Systematic Desensitization

Systematic Desensitization means that the situation which used to provoke fear is connected with a completely positive feeling, for example, with a feeling of calmness. So, the situations which used to evoke growing fear start to cause growing relaxation. Before facing dangerous stimuli a patient is prevented from fear. Relaxation methods are often used for that. Of course, before using this method the patient should be taught certain rules of relaxation (for example, using auto training or progressive muscular relaxation by Jacobson). Sometimes (but very rarely not to provoke addiction to outward therapeutic interference) hypnosis or medicine is also used for these purposes. While dealing with children researchers often use feelings of joy, interest, pleasure from meal. In adult therapy the feeling of self confidence is often used. Then the client chooses a certain sign to show the doctor that relaxation has been reached (for example, the patient will show his or her forefinger of the right hand). After that the client makes himself or herself comfortable, tries to relax and raises his forefinger. At this moment the doctor reads the first description of (the least terrifying) situation. The client tries to relax imagining himself in this situation. When it works, the client using the prearranged sign shows that the next, more terrifying situation can be read. If the client can not relax then they return to the previous step. The sessions last till the client can stay calm going through the whole chain of the situations for several times.

In this standard form of systematic desensitization they use the client's capability to imagine-to take part in this or that situation in your imagination like in reality. It is supposed that imaginary situation and real participation in it are closely connected. If we can stay calm in imaginary situation then this calmness will be transferred to real life. 'Things that we are afraid of in reality, scare us in imagination too. So, the things that stopped frightening us in imagination won't do that in reality. However, sometimes it 'does not work'. For some clients imagination and real life mean a little bit different realities and it is necessary to make systematic desensitization in real conditions.

Training 'in vivo' or in reality is often quite a complicated matter but without it it's impossible to finish the therapy. Using the same principle as in imaginative systematic desensitization they confront the client to real events of growing difficulty and immediately take him or her out of the situations in which he or she can not calm down or reduce the intensiveness of circumstances in the situation.

Systematic Desensitization Example

the fear of driving a car is removed by helping the client stay calm while looking at the car first, then planning a car trip, then the client is asked to sit in a parked car, then to drive on a country road at a low speed and so on. The client is returned to the previous step if he or she can not calm down. Systematic desensitization is used as the main method in treating different fears and phobias strong feelings of guilt and shame, sexual dysfunction, obsessions, depression and stammering. Systematic desensitization is often combined with other methods of behavior psychotherapy, for example, in social skills training, in therapy of shyness or uncontrolled aggression.

After the therapy is finished, the client can go through all the steps of systematic desensitization himself or herself applying it to remaining fears. To do it the client should make a gradual list of events or situations in which he or she will try to relax. Then he or she tries to do it either imagining these situations or taking part in them in reality. If systematic desensitization is held without a psychiatrist, then it is often called self- desensitization.

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