Systematic Desensitization Therapy For Treating Phobias
When severe anxiety disrupts daily life, it could signal a more serious issue, like anxiety disorders or a severe phobia, such as a fear of flying. Various treatments, including systematic desensitization and virtual reality exposure therapy, are available for diverse phobias. In this article, we will delve into the evidence-based systematic desensitization process and its components.
What is a phobia?
A phobia is defined as an irrational fear or an aversion to something. There are a wide variety of phobias, from insects and death to numbers (aritmophobia) and natural disasters. A phobia, regardless of its specific object, can disrupt daily life and potentially result in panic disorders, depression, and other mental health issues if left untreated.
An effective behavioral therapy for addressing phobias is systematic desensitization, which utilizes the classical conditioning and counter conditioning process. This treatment involves gradually exposing the individual to the feared object or situation in a controlled and safe environment while simultaneously engaging in relaxation techniques to counteract the anxiety response. Experimental desensitization is a form of this therapy involving real-life exposure, while imaginal desensitization involves visualizing the feared object or situation. This therapy has been shown to be particularly effective in PTSD treatment and can help individuals regain control over their lives by reducing the severity of their phobic reactions.
There are three common types of phobias in the realm of abnormal and social psychology:
Specific: These phobias tend to have a very specific “trigger,” such as seeing a spider, experiencing test anxiety, or seeing the color blue.
Social: Fear of public humiliation or social gatherings is sometimes considered a social phobia or social anxiety.
Agoraphobia: Agoraphobia is a fear of being in open or crowded places or a place that you can't escape from. People with agoraphobia may also fear leaving their homes.
People with any of these types of phobias may experience uncontrollable anxiety when encountering their fear. They may do everything that they can to avoid that fear in their life.
In general, these individuals may recognize that their fear is irrational or exaggerated, but they often still can't relax or stop the intense feelings associated with thinking about their fears. Panic, anxiety, nausea, dizziness, rapid heartbeat, staggered breathing, chest pain, flushing, trembling, and dry mouth are just a few of the unpleasant symptoms that might occur with a phobia. When this occurs, it may help to seek phobia therapy from a licensed therapist with experience treating phobias.
What is systematic desensitization?
Systematic desensitization treatment is designed to gradually expose an individual to their phobia while they engage in relaxation response techniques and deep breathing exercises. The concept is that combining these elements may help the person learn to stop associating their phobia with the physiological symptoms of fear, aiming to ultimately eliminate the symptoms altogether.
The work is facilitated by a therapist trained in exposure therapy. The process typically begins with gradual exposure, starting with situations that provoke minimal anxiety and progressing to more anxiety provoking scenarios. The treatment can be extensive, particularly if the fear is more intense or has persisted for a longer duration.
The process of systematic desensitization
The therapist typically initiates the process by instructing the client on muscle relaxation techniques to employ when confronted with a situation that triggers their phobia. These techniques can encompass progressive muscle relaxation, meditation, deep breathing, visualization, and more. After the individual learns to calm themselves under stress, the therapist may carefully help them in discussing their fears and anxiety in detail. This could involve gradually exposing their phobias using a fear hierarchy or anxiety hierarchy.
For instance, if a person experiences childhood water phobia, the first and least fear-inducing aspect may be looking at a picture of a pool. Watching a swimming scene on TV or in a movie might be next, and that may progress to being near a pool without getting in.
The next step may involve the patient dipping their feet in the water, and then gradually progressing to swimming. Each of these steps builds on the previous one, bringing the individual closer to confronting their initial fear. This modality works effectively in helping people overcome various types of phobias.
During therapy sessions, the therapist often encourages the person and carefully pushes them to reach slightly beyond their comfort zone. They may assist them in focusing on relaxation techniques both before and during treatment.
Fear vs. phobia
Some people may wonder why a phobia can create significant distress given that everyone is afraid of something. However, most people have what are considered fears rather than phobias.
Fears typically don't interfere significantly with a person's daily life. For instance, a fear of spiders implies the individual dislikes them and avoids their presence, but when encountering a spider, they can usually cope and exhibit a response prevention strategy that's proportionate to the actual threat or danger posed by the spider.
However, for someone with a phobia of spiders (arachnophobia), just seeing one can trigger a panic attack. A person with a spider phobia may exhibit obsessive compulsive disorder-like behaviors to avoid even the potential exposure to spiders, such as insisting their clothing is stored in vacuum bags or freshly laundered before wearing. They might request frequent insect treatments in their home or completely avoid hiking for fear of encountering a spider.
In other words, a phobia may significantly impact a person's life, but clinical psychology and behavior research suggest that behavior therapy may help them take essential steps toward recovery.
Takeaway
If you’re experiencing a phobia and you're not sure what to do, you don’t have to face it alone. There are licensed counselors with experience helping people overcome their phobias via systematic desensitization. While visiting a therapist in person is a common way to treat phobias, the rise in popularity of online therapy is rapidly replacing the need for individuals to travel to an office to receive therapy. Studies show that internet-based treatment is just as effective in treating phobias as in-person therapy, and you can receive treatment online from anywhere with an internet connection at any time.
With BetterHelp, you can be matched with an online therapist with training in phobia treatment methods. You can also contact your therapist via in-app messaging in between sessions, and they’ll get back to you as soon as they can. Take the first step and contact BetterHelp today.
What is an example of desensitization in psychology?
A common type of desensitization in psychology is systematic desensitization therapy, used to assist patients in overcoming anxiety, fear, and phobias. For example, someone with a fear of spiders (arachnophobia) might engage in systematic desensitization to learn to cope with the intense feelings they have and then gradually overcome their fear of spiders. There are three typical phases to treatment—here is an example of how they might apply to an individual with arachnophobia:
Relaxation training
During the first phase, the patient learns relaxation techniques, such as deep breathing or progressive muscle relaxation, to manage fear and anxiety during the desensitization process. This phase is critical for treatment success, as the patient must maintain a state of relaxation to successfully neutralize an anxiety response (a concept called reciprocal inhibition).
Creation of a fear hierarchy
The therapist and the patient will then work together and create a list of situations involving spiders, ranked from least to most anxiety-inducing. For example, they might list looking at a picture of a spider, then being around a live spider, and then eventually holding a live spider. The list of steps might be longer or shorter depending on the patient’s level of fear.
Gradual exposure
The patient is gradually exposed to these situations, beginning with the least fear-provoking scenario. While confronting each step, they use the relaxation techniques they’ve learned to reduce anxiety. Over time, repeated exposure leads to desensitization, and the individual experiences less fear or anxiety when encountering spiders. Eventually, the patient may learn to overcome their fear of spiders entirely.
What causes desensitization?
Desensitization is caused by repeated exposure to an anxiety-provoking object or situation. The longer one is exposed to the stimulus, the less intense their reaction becomes. While one can be desensitized to many things like temperature, touch, or fear—many recent studies on the phenomenon focus on desensitization to violence, particularly in young people.
How do you desensitize your anxiety?
Desensitizing anxiety typically involves a combination of mental exercises and behavioral strategies. If you have overwhelming anxiety that regularly interferes with your daily life and productivity, speaking with a therapist trained in desensitization techniques is recommended. However, in some cases, it is possible to desensitize yourself to anxiety without the help of a mental health professional. Here are some suggestions:
Mindfulness and relaxation exercises
Mindfulness and relaxation practices are foundational for addressing fear and anxiety. Meditation, controlled breathing, progressive muscle relaxation (PMR), and guided imagery techniques work to reduce anxiety by activating the body’s parasympathetic nervous system. Mindfulness and meditation also allow you to identify and challenge negative, unrealistic thoughts that contribute to fear and anxiety. For most people, mindfulness and relaxation techniques are most effective when practiced regularly as part of a daily routine.
Set and work through your anxiety hierarchy
Make a list of the things that provoke your anxiety and rank them by intensity. For example, if you have anxiety around engaging with new people, you may begin your list by making small talk with a stranger and end it with giving a speech to a room full of strangers. Once you’ve listed your sources, begin gently working through the scenarios. Gage your comfort level at each “stage” and move forward when you’re ready.
Take care of yourself physically and mentally
Self-care plays a critical role in managing fear and anxiety by promoting physical, emotional, and mental well-being. Consistent self-care also fosters a sense of control, empowering individuals to better cope with stressors and progress more confidently through the therapeutic process.
Like mindfulness and relaxation exercises, regular physical exercise can be an effective tool for neutralizing anxiety. Even light exercises such as walking, stretching, or yoga can help calm anxiety by reducing stress hormones like cortisol and increasing endorphins, which are natural mood boosters. Additionally, be sure to get plenty of quality sleep, eat nutritiously, and cut back or eliminate stimulants like caffeine and sugar, which can intensify anxiety.
Engage in recreational activities that bring you joy and nurture self-growth to nourish your mental and emotional health. Spend time with people who support and uplift you—practice self-compassion by treating yourself kindly and acknowledging that it’s okay to feel anxious. Self-affirmation techniques and positive self-talk can help. If necessary, seek support from a mental health professional who can assist you and provide tools for coping with fear and anxiety in everyday life.
Track your progress
Keep a log of how you’re feeling every day and reflect on your successes as well as opportunities for growth. Take your time during the process and stay mindful of your mental and emotional state throughout. Journaling, checklists, and other “assignments” can help you keep track.
Why is systematic desensitization effective?
Not everyone responds to systematic desensitization in the same way, and some people have less success than others. However, it is a highly evidence-based technique whose effectiveness is widely accepted with decades of peer-reviewed studies and research. Its effectiveness lies in its combined strategy of physiological stress-reduction techniques, controlled exposure to emotionally distressing stimuli, and psychotherapeutic support.
What is the simple definition of desensitization?
Merriam-Webster defines desensitization as a verb meaning “to make (a sensitized or hypersensitive individual) insensitive or nonreactive to a sensitizing agent.”
What is the purpose of desensitization therapy?
Developed in the 1950s by Joseph Wolpe, systematic desensitization is a method of exposure therapy typically used for treating anxiety disorders and phobias. The process involves reducing emotional sensitivity or reactivity to a specific stimulus through repeated exposure. The purpose of desensitization therapy is to alleviate and eventually eliminate psychological discomfort (anxiety and fear) associated with a particular stimulus.
What is the goal of systematic desensitization?
The goal of systematic desensitization is to help individuals overcome fears, phobias, or anxiety by gradually exposing them to an anxiety-provoking stimulus in a controlled, structured way. With time, the method reduces or eliminates psychological distress and decreased quality of life caused by the phobia or anxiety.
How do you practice systematic desensitization?
Practicing systematic desensitization requires highly controlled, carefully measured steps—beginning with learning how to relax the mind and body through mindfulness and grounding exercises, deep breathing, and progressive muscle relaxation techniques. Then, the patient is exposed to anxiety-provoking stimuli in small, increasing increments. During the process, the therapist works with the patient to measure their level of fear, guide them through progression, adjust treatment as necessary, and provide psychological support.
How does systematic desensitization help people cope with irrational fears?
Systematic desensitization helps people learn to cope with and overcome irrational fears by breaking the fear cycle. Pairing relaxation with exposure to feared situations allows patients to neutralize the fear and “unlearn” the anxiety response. It also helps individuals gain confidence as they gradually face irrational fears in a controlled environment. As the patient increases the frequency and intensity of exposure to their fears, they become more adept at managing their reactions.
Also, the process decreases avoidance behaviors, which often maintain and reinforce irrational fears. For example, someone with arachnophobia might avoid hiking or camping for fear of encountering a spider in the wilderness. With systematic desensitization, such avoidance behaviors are managed progressively and eventually eliminated.
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