Desensitization

Systematic Desensitization (SD or Desensitization) is defined by Wikipedia as a type of behavioral therapy used in the field of psychology to help effectively overcome fears, phobias, and other anxiety disorders. More specifically, it is a type of Pavlovian therapy developed by a South African psychiatrist, Joseph Wolpe.

To begin the process of systematic desensitization, one must first be taught relaxation skills in order to control fear and anxiety 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 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.

In the early 1900's Russian physiologist Ivan Pavlov used dogs in studying the concept of classical conditioning. Pavlov knew that a dog salivates when eating. In his experimentation, Pavlov began to present a neutral stimulus, such as signal light or bell, before feeding the dogs. Obviously, the signal had no noticeable effect on the dogs’ salivation. But Pavlov kept the signal on when the dogs were being fed (and actively salivating), and, over the course of time, Pavlov found that the signal alone, even without his offering food, gradually caused the dogs to salivate.

So, in classical conditioning an unconditioned stimulus (food) leads to an unconditioned response (salivation), a conditioned stimulus (light or bell), when paired consistently with the unconditioned stimulus (food) leads to a conditioned response (salivation) similar to the unconditioned response (salivation). Interestingly enough, there’s a reverse side to classical conditioning, and it’s called counterconditioning. This amounts to reducing the intensity of a conditioned response (anxiety, for example) by establishing an incompatible response (relaxation) to the conditioned stimulus (a snake, for example).

Through his experience in the late 1950s Joseph Wolpe developed a treatment program for anxiety that was based on the principles of counterconditioning. Wolpe found that anxiety symptoms could be reduced (or inhibited) when the stimuli to the anxiety were presented in a graded order and systematically paired with a relaxation response. Hence this process of reciprocal inhibition came to be called systematic desensitization. Wolpe's    Systematic Desensitization program, as a practical application of his theories, proved to be highly successful in the treatment of neurotic anxiety.

Many researchers have since concluded that “exposure” to the feared object or situation is the critical factor in treatment.

Specific phobias are one class of mental illness often treated through cognitive-behavioral therapy and the process of Systematic Desensitization (SD). When individuals possess irrational fears of an object, 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. 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).

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, is one type of coping strategy. Patients 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 psychotherapist 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.

The second component of systematic desensitization is gradual exposure to the feared object. 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.

Research has shown that systematic desensitization can be effective in treating fears, phobias, other anxiety disorders, and a wide variety of other mental health and behavior problems.  The effectiveness of systematic desensitization does not appear to depend on the intensity of your anxiety or problem, the duration of your anxiety, or on whether the anxiety was acquired suddenly or gradually.

The more you understand about systemic densensitization and other therapeutic approaches, the better you can cope with mental health problems. Reaching out for information and assistance can help you live a healthier and more fulfilling life. People who suffer from mental health problems can get help from a mental health professional such as a psychologist, psychiatrist, or clinical social worker. For more information about Systematic Desensitization and other therapeutic approaches, please click on the linked websites listed below.

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