Human behavior is primarily shaped by learning. Experiences and learned rules influence actions and thinking. However, this can also lead to mental disorders that have been shaped by learning experiences. In the field of psychotherapy there is especially the treatment form of behavior therapy. This presupposes that possible behavioral disorders can be traced back to learned faulty attitudes, which can be eliminated through targeted deconditioning, i.e. conscious re-learning. The aim is not to uncover the roots of maladaptive attitudes, but to examine and, if necessary, correct the person’s views and behavior. An applied method of behavior therapy is again systematic desensitization.
What is systematic desensitization?
Systematic desensitization is an applied method of behavior therapy. Systematic desensitization was founded by the American psychiatrist Joseph Wolpe and is used primarily to reduce fears and phobias. It is based on classical conditioning, which was developed by Ivan P. Pavlov, who carried out the first conditioning experiments on a dog. This dog reacted with salivation not only at the sight of food, but also at the ringing of a bell. From this, Pavlov concluded that a reaction is inevitably to a stimulus. Especially in humans, many fears and associated psychosomatic diseases are classically conditioned.
Function, effect, and goals
Systematic desensitization assumes that a state of anxiety and physical relaxation are not possible simultaneously. Therefore, the first step is to get to the bottom of the anxiety. The sequence of therapy is a multiphase process. The patient creates a hierarchy of his fears at the beginning of the therapy. As an example, the fear of dogs can be considered more specifically, when the fear increases with large dogs compared to small ones. This is followed by relaxation training. Once the fear is defined, the person learns relaxation techniques that he can use to gradually overcome his fears. These can be autogenic training, meditation exercises or progressive muscle relaxation, for example. Autogenic training is a relaxation technique based on autosuggestion, developed in 1920 by the German psychiatrist Johannes H. Schultz. It is based on the knowledge of biological processes in the body during the state of hypnosis. During autogenic training, the patient, under the guidance of his therapist, and later on his own, puts himself into a hypnoid, that is, into an imagination that is removed from consciousness itself and is intended to cause relaxation produced from within. He may lie or sit during this process. Successive formulas soon enable a withdrawal from the environment and everyday stress as a meditative absorption. Such formulas can support the experience of heaviness, warmth, regulation of heart and breathing, as the patient suggests to himself that he is completely calm, he feels his arms and legs, the heart, his own breathing. After being absorbed, the patient returns to the environment and stretches his body. Meditation is a more spiritual practice that promotes mindfulness and calmness. It is designed to help one see the present as the foremost state of consciousness alongside awareness of everyday life, and thus achieve inner balance through concentration. Various techniques, which are influenced by the eastern art of healing, have also been adapted to the needs of the West. There are active and passive exercises. Active techniques include ZEN, concentration and quiet meditation, while active techniques include yoga, martial arts and Tantra. Passive meditation is more suitable for systematic desensitization because breathing is deepened, the heartbeat is slowed down and the muscles are relaxed. Progressive muscle relaxation is founded by physiologist Edmund Jacobson. It is a technique aimed at relaxing the mind and body, and also improving self-awareness. Individual, precisely defined muscle parts are tensed and relaxed one after the other in a fixed sequence. The patient must distinguish between tension and relaxation and consciously observe them in order to concentrate on them. This is intended to reduce anxiety.After these exercises, the fear is looked at more closely again, the fear object should be consciously perceived as an imagination during the relaxation phase. As soon as fear arises, the training is interrupted. These actions take place until the patient can look at the object without fear. Through the previously established fear hierarchy, in the relaxed state of systematic desensitization, all the objects that trigger more fear at each of the different levels are gradually gone through until finally the highest object is reached. Once all the stages are passed, the patient is finally confronted with the object itself, e.g., the dog he was previously afraid of, or his fear of flying, in which case he takes a flight.
Risks, side effects, and dangers
Anxiety disorders are misreactions or overreactions of the body. Although there is no actual reason for such a reaction, it switches on alarm in the autonomic nervous system. Anxiety disorders include phobias, panic attacks, post-traumatic stress disorder, and generalized anxiety. All of these disorders involve a strong anxiety and experienced physical arousal and entail the desire to avoid the respective anxiety trigger through specific thoughts or actions, whereby the anxiety, however, is intensified and cannot disappear. Various procedures in the field of behavioral therapy are helpful in such conditions. The advantage of systematic desensitization is, among other things, that the affected person initially only has to imagine the fear situation in order to overcome the fear through relaxation. The procedure is primarily used when practical exercises are not yet possible because of the phobias and fears.
