What is Systematic Desensitization?

Systematic desensitization is a technique which is used to help people manage and eventually conquer phobias. It can be performed by a psychologist or psychotherapist or by a patient who is willing to invest energy in doing systematic desensitization at home. The goal of the treatment is to allow the patient to experience situations which would normally result in anxiety, fear, and stress without tension.

This technique relies upon the principle of operant conditioning, which involves a slow process to get someone accustomed to something, until he or she becomes used to it. Operant conditioning is heavily used in psychotherapy, and also in the training of animals, because it can be utilized to make permanent behavioral changes. Patients with phobias who undergo systematic desensitization should be able to interact with the objects of their fear without tension after the conditioning takes place, and in some cases, the phobia may vanish altogether.

Phobias form as the mind's method of self protection, and the process of formation usually involves reinforcement, as the patient's avoidance of the object of fear results in reduced stress, causing the patient's brain to remember to avoid the object of the phobia. In systematic desensitization, the patient is exposed to the object of the phobia in small doses which gradually increase in intensity over time, teaching the brain that fear of the object is not necessary.

The first step in the technique involves developing relaxation exercises. Learning to relax is important, as when someone is in a deep state of relaxation, it is more difficult to experience fear and anxiety. The therapist usually works with the patient in the office, and the patient practices exercises at home until he or she can relax easily.

Then, the patient and the doctor discuss the phobia, and come with a hierarchy of fears. For example, someone who is afraid of planes might experience relatively low levels of tension when exposed to a cartoon drawing of a plane, with very high levels of fear and stress when he or she is actually seated in a plane which is getting ready to take off.

Over a series of sessions, the therapist encourages the patient to relax and then exposes him or her to an increasingly intense series of experiences. In the example above, the therapist might start with a drawing of a plane, then produce a photograph, then show the patient a model airplane, and so forth. At each stage, the stimulus will be repeated until the patient is able to view it calmly, before the next stimulus is introduced. By the end of the systematic desensitization, the patient should be able to stay calm and relaxed, even when he or she is in the most potentially frightening or stressful situation.