Table of ContentsView AllTable of ContentsHow Does It Work?How Long Does It Take?Examples of Systematic Desensitization TherapyPros and ConsDoing It on Your OwnChoosing a Therapist
Table of ContentsView All
View All
Table of Contents
How Does It Work?
How Long Does It Take?
Examples of Systematic Desensitization Therapy
Pros and Cons
Doing It on Your Own
Choosing a Therapist
Systematic desensitizationis a type of behavioral treatment that usesexposure therapyto treatanxietydisorders,post-traumatic stress disorder (PTSD), andphobias. It involves gradually exposing a person to something that causes extreme fear and panic, and teaches them to replace fear responses with relaxation responses.
This article explains systematic desensitization, techniques, benefits, and how to find a therapist.
How Does Systematic Desensitization Therapy Work?
Systematic desensitization is a type oftherapythat focuses on teaching you how to relax in the midst of your fears. Essentially, you’ll learn the skills and tools you need to navigate situations that would have previously felt unmanageable.
Step 1: Relaxation Techniques
Developing strategies to help you relax your body during moments of distress is the first step of systematic desensitization.
Relaxation techniques are helpful for calming physical sensations in the body. These strategies are versatile, in that you can use them on their own or combine them.
Many different types of tactics can help. Trying a variety of techniques can help you determine what works best for you. It’s also important to note that what works best in one situation may not be as effective in another. Having multiple strategies in your toolbox gives you the ability to choose what you need at the moment.
Deep breathing
Deep breathinginvites you to slow down your breathing and lengthen the exhale to relax the sympathetic nervous system:
This is also known asdiaphragmaticbreathing.
Muscle relaxation
Progressive muscle relaxation teaches you to spot tension in your muscles and relax it. By concentrating on one group at a time, you learn to tense and relax your muscles, feeling tension melt away as you release.
Visualization
Visualization is an exercise that transports you to a place that feels safe and relaxing.
To do this:
For example, you may visualize the beach with slow and steady waves, white sand, and sun. You might imagine that you can smell the saltwater and hear the movement of the waves.
Meditation
Step 2: Creating a Fear Hierarchy
To do this, you can work with a therapist to determine what situations cause you the most fear and least fear. Extreme fear-inducing situations would be a “10,” while situations provoking the least amount of fear are rated as a “1.” It’s important to identify levels in between as well.
Example of Fear HierarchySomeone with a fear of flying might rank taking a flight as a “10” with thinking about flying as a “1.” Fear situations that might be ranked between 1 and 10 can include purchasing a plane ticket, arriving at the airport, or sitting in a seat on the plane.
Example of Fear Hierarchy
Someone with a fear of flying might rank taking a flight as a “10” with thinking about flying as a “1.” Fear situations that might be ranked between 1 and 10 can include purchasing a plane ticket, arriving at the airport, or sitting in a seat on the plane.
Step 3: Gradually Expose Yourself to the Fears
While you are exposing yourself to fearful situations, you can use relaxation techniques to manage thoughts, emotions, and sensations that come up. Over time, your body comes to realize that the anticipated danger it expects isn’t going to occur and that you don’t need to use avoidance to short-circuit the distressing feelings. You can use the strategies as many times as you need to reduce the anxiety.
How Long Does Treatment Take?
Though patients may see progress after even a few sessions, the length of exposure therapy may be different for each patient. Typically, patients will begin to see changes after a few sessions, while moresevere phobiascan take around 12 sessions.
The length of treatment may depend on factors such as the problem, severity of the issue, comfortability with relaxation and coping techniques, and how a patient responds to different levels of the fear hierarchy.
The process of systematic desensitization can be different for everyone. For some people, different relaxation techniques may be more helpful than others. Additionally, a person’s progress will depend on how quickly they are able to successfully move through each level of their fear hierarchy.
The following are examples of fear hierarchies that one may create and use to overcome a specific phobia.
Social Anxiety
People with social anxiety often fear a variety of social situations.For someone confronting asocial phobia, their fear hierarchy may look something like this:
Dog Phobia
For persons with adog phobia, a fear hierarchy may look like the following:
What Are the Pros and Cons of Systematic Desensitization?
Pros
Exposure therapy is effective in treating a range of mental health conditions, including:
Systematic desensitization often gives patients a sense of empowerment when it comes to facing their fears. In working with a therapist, there’s space to process thoughts, emotions, and beliefs related to the fear situation. This allows you to identify avoidance reactions and unhelpful thoughts.
Through this work, you can establish new associations and manage emotional discomfort when in contact with fear.
Cons
Although systematic desensitization can be very effective in treating a range of mental health conditions, it can take time to see results. Additionally, this therapy may trigger distressing emotions, like anxiety, during the process.
How to Do It on Your Own
You can gradually expose yourself to fearful situations. But before starting that process, it’s important to make sure that you feel comfortable using relaxation techniques and have a few in your reserve that reduce your anxiety.
Once you feel confident in using relaxation strategies, you can start exposing yourself to situations that bring up lower levels of fear. Take your time as you begin exposure. The goal is to learn to manage your fear when faced with frightening situations.
Exercises
To implement gradual exposure on your own, you might try the following steps:
Tracking Your ProgressIt may be helpful to keep a journal or track your mood, fear levels, and relaxation techniques used before, during, and after exposure. This can give you some insight into what is helping and how you are progressing. This information can also be useful to share with a therapist if you decide to seek professional support.
Tracking Your Progress
It may be helpful to keep a journal or track your mood, fear levels, and relaxation techniques used before, during, and after exposure. This can give you some insight into what is helping and how you are progressing. This information can also be useful to share with a therapist if you decide to seek professional support.
Working With a Therapist
Because systematic desensitization involves exposure to fears, you may experience distressing emotions, anxiety, or even panic during the process. Working with a therapist to help you identify coping skills, list and rank your fears, and determine a plan for the best way to begin gradual exposure.
Questions When Considering a Potential TherapistWhen looking for a therapist, it may be worthwhile to consider:What are the concerns you’re seeking help with?What qualities are important in a therapist?What is the education, background, and training of the therapist? Do they have training and experience using exposure therapy with patients?What options do you have for getting access to care?
Questions When Considering a Potential Therapist
When looking for a therapist, it may be worthwhile to consider:What are the concerns you’re seeking help with?What qualities are important in a therapist?What is the education, background, and training of the therapist? Do they have training and experience using exposure therapy with patients?What options do you have for getting access to care?
When looking for a therapist, it may be worthwhile to consider:
Being able to communicate any problems, goals, and hopes for therapy is beneficial information for you and a potential therapist.
Additionally, you may want to consider what traits matter to you in a therapist. Asking questions about the therapist’s education, training, and experience treating your particular concerns can help you decide if they’re a good fit.
Therapy can be expensive, so it can be helpful to evaluate your options. That might mean going through health insurance, an Employee Assistance Program, or seeking a referral from your primary healthcare provider. In some cases, you may need to explore other community-based options.
Help Is AvailableIf you or a loved one are struggling with anxiety or phobias, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.
Help Is Available
If you or a loved one are struggling with anxiety or phobias, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.
Summary
Systematic desensitization is an effective and evidence-based treatment method to gradually expose yourself to phobias or situations that create extreme fear or anxiety. With the support of a therapist, you can learn relaxation strategies, pinpoint your fears, and begin exposing yourself to distressing situations while using techniques to cope with strong emotions. When seeking help, it’s important to locate a therapist with specialized training to guide you through the process.
5 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.MedlinePlus.Relaxation techniques for stress.American Psychological Association.Mindfulness meditation: A research-proven way to reducestress.Dubord, Greg.Part 12. Systematic desensitization.Can Fam Physician. 2011;57(11):1299.NHS.Social anxiety (social phobia).American Psychological Association.What is exposure therapy?.
5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.MedlinePlus.Relaxation techniques for stress.American Psychological Association.Mindfulness meditation: A research-proven way to reducestress.Dubord, Greg.Part 12. Systematic desensitization.Can Fam Physician. 2011;57(11):1299.NHS.Social anxiety (social phobia).American Psychological Association.What is exposure therapy?.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
MedlinePlus.Relaxation techniques for stress.American Psychological Association.Mindfulness meditation: A research-proven way to reducestress.Dubord, Greg.Part 12. Systematic desensitization.Can Fam Physician. 2011;57(11):1299.NHS.Social anxiety (social phobia).American Psychological Association.What is exposure therapy?.
MedlinePlus.Relaxation techniques for stress.
American Psychological Association.Mindfulness meditation: A research-proven way to reducestress.
Dubord, Greg.Part 12. Systematic desensitization.Can Fam Physician. 2011;57(11):1299.
NHS.Social anxiety (social phobia).
American Psychological Association.What is exposure therapy?.
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