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Systematic Desensitization

Systematic Desensitization

Systematic desensitization is a therapeutic treatment, employed in the field of psychotherapy, to treat phobias and other anxiety-causing conditions. Let's understand the nuances of the treatment procedure.
Puja Lalwani
In the field of psychology, this behavioral treatment is also called graduated exposure therapy. It works to ultimately overcome and eliminate the fear of any particular object or situation by slowly having the mind adjust to it, and gradually accepting the fear. For this procedure to be effective, a patient is first taught some relaxation techniques. These include deep breathing and learning how to relax the mind as well as the muscles. Then, this feeling of relaxation is made to be associated with the object or situation (stimulus) that causes fear. Slowly and steadily, the mind learns to associate the positive feeling with the negative stimulus, and it overcomes the fear.

Systematic Desensitization Therapy

This therapy works on the principle that whatever the mind is conditioned to believe, for instance, anxiety symptoms triggered upon seeing a spider, can be reversed or unlearned. Fears and phobias are developed as a result of classical conditioning, a theory studied by a famous, Russian physiologist, Ivan Pavlov.

He conducted an experiment involving a dog salivating at the sight of food. When a dog sees food, it automatically begins to salivate. Pavlov started introducing the sound of a bell every time he presented food to the dog. Slowly, the dog began to associate the ringing of the bell to the presence of food. Over a period of time, by constant repetition of this act, the dog started to salivate when the bell was rung, even in the absence of food. This means, it began to associate the conditioned stimulus (the bell) to the unconditioned stimulus (food), and what initially was an unconditioned response to the unconditioned stimulus (salivating at the sight of food), became a conditioned response to a conditioned stimulus (salivating at the sound of the bell). This concept is called classical conditioning.

The theory mentioned above is true to our phobias and fears too. For example, a person may have noticed the presence of a bunch of red roses at the death of a loved one. The anxiety caused by the death of a loved one may have then become associated to the presence of all those roses, and the mind would then begin to associate red roses with death. This could be true of any object and situation.

As a means of psychotherapy, the systematic desensitization treatment procedure involves the process of counter-conditioning or learned behavior modification, which means learning to dissociate the anxiety symptoms from the object that causes it. This is done by exposing the object to the person who has the phobia in a manner that causes least amount of distress to that which causes maximum distress. For example, it could range from a picture of a red rose to holding a whole bunch of red roses in the hand. This is known as the anxiety hierarchy. This process takes place over a period of time, and ultimately defeats the fear. Thus, instead of avoiding the anxiety-causing object, a person learns to face it and then overcome it with the help of gradual exposure.


If a person has associated some kind of fear to a red rose, and he experiences extreme panic attacks or a nervous breakdown upon seeing or touching one, the following ways can help in overcoming this.
  • The patient is first taught to relax through muscle relaxation and deep breathing exercises. With these relaxation methods, a general sense of calm prevails over the mind.
  • Next, the patient is asked only to think about a red rose. Of course, this will generate the feeling of anxiety, but only in a limited amount, as the object of fear is just imaginary.
  • Then, the patient will be presented a funny drawing, representing a person or a scene, that includes a rose. If this generates anxiety, the patient will be asked to close his eyes, relax his mind, and look at the picture again. This constant repetition of retreating, relaxing, and then repeating the pattern, is one of the core principles of systematic desensitization.
  • Sometime later, a picture of a rose will be presented in a pleasant situation. For instance, a picture of a boy giving a red rose to a girl as a symbol of love, will be shown to the patient. This will help him associate pleasant feelings to a rose.
  • Now, the patient has to just see a real rose, placed in a vase, from a distance. This will be done with constant reassurance that it can possibly cause no harm.
  • The patient will slowly be made to approach the red rose and look at it from a shorter distance.
  • Then, the patient will go close to the rose placed in the vase, and he will just be asked to touch the vase.
  • This will be followed by touching the red rose. The patient will hold the red rose in his hand.
  • Finally, he will be able to hold an entire bouquet of red roses without experiencing any anxiety or fear.
Systematic desensitization can be practiced by one at home, but this depends on the level of anxiety caused upon seeing the fear-generating object. However, it is definitely safer to do it under a psychotherapist's guidance. He is trained to help in controlling and then overcoming the fear effectively. If the process goes wrong, instead of being eliminated, the phobia can be heightened to a newer level. Thus, by unlearning certain behavior and habits, various anxiety-causing fears can be overcome.
