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Systematic Desensitization

Systematic Desensitization

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Behavior Therapy and Modification
Behavior Therapy and Modification

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Categories:Types, Research
Published by: Oniwura Bolarinwa Olapade on Jan 23, 2013
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10/12/2013

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Introduction
Inpsychology,desensitization (also called inurement) is defined as the diminishedemotional responsiveness to a negative or aversive stimulus after repeated exposure toit. It also occurs when an emotional response is repeatedly evoked in situations inwhich the action tendency that is associated with the emotion proves irrelevant orunnecessary. Desensitization is processes primarily used to assist individuals unlearnphobias and anxieties.Systematic desensitization (sometimes called
 graduated exposure therapy
) is a typeof behavioural therapyused in the field of psychologyto help effectively overcome phobiasand otheranxiety disorders.More specifically, it is a type of  
 Pavlovian therapy
 
developed by a South African psychiatrist,Joseph Wolpewho developed a method of a hierarchal list of anxiety evoking stimuliin order of intensity, which allows individuals to undergo adaption.This therapy aims to remove the fear response of a phobia or anxiety, and substitute arelaxation response to the conditional stimulus gradually using counter conditioning.To begin the process of systematic desensitization, one must first be taught relaxationskills in order to extinguish fear andanxietyresponses to specific phobias. Once theindividual has been taught these skills, he or she must use them to react towards andovercome situations in an establishedhierarchyof fears. The goal of this process isthat an individual will learn to cope and overcome the fear in each step of thehierarchy, which will lead to overcoming the last step of the fear in the hierarchy.
Overview
Phobia
A
 phobia
is an excessive, enduring fear of clearly defined objects or situations that
interferes with a person’s normal functioning. Although they know their fear is
irrational, people with phobias always try to avoid the source of their fear. Commonphobias include fear of heights
(acrophobia)
, fear of enclosed places
(claustrophobia)
,fear of insects, snakes, or other animals, and fear of air travel. Social phobias involvea fear of performing, of critical evaluation, or of being embarrassed in front of otherpeople.Phobic anxiety is distinguishable from other forms of anxiety only in that it occursspecifically in relation to a certain object or situation. This anxiety is characterized byphysiological symptoms such as a rapid, pounding heartbeat, stomach disorders,nausea, diarrhoea, frequent urination, choking feelings, flushing of the face,perspiration, tremulousness, and faintness. Some phobic people are able to confront
 
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their fears. More commonly, however, they avoid the situation or object that causesthe fear
 — 
an avoidance that impairs the sufferer's freedom.Psychiatrists recognize three major types of phobias. Simple phobias are fears of specific objects or situations such as animals, closed spaces, and heights. The secondtype, agoraphobia, is fear of open, public places and situations (such as public vehiclesand crowded shopping centres) from which escape is difficult; agoraphobics tendincreasingly to avoid more situations until eventually they become housebound. Socialphobias, the third type, are fears of appearing stupid or shameful in social situations.The simple phobias, especially the fear of animals, may begin in childhood and persistinto adulthood. Agoraphobia characteristically begins in late adolescence or earlyadulthood, and social phobia is also associated with adolescence.
Anxiety Disorders
Anxiety disorders involve excessive apprehension, worry, and fear. People withgeneralized anxiety disorder experience constant anxiety about routine events in theirlives. Persons with
anxiety disorder 
feel anxious most of the time. They worryexcessively about routine events or circumstances in their lives. Their worries oftenrelate to finances, family, personal health, and relationships with others. Althoughthey recognize their anxiety as irrational or out of proportion to actual events, theyfeel unable to control their worrying. For example, they may worry uncontrollably andintensely about money despite evidence that their financial situation is stable. Childrenwith this disorder typically worry about their performance at school or aboutcatastrophic events, such as tornadoes, earthquakes, and nuclear war.People with anxiety disorder often find that their worries interfere with their ability tofunction at work or concentrate on tasks. Physical symptoms, such as disturbed sleep,irritability, muscle aches, and tension, may accompany the anxiety. To receive adiagnosis of this disorder, individuals must have experienced its symptoms for at leastsix months.
Background
Russian physiologist Ivan P.
Pavlov’s
classical conditioning therapy involved the useof dogs in studying the concept of behaviour modification. Pavlov knew for a fact thatdogs
 — 
indeed all animals
 — 
salivates when eating. In his experimentation, Pavlovbegan to present a neutral stimulus, such as signal light or bell, before feeding the
dogs. Obviously, the signal had no noticeable effect on the dogs’ salivation. But
Pavlov kept the signal on when the dogs were being fed (and actively salivating), and,over the course of time, Pavlov found that the signal alone, even without his offeringfood, gradually caused the dogs to salivate.
 
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In a nutshell, classical conditioning involves; given that an
unconditioned stimulus
 (food) leads to an
unconditioned response
(salivation), a
conditioned stimulus
(light orbell), when paired consistently with the unconditioned stimulus (food) leads to a
conditioned response
(salivation) similar to the unconditioned response (salivation).
Interestingly enough, there’s a reverse side to classical conditioning, and it’s called
counter conditioning
. This amounts to reducing the intensity of a conditionedresponse (anxiety, for example) by establishing an
incompatible response
(relaxation)to the conditioned stimulus (a snake, for example).ThroughJoseph Wolpe
s
experience in the late 1950s in extinguishing laboratory-induced neuroses in cats, Wolpe developed a treatment program for phobia andanxiety disorders that was based on the principles of 
counter conditioning
an off-shotof classical conditioning. Wolpe found that phobias and anxiety symptoms could bereduced (or
inhibited 
) when the stimuli to the anxiety were presented in a graded orderand systematically paired with a relaxation response. Hence this process of 
reciprocalinhibition
came to be called
systematic desensitization
.Although the theoretical assumptions about the role of the sympathetic andparasympathetic nervous systems in extinguishing anxiety were actually erroneous,however, Wolpe Systematic Desensitization program, as a practical application of histheories, proved to be highly successful. In fact, it revolutionized the treatment of neurotic anxiety.
Systematic Desensitization Procedure
Hierarchy of Fear
Involving the conditioned stimulus (e.g. a spider), that are ranked from least fearful tomost fearful. The patient works their way up starting at the least unpleasant andpracticing their relaxation technique as they go. When they feel comfortable with this(they are no longer afraid) they move on to the next stage in the hierarchy.Thus, for example, a spider phobic might regard one small, stationary spider 5 metersaway as only modestly threatening, but a large, rapidly moving spider 1 meter away ashighly threatening. The client reaches a state of deep relaxation, and is then asked toimagine (or is confronted by) the least threatening situation in the anxiety hierarchy.The client repeatedly imagines (or is confronted by) this situation until it fails to evokeany anxiety at all, indicating that the therapy has been successful. This process isrepeated while working through all of the situations in the anxiety hierarchy until themost anxiety-provoking.

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