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Thursday, February 15, 2007

Systematic Desensitization in Anxiety Treatment

Systematic desensitization refers to a form of psychotherapy used to treat anxiety disorders and phobias in patients. It was pioneered by a South African psychiatrist named Joseph Wolpe. This type of therapy sees a doctor cautiously exposing a patient to various stimuli that the patient initially fears. The theory is that the more desensitized a patient becomes to what was initially fearsome, the more he will be able to confront the source of anxiety and learn how to cope with his or her feelings.
Because of the sensitive nature of this practice, patients must first be taught how to relax and thus better control fear and anxiety responses that will later be provoked by the appearance of the feared object or situation. Once taught these coping skills, the patient will use them to react towards stimuli and overcome challenging situations involving anxiety. This practice is also known as graduated exposure therapy.
Common phobias, which are specific forms of an anxiety disorder, include objects like spiders, dogs, snakes or situations like being in a closed space, amongst crowds or in high places. Up until this point the patient has avoided these objects and situations. However, their exaggerated fears may have been interfering with their daily routine, hence they realize the need for some form of therapy to help relieve the constant anxiety.
That's not to say that they seek distraction, or ways to further avoid the source of their anxiety. Such distractions may include drinking alcoholic beverages, smoking and other addictive behavior. Even prescribed medication can be a distraction, as some medicines work as a depressant and merely slow the mind down rather than actually confronting the source of anxiety.
This goal of this therapy is to overcome the phobia by gradually exposing patients to the phobic object until it can be reconciled, tolerated and eventually accepted. The key word here is gradual. To expose a patient quickly and incautiously to their object of intense fear would be emotionally dangerous or even traumatic. Before the encounter ever takes place the therapist teaches the patient cognitive strategies that can be used to cope with anxiety in general and specific anxiety caused by the appearance of the phobic object. This lets the patient control their fear, and much meditation as well as relaxation techniques are introduced at the outset.
Some forms of relaxation techniques may include breathing techniques, or to reinforce positive thoughts. Another technique that might be used is called cognitive reappraisal, in which the therapist asks the patient to imagine what might happen if he or she would be exposed to the phobic object. This would result in the patient giving an exaggerated vision of disaster and yet contrast the actual exposure, which would be surprisingly peaceful to the patient.
This form of therapy is professionally supervised and safe to the patient's psyche. This is not the type of "Fear Factor" theatrics where patients are thrown into their worst nightmare and manage to instantly learn how to deal with it. Systematic desensitization, when done properly, is a very effective means of coping with anxiety and confronting the source of fear-not avoiding it.

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