by Saul McLeod published 2008
This therapy aims to remove the fear response of a phobia, and substitute a relaxation response to the conditional stimulus gradually using counter conditioning.
This is done by forming a hierarchy of fear, involving the conditioned stimulus (e.g. a spider), that are ranked from least fearful to most fearful. The patient works their way up starting at the least unpleasant and practicing their relaxation technique as they go. When they feel comfortable with this (they are no longer afraid) they move on to the next stage in the hierarchy.
Thus, for example, a spider phobic might regard one small, stationary spider 5 meters away as only modestly threatening, but a large, rapidly moving spider 1 meter away as highly threatening. The client reaches a state of deep relaxation, and is then asked to imagine (or is confronted by) the least threatening situation in the anxiety hierarchy.
The client repeatedly imagines (or is confronted by) this situation until it fails to evoke any anxiety at all, indicating that the therapy has been successful. This process is repeated while working through all of the situations in the anxiety hierarchy until the most anxiety-provoking.
The patient is also given training in relaxation techniques. E.g. control over breathing, muscle detensioning. However, studies have shown that neither relaxation nor hierarchies are necessary, and that the important factor is just exposure to the feared object or situation.
The number of sessions required depends on the severity of the phobia. Usually 4-6 sessions, up to 12 for a severe phobia. The therapy is complete once the agreed therapeutic goals are met (not necessarily when the person’s fears have been completely removed).
Exposure can be done in two ways:
· In vitro the client imagines exposure to the phobic stimulus
· In vivo the client is actually exposed to the phobic stimulus
· Systematic Desensitization is highly effective where the problem is a learned anxiety of specific objects/situations (e.g. phobias).
· Systematic Desensitization is a slow process. Although, research suggests that the longer the technique takes the more effective it is.
· Systematic Desensitization is not effective in treating serious mental disorders like depression and schizophrenia.
· However, it only treats the symptoms of the disorder, not the underlying cause.
Wolpe, J. (1958). Psychotherapy by reciprocal inhibition. Stanford, CA: Stanford University Press.
How to cite this article:
McLeod, S. A. (2008). . Retrieved from
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