Systematic Desensitisation

Systematic Desensitisation

1. Main components

   • Counterconditioning
     • Steps of SD
       • Taught how to relax muscles completely
         • Therapist and patient construct a desensitisation hierarchy together - series of imagined scenes, each one causing more anxiety than previous
           • Patient works way through hierarchy
             • Patient mastered one step, ready to move onto next! (They can remain relaxed while imagining it)
               • Eventually masters feared situation!
       • Aim is to respond to feared stimulus with relaxation rather than fear!
     • Called this because client is taught new association that runs counter to original association!
       • relaxation inhibits anxiety
   • Desensitisation hierarchy
     • Series of gradual steps that are determined at the beginning of therapy when the client and therapist work out a hierarchy of feared stimuli from least to most!
   • Different forms

2. Effectiveness

   • Research support
     • Proven successful when problem is learned one (specific phobias).
       • CAPAFONS ET AL
         • Clients with fear of flying reported lower fear levels whilst in a flight simulator following a 12-25-week treatment period, where both IN VITRO and IN VIVO techniques were used!
   • Not appropriate for all phobias
     • Unsuitable for 'ancient' fears.
       • MARTIN SELIGMAN ARGUED
         • Humans and animals are genetically programmed to rapidly learn an association between life-threatening 'ancient' fears and fear.
       • things that would have been dangerous in our EVOLUTIONARY past.
         • ADAPTIVE to rapidly learn to avoid these!
           • This concept of BIOLOGICAL PREPAREDNESS explains why people are less likely to develop fears for modern objects that are much more of a threat than spiders.
   • Research support for biological preparedness
     • SELIGMAN'S concept has been supported
       • BREGMAN failed to condition a fear response in infants aged 8-16 months by pairing a loud bell with wooden blocks.
         • Fear respnses are only learned with living animals (link with ANCIENT FEARS)
   • Symptom substitution
     • symptoms are only tip of iceberg, If you remove them the cause still remains and they may resurface
       • PSYCHODYNAMIC APPROACH = Phobias develop because of projection
         • Little Hans who had fear of horses. Actual problem was envy of father but could not express this directly so his anxiety was projected on horse. Phobia was cured when he accepted feelings about father.
           • So, if the therapist had treated the horse phobia the underlying problem would have remained and resurfaced elsewhere.
             • Behavioural therapies may APPEAR to resolve problem but simply ELIMINATING SYMPTOMS can result in others appearing!

3. Ethical Issues

   • Considered more ethical than other forms of behavioural therapies ('flooding' techniques)
     • Forcing someone to face fear
     • Each step is conducted slowly and at a pace dictated by client. Therapist is able to gauge whether client is fully relaxed at each stage!
       • Therapist must only attempt to move hierarchy when client is comfortable
   • Used mainly with phobias
     • Clients are in touch with reality and in a healthy enough frame of mind to understand what it'll entail!
       • Client attends therapy sessions at their own FREE WILL and is able to choose to withdraw at any point.
         • However, still element of stress involved as client is exposed to object which causes anxiety/fear.