Systematic desensitization is a method to reverse learned fear behaviors in a patient. It is a behavior-based approach to phobia treatment and is often very successful, relying on a classical conditioning method to slowly break the cycle of escalating fear in a patient with a phobia. Many psychotherapists offer this treatment to their patients or can refer them to someone who specializes in phobias.
The first step in systematic desensitization involves providing the patient with some relaxation techniques. The therapist teaches the patient to use meditation, breathing exercises, and other tools to remain calm. These will be useful over the course of treatment, and are usually customized to the needs of the patient. Not all patients, for example, find meditation beneficial.
Next, the patient and therapist will work together to create a hierarchy, from the least traumatic exposure to the object of a phobia to the most traumatic one. For someone with a fear of flying, this might start with low level activities like reading about planes in the newspaper or thinking about going on a trip, and would escalate all the way to actually riding on a plane. With this list in hand, the therapist can start working with the patient on a systematic desensitization program.
The program starts with exposure to the least frightening form of the phobia. A patient who is afraid of dogs might look at dog pictures, for example. As the patient starts to experience the early symptoms of fear, the therapist works with him on relaxing and staying calm in response to the exposure. Eventually, the patient will reach a point where he is desensitized, and reacts neutrally to pictures of dogs. Then, the therapist can try escalating the exposure with a dog video, asking the patient to imagine dogs, and so forth, until the patient is comfortable enough for the final stage, exposure to an actual live dog.
This process can take varying lengths of time. Some patients do very well with systematic desensitization and may quickly progress through the steps of the hierarchy. Others may experience plateaus, where they struggle for a full session or even longer with a given exposure. It is important to avoid pushing patients, as this can traumatize them and may cause them to relearn their fear response. Knowing that someone is in therapy to overcome a fear of snakes, for example, friends and family should refrain from snake-related pranks.
