Systematic Desensitization

Systematic desensitization is a type of behavioral therapy used in the field of psychology to help effectively overcome phobias and other anxiety disorders. More specifically, it is a type of Pavlovian therapy / classical conditioning therapy developed by a South African psychiatrist, Joseph Wolpe. To begin the process of systematic desensitization, one must first be taught relaxation skills in order to control fear and anxiety responses to specific phobias. Once the individual has been taught these skills, he or she must use them to react towards and overcome situations in an established hierarchy of fears. The goal of this process is that an individual will learn to cope and overcome the fear in each step of the hierarchy, which will lead to overcoming the last step of the fear in the hierarchy. Systematic desensitization is sometimes called graduated exposure therapy.

Specific phobias are one class of mental illness often treated through the behavior therapy or cognitive-behavioral process of systematic desensitization. When individuals possess irrational fears of an object, such as height, dogs, snakes, and close spaces, they tend to avoid it. Since escaping from the phobic object reduces their anxiety, patients’ behavior to reduce fear is reinforced through negative reinforcement, a concept defined in operant conditioning. The goal of Systematic Desensitization is to overcome this avoidance pattern by gradually exposing patients to the phobic object until it can be tolerated. This will be challenging for the patient at first to deal with the fear, but gradually, most will overcome this fear. In classical and operant conditioning terms the elicitation of the fear response is extinguished to the stimulus (or class of stimuli).

根據古典制約學習原理，使個體對某種平常刺激的異常反應改變為正常反應的歷程。其步驟如下：

1.訂出焦慮階層表：個體對某一刺激由弱至強的反應程度。
2.實施放鬆訓練：對身心活動的自主控制學習，以身心放鬆減緩情緒上焦慮或緊張。
3.在想像中試驗：運用放鬆訓練抵制可能的情緒反應。
4.在現實中驗證：運用放鬆訓練抵制真實的情緒反應。

Ex：認知治療創始者Beck患有傷血恐懼症，看到手術會害怕、聞到乙醚會頭暈，甚至看到有關醫院實習生的實習紀錄片就昏倒，Beck為了克服這項恐懼。他使用經驗學習系統減敏法，在手術室當助理，強迫自己力持鎮定，直到恐懼開始消退，逐步接觸狀況，到了自己真正操刀時，雖然還是不自在，卻能夠順利進行手術。