Chapter 36. Systematic Desensitization

Learning Objectives

behavior therapy

a type of psychotherapy that focuses on eliminating unwanted behaviors by applying the principles of classical and operant conditioning

habituation

a simple form of learning in which repeated exposure to a stimulus leads to a gradually decreasing response

behavioral perspective

an approach to psychology that emphasizes observable behaviors and the environmental forces that influence those behaviors

phobia

a persistent, irrational fear of an object or situation; the fear is out of proportion to the actual danger

counterconditioning

a kind of behavior therapy based on classical conditioning; eliminating an unwanted response to a stimulus by conditioning a new, more desirable response

stimulus

an external event, such as a light or sound, detected by our senses

exposure therapy

form of behavior therapy that treats a phobia by repeatedly exposing the person to the feared object or situation

systematic desensitization

form of exposure therapy that leads a person through a series of experiences that gradually increase the intensity of the feared stimulus

Systematic Desensitization

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Learning Objectives:

Describe the behavioral therapy called systematic desensitization.

Identify the sequence of steps in systematic desensitization therapy.

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person reacting in fear to some visible object (spider preferred)

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1. Behavior therapies focus on the symptoms of a disorder, not on its possible underlying causes. According to the behavioral perspective, people with phobias have been conditioned to fear specific objects or situations.

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2. According to the behavioral perspective, phobias should be treated with counterconditioning—helping people replace the fear response with a more neutral (no fear) response.

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The figure describes how the fear to a bee starts as a severe response but decreases over time to be only a mild fear response.

3. One form of counterconditioning is exposure therapy, in which people are repeatedly exposed to the things that they fear, in a controlled environment that ensures that nothing bad will actually happen. This allows them to habituate to those feared stimuli.

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The figure includes a woman running away from a bee that is behind her.

4. One problem with exposure therapy is that people who have a phobia about something will avoid that specific object or situation, because it produces anxiety. As a result, they never habituate to the feared stimulus.

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5. The solution is systematic desensitization, a form of exposure therapy based on gradual, incremental exposure to the feared object or event. The therapist begins by constructing an anxiety hierarchy ranging from a very weak stimulus to the original strongly feared stimulus.

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6. The therapist then leads the person, step by step, through the gradually increasing level of exposure to the feared stimulus, helping the person stay relaxed at each stage.

Practice: A Simplified Anxiety Hierarchy

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Practice: A Simplified Anxiety Hierarchy

Use the “Continue” button to move through the sequence of events.

This patient wants to get rid of her fear of spiders.

Systematic desensitization is based on the idea that you cannot be relaxed and anxious at the same time. The therapist would first help the patient to relax, and then present a sequence of exposures to the feared stimulus. Each step increases the intensity of the stimulus a little, while giving the patient time to learn to relax in the presence of that stimulus.

Patient views a picture of a spider at a distance.

First, the therapist presents a very weak version of the feared stimulus. Because this patient has a phobia about spiders, the therapist might place a picture of a spider on a wall. It shouldn't be difficult for the patient to stay relaxed while viewing the picture. After all, that spider can't possibly hurt her!

Patient holds a picture of a spider in her hands.

If the patient can relax while viewing a picture of a spider at a distance, the therapist would next have her view the picture close up. If she became extremely anxious, the therapist would remove the picture. After helping the patient relax again, the therapist would reintroduce the picture gradually, until the patient could hold the picture in her hand without becoming anxious.

Patient views a toy spider hanging on a string.

If the patient can relax while viewing a picture of a spider close up, the therapist might introduce a three-dimensional toy spider, gradually moving the spider closer to the patient. Once again, the therapist would remove the spider if the patient became anxious, but would keep exposing her to the toy spider until she could relax in its presence.

Patient views a toy spider on the therapist's hand.

Now things get really interesting. People with phobias about spiders seem to be especially fearful about spiders touching their skin. An important step in the anxiety hierarchy would have the patient view the toy spider on the therapist's hand. Can you predict what the next step would be?

Patient views a toy spider on her own hand.

You may have guessed that, once the patient can remain relaxed while viewing the toy spider on the therapist's hand, it's time to place the toy spider on the patient's hand. If the patient can learn to view the toy spider resting on her own skin without becoming anxious, the therapist would move on to a real spider!

Patient views a live spider in a glass enclosure.

Introducing a real spider will probably produce a big jump in the patient's anxiety. To make the patient more comfortable, the therapist might place the spider in a glass container.

Patient views a live spider on the therapist's hand.

As the patient approaches the top of the anxiety hierarchy, the stimulus intensity gets higher and higher. Watching a live spider crawl on another person's skin could trigger a lot of anxiety. But, by this time, the patient has become well-practiced in relaxation techniques, so she can view the spider without feeling fearful.

Patient allows a live spider to crawl on her own hand.

Now, at last, the therapist places the live spider on the patient's hand. At any earlier point, this would have produced unbearable anxiety. But because the therapist has guided the patient slowly and carefully through the anxiety hierarchy, the patient can now stay calm in the presence of the feared stimulus.

Quiz 1

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Quiz 1

Match the terms to their descriptions by dragging each the colored circle to the appropriate gray circle. When all the circles have been placed, select the CHECK ANSWER button.

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Perhaps you should go back to review systematic desensitization therapy.

counterconditioning

exposure therapy

systematic desensitization

habituation

phobia

a simple form of learning in which repeated exposure to a stimulus leads to a gradually decreasing response

eliminating an unwanted response to a stimulus by conditioning a new, more desirable response

a persistent, irrational fear of an object or situation; the fear is out of proportion to the actual danger

leading a person through a series of experiences that gradually increase the intensity of the feared stimulus

treating a phobia by repeatedly exposing the person to the feared object or situation

Quiz 2

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Quiz 2

Drag each image to one of the gray areas to create an anxiety hierarchy for treating a phobia about spiders. When all the images have been placed, select the CHECK ANSWER BUTTON.

Select the NEXT button and move to the Conclusion.

Perhaps you should go back to review systematic desensitization therapy.

View drawing of a spider at a distance

Hold drawing of a spider

View toy spider on a string

View live spider in glass container

View live spider on therapist’s hand

Allow live spider to crawl on own hand

Conclusion

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