Systematic desensitization
Encyclopedia
Systematic desensitization is a type of behavioral therapy used in the field of psychology
Psychology
Psychology is the study of the mind and behavior. Its immediate goal is to understand individuals and groups by both establishing general principles and researching specific cases. For many, the ultimate goal of psychology is to benefit society...

 to help effectively overcome phobias and other anxiety disorders. More specifically, it is a type of Pavlovian therapy / classical conditioning
Classical conditioning
Classical conditioning is a form of conditioning that was first demonstrated by Ivan Pavlov...

 therapy developed by a South African psychiatrist, Joseph Wolpe
Joseph Wolpe
Joseph Wolpe was born on April 20, 1915, in Johannesburg, South Africa, and died on December 4, 1997, from lung cancer. He is one of the most influential figures in behavior therapy....

. To begin the process of systematic desensitization, one must first be taught relaxation skills in order to extinguish fear and anxiety
Anxiety
Anxiety is a psychological and physiological state characterized by somatic, emotional, cognitive, and behavioral components. The root meaning of the word anxiety is 'to vex or trouble'; in either presence or absence of psychological stress, anxiety can create feelings of fear, worry, uneasiness,...

 responses to specific phobias. Once the individual has been taught these skills, he or she must use them to react towards and overcome situations in an established hierarchy
Hierarchy
A hierarchy is an arrangement of items in which the items are represented as being "above," "below," or "at the same level as" one another...

 of fears. The goal of this process is that an individual will learn to cope and overcome the fear in each step of the hierarchy, which will lead to overcoming the last step of the fear in the hierarchy. Systematic desensitization is sometimes called graduated exposure therapy.

Specific phobias are one class of mental illness often treated through the behavior therapy or cognitive–behavioral
Cognitive therapy
Cognitive behavioral therapy is a psychotherapeutic approach: a talking therapy. CBT aims to solve problems concerning dysfunctional emotions, behaviors and cognitions through a goal-oriented, systematic procedure in the present...

 process of systematic desensitization. When individuals possess irrational fears of an object, such as height, dogs, snakes, and close spaces, they tend to avoid it. Since escaping from the phobic object reduces their anxiety, patients' behavior to reduce fear is reinforced through negative reinforcement, a concept defined in operant conditioning
Operant conditioning
Operant conditioning is a form of psychological learning during which an individual modifies the occurrence and form of its own behavior due to the association of the behavior with a stimulus...

. The goal of systematic desensitization is to overcome this avoidance pattern by gradually exposing patients to the phobic object until it can be tolerated. In classical and operant conditioning terms the elicitation of the fear response is extinguished to the stimulus (or class of stimuli).

Coping strategies

Prior to exposure, the therapist teaches the patient cognitive strategies to cope with anxiety. This is necessary because it provides the patient with a means of controlling their fear, rather than letting it build until it becomes unbearable. Relaxation training, such as meditation
Meditation
Meditation is any form of a family of practices in which practitioners train their minds or self-induce a mode of consciousness to realize some benefit....

, is one type of coping strategy. Administration of an anti-anxiety medicine prior to exposure to the phobia-inducing stimuli is another type of coping strategy. Patients who have serious anxiety that leads to breathing problems might be taught to focus on their breathing or to think about happy situations. Another means of relaxation is cognitive reappraisal of imagined outcomes. The therapist might encourage subjects to examine what they imagine happening when exposed to the phobic object, allowing them to recognize their catastrophic visions and contrast them with the actual outcome. For example, a patient with a snake phobia might realize that they imagine any snake they encounter would coil itself around their neck and strangle them, when this would not actually occur. These patients need to see that not all snakes are large and that most snakes are completely harmless so that they can get over their fear. Research has demonstrated the effectiveness of this technique in helping subjects reduce similar animal phobias.

Progressive exposure

The second component of systematic desensitization is gradual exposure to the feared objects or situations. Continuing with the snake example, the therapist would begin by asking their patient to develop a fear hierarchy, listing the relative unpleasantness of various types of exposure. For example, seeing a picture of a snake in a newspaper might be rated 5 of 100, while having several live snakes crawling on one's neck would be the most fearful experience possible. Once the patient had practiced their relaxation technique, the therapist would then present them with the photograph, and help them calm down. They would then present increasingly unpleasant situations: a poster of a snake, a small snake in a box in the other room, a snake in a clear box in view, touching the snake, etc. At each step in the progression, the patient is desensitized to the phobia through the use of the coping technique. They realize that nothing bad happens to them, and the fear gradually extinguishes.

Organizations

Systematic desensitation is a behavior therapy technique. Many organizations exist for behavior therapists around the world. The World Assocaition for Behavior Analysis offers a certification in behavior therapy http://worldcenterba.com/index.html.

See also

  • Desensitization (psychology)
    Desensitization (psychology)
    In psychology, desensitization is a process for mitigating the harmful effects of phobias or other disorders. It also occurs when an emotional response is repeatedly evoked in situations in which the action tendency that is associated with the emotion proves irrelevant or unnecessary...

  • Sensitization
    Sensitization
    Sensitization is an example of non-associative learning in which the progressive amplification of a response follows repeated administrations of a stimulus. An everyday example of this mechanism is the repeated tonic stimulation of peripheral nerves that will occur if a person rubs his arm...

  • Flooding (psychology)
    Flooding (psychology)
    Flooding is a form of behavior therapy and based on the principles of respondent conditioning. It is sometimes referred to as exposure therapy or prolonged exposure therapy. As a psychotherapeutic technique, it is used to treat phobia and anxiety disorders including post-traumatic stress disorder...

  • Immersion therapy
    Immersion Therapy
    Immersion therapy is a psychological technique which allows a patient to overcome fears .First a fear-hierarchy is created: the patient is asked a series of questions to determine the level of discomfort the fear causes in various conditions...


External links

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