SYSTEMATIC DESENSITIZATION: TECHNIQUE, DISORDERS AND EXAMPLES - GEOGRAFÍA - 2025

The systematic desensitization is one of the techniques used in some psychological therapies, and one of the fundamental components of cognitive - behavioral. It is an approach that has been shown to be extremely effective in treating all types of disorders, especially anxiety disorders.

Systematic desensitization consists of gradually making a person face situations that cause fear or are related to their disorder. So instead of having to overcome all your problems at once, you can reduce your feelings of anxiety in a simple way.

Person with agoraphobia. Source: pexels.com

This technique is based mainly on theories of classical and operant conditioning. The idea behind systematic desensitization is that a learned response (such as fear of spiders) can be unlearned through classical conditioning, replaced by a more useful one.

Systematic desensitization is used by millions of psychologists, and has helped alleviate the suffering of large numbers of people. In this article you will learn the basics of how it works, as well as in which cases it is convenient to apply it. On the other hand, you will also see a concrete example of its use.

Technique (steps)

The idea behind systematic desensitization is very simple. To help a person eliminate a fear or anxiety situation, it is only necessary to face it little by little and in a safe environment, while learning to relax. However, to be carried out correctly, a series of steps must be followed.

Diagnosing the problem

Before systematic desensitization (or any other therapeutic technique) can begin, the psychologist has to carry out an in-depth evaluation of the patient.

Thus, it is common for a structured interview to be carried out in which the nature of the problem is investigated, to ensure that this technique is the most appropriate.

In this structured interview, the psychologist will ask questions about when and how the problem appeared, the patient's past in this regard, the family and medical history and the therapies received so far, if any have been tried.

In this way, the suitability of using systematic desensitization with the person can be tested.

Learning relaxation techniques

Once it has been decided that systematic desensitization can really help the patient to solve their problem, it is possible to start with the process itself. The first step is to teach the person a relaxation technique and practice it with them until they have fully mastered it.

The most used relaxation techniques in therapy are progressive muscle relaxation, deep breathing, or meditation or mindfulness. In principle, it is only necessary for the patient to master one of them before moving on to the next phase; but if necessary, you could try several to find one that was suitable.

There is one main reason for teaching relaxation: when you are practicing one of these techniques, due to an effect known as "reciprocal inhibition," it is physically impossible to be in a state of anxiety, fear, or worry. However, relaxation only works when the discomfort is not too high.

Creation of a hierarchy of anxiety situations

In the second step of systematic desensitization, the patient has to think of a list of possible situations in which they experience their specific fear.

For example, if the person goes to therapy due to a phobia of snakes, some of the situations included could be imagining one of these animals or having one around.

Once five to ten anxiety situations have been found, the person is asked to classify them according to the fear that each one provokes.

In addition, he is also told that he categorizes each of them with a number between 1 and 10, with 1 being "no discomfort" and 10 being the maximum possible fear.

Progressive exposure

The last step of systematic desensitization is the longest, and also the most important of all. Once the classification of the previous point has been made, the therapist will help the patient to face each of the situations on the list, starting with the simplest, until ending with the most difficult.

In each of these situations, the person has to apply the relaxation technique that he worked on in the first point until he is able to live it without fear. Once one of the list has been mastered, it will move on to the next, repeating the process until the anxiety is completely eliminated.

This exposition can be done in two ways. The first, known as the "In Vitro method", consists of the patient imagining each of the situations in the most realistic way possible. In the second, on the contrary, the person has to really face the situations that scare them. This method is known as "In Vivo".

The choice of one or the other method will depend on several factors. For example, whether it is realistic or not to create the situations live, or the level of fear that the person has when starting therapy. In any case, it is possible to combine both or change from one to the other at any time.

For which disorders is routine desensitization indicated?

Despite its proven effectiveness, systematic desensitization does not treat all psychological problems that exist. In some cases it does not seem to be very useful, while with certain disorders it could even be counterproductive.

Generally, systematic desensitization works perfectly with most types of specific phobias. When one of these disorders occurs, usually only a few sessions are necessary to eliminate it completely and it does not pose a problem to the patient ever again.

In addition to specific phobias, systematic desensitization can also help treat more complex problems such as phobia or social anxiety, and some other anxiety disorders such as post-traumatic stress disorder or obsessive-compulsive disorder. However, in these cases it will generally be necessary to accompany it with other techniques.

Finally, other psychological illnesses, such as those belonging to mood disorders or schizophrenia, cannot be treated using this approach. In fact, some studies seem to suggest that systematic desensitization might even make the problem worse in these cases.

Criticism and controversy

Systematic desensitization, being based on behavioral theory, is based on the idea that fears are learned throughout the person's life, and therefore can be completely eliminated through a new learning process. However, the evidence is not entirely clear in this regard.

For example, the fact that social phobia generally cannot be completely cured using this approach highlights the possible existence of other factors that may be behind the appearance of fear.

In addition to this, today it is known that the emotion of fear is innate, thanks to cross-cultural studies and the efforts of evolutionary psychology. Therefore, the idea that a phobia is acquired completely due to the experiences of the person is, to say the least, incomplete.

However, the fact is that routine desensitization is very helpful in treating the disorders for which it is most indicated. Therefore, although there are certain problems with the underlying theory, this technique is still used frequently throughout the world.

Application example

Next we will see a fictitious case in which systematic desensitization is applied to treat a case of phobia to wasps, one of those that appear more frequently and that can cause more problems due to the presence of these insects in our environment.

During the initial interview, the patient tells the psychologist that he has been in great discomfort all his life every time he has a wasp nearby.

Just imagining this situation, you begin to become visibly nervous, and you say that the problem is causing interference in your daily life.

After teaching a deep breathing exercise, the psychologist and the patient practice it together until the patient is able to calm down from a somewhat agitated mood. You are asked to do the exercise at home for a week, and in the next session you move on to the next phase.

In the next step, the person creates a list of situations that cause anxiety, and adds a number from 1 to 10, symbolizing their level of discomfort towards each of them. The list is as follows:

- Think of a wasp: 2.

- See a picture of a wasp: 4.

- See a wasp from three meters away: 6.

- See a wasp from a meter away: 8.

- For a wasp to perch on your arm: 10.

Once the list is finished, the person has to go through each of the situations while performing the relaxation technique that they have learned.

Thus, in one session you have to imagine a wasp while breathing deeply, until you get calm. In the next one, you will be presented with a picture of this insect.

As for the three situations that have to do with real wasps, depending on the person's level of fear, the psychologist can decide to just imagine them, or expose them to them in the real world. In any case, after a few sessions, the person is able to feel comfortable in any of these cases.

References

1. "Systematic Desensitization" in: Simply Psychology. Retrieved on: January 14, 2019 from Simply Psychology: simplypsychology.org.
2. "Systematic Desensitization for Panic Disorders" in: Very Well Mind. Retrieved on: January 14, 2019 from Very Well Mind: verywellmind.com.
3. "Systematic Desensitization" in: Encyclopedia of Mind Disorders. Retrieved on: January 14, 2019 from Encyclopedia of Mind Disorders: minddisorders.com.
4. "What Is Systematic Desensitization?" in: The Psychology Notes HQ. Retrieved on: January 14, 2019 from The Psychology Notes HQ: psychologynoteshq.com.
5. "Systematic Desensitization" in: Wikipedia. Retrieved on: January 14, 2019 from Wikipedia: en.wikipedia.org.