Systematic desensitization

Human behavior is primarily shaped through learning. Experience and learned rules have an influence on doing and thinking. However, this can also lead to mental disorders that have been shaped by learning experiences.

In the field of psychotherapy, there is a special form of treatment called behavioral therapy. This presupposes that possible behavioral disorders can be traced back to learned incorrect attitudes, which can be eliminated through targeted deconditioning, i.e. conscious relearning. The aim is not to uncover the roots of undesirable developments, but to examine people's points of view and behavior and correct them if necessary. Another method used in behavior therapy is systematic desensitization.

What is systematic desensitization?

Systematic desensitization was founded by the American psychiatrist Joseph Wolpe and is primarily used to reduce fears and phobias.

In doing so, it relies on the classic conditioning that was developed by Ivan P. Pavlov, who carried out the first attempts at conditioning on a dog. This reacted not only to the sight of food with saliva formation, but also to the ringing of a bell. From this, Pavlov concluded that a reaction inevitably occurs to a stimulus. In humans in particular, many fears and associated psychosomatic illnesses are classically conditioned.

Function, effect & goals

Systematic desensitization assumes that a state of anxiety and physical relaxation are not possible at the same time. Therefore, the fear must first be investigated.The sequence of therapy is a multi-phase process.

At the start of therapy, the patient creates a hierarchy of their fears. As an example, fear of dogs can be viewed more specifically when the fear of large dogs increases towards small ones. This is followed by relaxation training. Once the fear is defined, the person concerned learns relaxation techniques which he can use to gradually overcome his fears. That can be B. autogenic training, meditation exercises or progressive muscle relaxation.

Autogenic training is a relaxation technique based on autosuggestion and 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. With autogenic training, the patient puts himself under the guidance of his therapist, later alone, in a hypnoid, i.e. in an idea that is withdrawn from consciousness itself and is intended to bring about relaxation generated from within. He can lie or sit.

Successive formulas soon allow a retreat from the environment and everyday stress as meditative absorption. Such formulas can support the experience of heaviness, warmth, the regulation of heart and breathing, in that the patient suggests to himself that he is very calm, he can feel his arms and legs, the heart, his own breathing. After being immersed, the patient returns to the environment and stretches his body.

Meditation is a more spiritual practice that promotes mindfulness and calm. It should help to see the present as a superficial state of consciousness in addition to the awareness of everyday life and thus to achieve inner balance in concentration. Various techniques, which are shaped by the Eastern art of healing, were also adapted to the needs of the West. There are active and passive exercises. Active techniques include ZEN, concentration and rest meditations. B. Yoga, martial arts or tantra. Passive meditation is better suited for systematic desensitization, as it deepens breathing, slows the heartbeat and relaxes the muscles.

The progressive muscle relaxation is justified by the physiologist Edmund Jacobson. It is a technique that aims to relax the mind and body and also to improve self-awareness. Individual, precisely defined muscle groups are tensed and relaxed again one after the other in a fixed order. The patient must differentiate between tension and relaxation and consider them consciously in order to concentrate on them. This is to reduce anxiety.

After these exercises, the fear is examined more closely again, the fear object should be consciously perceived as an image in the relaxation phase. As soon as fear arises, 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 are gradually taken through, which trigger more fear at the various levels, until finally the highest object is reached. If all phases are over, the patient is finally confronted with the object itself, e.g. B. with the dog he was afraid of before, or with his fear of flying, where he then takes a flight.

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Risks, side effects & dangers

Anxiety disorders are incorrect or overreactions of the body. Although there is no real reason for such a reaction, it switches to an alarm in the autonomic nervous system.

Anxiety disorders include phobias, panic attacks, post-traumatic stress disorders and generalized anxiety states. All of these disturbances bring a great deal of anxiety and physical excitement with them and result in the desire to want to avoid the respective fear trigger through targeted thoughts or actions, whereby the fear is intensified and cannot go away.

Various behavioral therapy procedures are helpful in such conditions. The advantage of systematic desensitization is: a. that the person concerned first only has to imagine the fearful situation in order to overcome the fear through relaxation. The procedure is primarily used when practical exercises are not yet possible due to phobias and fears.