Systematic desensitization in the treatment of phobias

Systematic desensitization is a classic behavioral therapy technique, developed by Joseph Wolpe, that is effectively used in the treatment of specific phobias.

It combines gradual exposure to the feared stimuli with learning and implementing a response that is incompatible with anxiety, usually deep relaxation.

Principle of Counterconditioning

Systematic desensitization is based on the principle of counterconditioning.

The idea is that you cannot be anxious and relaxed at the same time, as they are opposite physiological and emotional responses.

Therefore, if the phobic stimulus can be associated with a state of relaxation, rather than with the fear response, the phobia can be weakened and extinguished.

Components of the Procedure

The systematic desensitization process generally includes three main components:

• Relaxation Training Deep: The person is taught relaxation techniques, such as progressive muscle relaxation or diaphragmatic breathing, until they can reach a state of calm and deep relaxation at will.

• Building an Anxiety Hierarchy: As with gradual exposure, a list of situations or stimuli related to the phobia is created, ordered from lowest to highest according to the level of anxiety they provoke (using the SUDS scale).

• Gradual Exposure in Imagination or In Live with Relaxation: Start with the least anxiety-provoking item in the hierarchy. The person is asked to relax deeply and then imagine (or expose themselves in vivo, if possible and safe) to that stimulus or situation.

If the person begins to feel anxious, the exposure is stopped and the focus is returned to relaxation until calm is restored.

This process is repeated until the person can imagine or confront the stimulus without experiencing significant anxiety.

Then, the next items in the hierarchy are gra