Systematic desensitization is a type of behavioral therapy based on the principle of classical conditioning. It was developed by Wolpe during the 1950s. This therapy aims to remove the fear response of a phobia, and substitute a relaxation response to the conditional stimulus gradually using counter conditioning. There are three phases to the treatment:
First the client forms a hierarchy of fear, involving the conditioned stimulus (e.g. a spider), that are ranked from least fearful to most fearful.
Next, the patient is also given training in relaxation techniques. E.g. control over breathing, muscle detensioning or meditation. Wolpe taught his patients relaxation responses because it is not possible to be both relaxed and anxious at the same time.
Finally, the client progresses along the fear hierarchy while simultaneously using relaxation techniques. The client 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.
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.
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 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.
Wolpe (1964) successfully used the method to treat an 18 year old male with a severe handwashing compulsion. The disorder involved a fear of contaminating others with urine. After urinating, the patient felt compelled to spend 45 minutes cleaning his genitalia, two hours washing his hands, and four hours showering.
Treatment involved placing the young man in a state of relaxation and then asking him to imagine low anxiety scenes (such as an unknown man touching a trough of water containing one drop of urine). As the patient’s anxiety gradually dissipated, Wolpe gradually increased the imaginary concentration of urine. In addition, a real bottle of urine was presented at a distance and moved closer to the patient in gradual steps. Finally Wolpe could apply drops of diluted urine to the back of the patient’s hand without evoking anxiety. A follow-up 4 years later revealed complete remission of the compulsive behaviors.
· One weakness of systematic desensitization is that it relies on the client’s ability to be able to imagine the fearful
situation. Some people cannot create a vivid image and thus systematic desensitization is not always effective (there are individual differences).
· Studies have shown that neither relaxation nor hierarchies are necessary, and that the important factor is just exposure to the feared object or situation.
· 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.
Wolpe, J. (1964). Behaviour therapy in complex neurotic states. The British Journal of Psychiatry, 110(464), 28-34.
How to cite this article:
McLeod, S. A. (2008). Systematic Desensitization. Retrieved from www.simplypsychology.org/Systematic-Desensitisation.html