Anxiety symptoms can be incredibly debilitating. If you’ve been hit with symptoms of anxiety, you may find yourself desperate for solutions. Though there is no substitute for the support of a professional counselor or psychiatrist, I hope this information provides some hope for your anxious symptoms.
Today we’re going a little more in-depth and looking into a specific tool to help you deal with anxiety called systematic desensitization.
What is Systematic Desensitization?
[Psych Jargon Alert!]
Systematic desensitization is a behavioral treatment for an array of symptoms of anxiety and anxiety disorders, including panic disorder, specific phobias, social phobia, obsessive compulsive disorder, and more. Systematic desensitization is based on classical conditioning theory, which assumes that individuals behave based on feelings and experiences that they associate with a particular environment or behavior.
Systematic desensitization involves creating a fear hierarchy, listing fearful scenarios from least anxiety-provoking to most anxiety-provoking. A therapist teaches coping skills for relaxation such as deep breathing and leads an individual through the fear hierarchy one item at a time while using these relaxation techniques. The individual remains in the feared scenario until their anxiety reduces by about half, and then they can continue to the next item on the hierarchy.
[Plain English Translation]
Systematic desensitization helps us break down our fears into smaller chunks and tackle them one piece at a time. For example, if someone experiences a fear of public speaking, we might imagine that the amount of anxiety they experience varies across different public speaking scenarios; speaking to a group of 3 friends at dinner might feel different than giving a presentation in front of 50 people at work.
The fear hierarchy helps us name all these individual scenarios in a list format along with how anxiety-provoking these items are on a scale of 1-100. We can then address one item at a time, tackling the least intense scenario first, and staying in that scenario while implementing relaxation techniques until the anxiety diminishes.
Let’s illustrate this concept with an example.
Fear of flying is a common anxiety-provoking scenario. Here is a sample fear hierarchy that someone might come up with:
After naming this hierarchy and practicing a few relaxation strategies, a therapist would walk an individual through the first item on the list. In this example, the fearful scenario would be talking about flying. The therapist would check-in with the client about their anxiety level before beginning the exercise (in this case, 20). While talking about flying, the client would focus on utilizing relaxation strategies while staying with the conversation. The exercise is complete once the client’s anxiety reduces to about half of what they were experiencing at the beginning (in this case, the goal number is 10 or less).
As you can imagine, this therapeutic technique is no walk in the park. It takes hard work and dedication to make it through the entire list. However, I’ve walked with many clients who have put in the hard work and come out the other side with great success, reducing their anxiety to more manageable levels.
Who is a Good Candidate for Systematic Desensitization?
I think most everyone can become a good candidate for systematic desensitization, but sometimes there are a few factors that need to be in place first before beginning. Here are the main factors I look for to assess readiness for this technique:
Let’s face it: if we’re not motivated to do something, we won’t do it. If there is anything remotely challenging about a scenario, there is no way we will touch it with a 100-foot pole without tapping into some motivation. Anxiety is incredibly powerful in persuading us to avoid our feared scenarios. The only way to overcome them is to be motivated.
Our motivation primarily stems from our values. If I’m working with a client experiencing symptoms of anxiety who seems unmotivated to face their fears, I will help them focus on what their core values are. Doing so usually sparks some motivational fire. Here are some common examples of motivators:
- Being a good spouse, parent, friend, or employee
- Demonstrating strength amidst challenges
- Being a person of integrity, bravery, and courage
We can’t do life alone, and we especially can’t wade through challenges without the support of others. Navigating the fear hierarchy of systematic desensitization is not unlike training for a marathon. The demand on our energy levels and motivation can push anyone to the edge of giving up. Without some kind of support the task can seem nearly impossible.
Support can take many forms. It’s always incredibly powerful to know we have the support of our immediate family and friends through thick and thin. But support can expand beyond this as well. Sometimes support comes through our faith. People find great social support through online communities of others going through similar challenges. Sometimes support looks like giving ourselves permission to utilize medication to help us manage the anxiety.
When I see that these two items are in place, I take them as a green light to move forward with this treatment in counseling if a client is ready and willing.
How to Implement Systematic Desensitization
There are a number of ways to implement this technique. In the examples I gave above I’ve reflected from my own experience of walking with clients in the counseling context. However, some may have success utilizing a workbook, either alone or with a support group. Others might be able to succeed on their own simply by creating their fear hierarchy and gently moving through the list on their own.
If you do opt to attempt this strategy outside the context of professional counseling, I encourage you to keep a close eye on how you are experiencing the process, and either setting the hierarchy aside if it becomes too much, or contacting a professional should the need arise. You can even call a therapist in advance of beginning the hierarchy so you have someone you know you can reach out to if you need it.
If you’re interested in the workbook idea, I’ve had great success with this book:
The Anti-Anxiety Workbook: Proven Strategies to Overcome Worry, Phobias, Panic, and Obsessions by (links to Amazon)
This workbook includes strategies for systematic desensitization plus an array of additional helpful tools. If you do well with structure, this may be a great option for you.
I hope you found these tools helpful in your journey with anxiety. As always, I’d like to be clear that this blog post isn’t intended as professional counseling or clinical advice. If you’re in need of support, please consider speaking to a professional to be evaluated.
Dr. Marie Fang is a licensed psychologist offering therapy and counseling services to individuals in the Silicon Valley. Her office is located in central San Jose. One of her primary specialties is working with those looking for help with anxiety. Learn more about Dr. Marie Fang’s Services for Anxiety Counseling.