to begin gradual exposure.

First, you’ll identify the most frightening level of your fear, or the “level 10” fear. You’ll focus on a relaxing scene, picturing it in your mind and concentrating on sensory details, such as sights or smells. This includes guided imagery, which involves someone describing a scene to you. There are three main steps that Wolpe identified to successfully desensitize an individual. Former height phobics should take the high road whenever possible. Advise the patient to continue each self-exposure until anxiety drops by at least 50%.

Anxiety disorders are caused by a unique combination of genetics, your environment, important life events, and learned coping patterns. The physical symptoms of anxiety can be overwhelming and more anxiety-inducing. Here are some examples of how interoceptive exposure can help. The effectiveness of psychoeducation and systematic desensitization to reduce test anxiety among first-year pharmacy students. A 2014 study showed the therapy effectively reduced symptoms of test anxiety among pharmacy students in Malaysia. A 2015 study saw similar findings in high school students from Nigeria’s urban areas.

When the patient has regained a sense of comfort, the exposure resumes. This cycle continues until the patient can tolerate all the stimuli on the fear hierarchy without anxiety. Relaxation training, such as meditation, is one type of best coping strategies. Wolpe taught his patients relaxation responses because it is not possible to be both relaxed and anxious at the same time.

Thus, if the presence of a snake (the anxiety-producing stimulus), which normally produces anxiety, was paired with relaxation , then a reduction in anxiety should occur. Wolpe thought that in this fashion the bond between the fear-producing stimulus and the anxiety response would be weakened or reciprocally inhibited. Wolpe thought that it was important that a hierarchy of fear-producing stimuli be constructed so the individual was not overwhelmed by anxiety early in the process. Starting with the first item on the hierarchy list, help expose the individual to this first level of fear while remaining in a relaxed state.

Systemic desensitization is also similar to applied behavior analysis — both are forms of behavioral therapy. Applied behavior analysis involves systematically encouraging particular behaviors and discouraging other behaviors. Eye movement desensitization and reprocessing is defined as a psychotherapy treatment created to address the distress that stems from trauma. Successful treatment will appear as continual exposure to the phobia in order to desensitize the client until they no longer experience anxiety. In time, the young man was able to tolerate a real bottle of urine in front of him.

They may manage this by indulging in compulsive hand washing until their skin is raw or even avoid using the washroom altogether, leading to additional health problems. Steps could include exposure to a realistic plastic spider in the room, then in their hand. Next, a dead spider and asking the client to touch it with a stick, then with their hand. After that, the client could be exposed to a spider in a transparent container, then asked again to approach the container and touch the spider with a stick.

Based on the principles of classical conditioning, the systematic desensitization technique is proved to be excellent in dealing with different phobias and anxiety disorder such as panic disorder. You can also use neurofeedback therapy if you choose to work with a therapist. Neurofeedback involves tracking changes in your own brainwaves, a form of electrical activity of the nervous system, as you work on calming your body.

Since 1970 academic research on why do old people shake causes of sudden shaking in the elderly has declined, and the current focus has been on other therapies. In addition, the number of clinicians using systematic desensitization has also declined since 1980. Those clinicians that continue to regularly use systematic desensitization were trained before 1986. It is believed that the decrease of systematic desensitization by practicing psychologist is due to the increase in other techniques such as flooding, implosive therapy, and participant modeling.

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