These behaviors include eating, sexual responses, problem solving (thinking about complex ideas), assertiveness, following instructions (focusing attention on something other than the feared stimulus), curiosity, and relaxation. The basic strategy behind desensitization is to gradually increase exposure to the feared stimulus while engaging in one of the incompatible behaviors. The procedure described here uses relaxation and self-instruction??
The desensitization procedure requires that you remain relaxed as you gradually approach the feared stimulus. This process can be per formed mentally, but whenever possible choose some real-life technique. There are three reasons why this is desirable. First, changes in real-life behavior typically lag behind changes made in fantasy. Second, imagination can rarely duplicate real-life experiences with all the sights, smells, sounds, tastes, and sensory richness. The success of desensitization depends on reconditioning the full array of stimuli that control the anxiety. Most importantly, real-life techniques allow for the learning of new behavior. For example, Frank becomes very anxious whenever he has to speak before a group, and avoids doing so whenever possible. Even if he were to suddenly get rid of his fear, he would still lack the skills necessary to give a dynamic, persuasive speech. The negative feedback he might receive could result in his relearning his fear. Therefore, whenever anxiety is accompanied by a deficiency in the skills necessary to function in the feared situation, you should work on getting rid of your fear and begin to practice the new behaviors required.
Shaping results in a gradual approach to a particular situation, and thus helps you learn new behaviors while desensitizing your fear. Frank could use shaping to overcome his fear of public speaking. He might begin by reinforcing himself for speaking to two or three close friends on a topic he knows well. Then he could gradually increase the difficulty of the topic, the number of listeners, and the threat level of the audience. In this way he would teach himself speaking skills while he reduced his fear of speaking.
But there are times when it is not possible to use shaping techniques. Suppose Frank has to give a speech at a convention scheduled for two weeks from now. The time factor would make shaping unfeasible, so he could use fantasy desensitization to reduce and control his anxiety. When you cannot arrange your daily life so that you can gradually move up real-life shaping steps, fantasy techniques can be used to reduce your anxiety about higher levels of performance. There are five steps in desensitization:
- Listing the feared situations.
- Arranging the feared situations into a hierarchy.
- Training yourself to relax.
- Developing a relaxing scene.
- Step-by-step reconditioning.
The first step is to identify the situations that evoke anxiety. Bill’s nervousness, for example, was not limited to flying itself; he found the takeoff and landing particularly uncomfortable. He experienced anxiety when talking about a trip requiring flying, as well as when others talked about their flights. Packing, leaving the house for the airport, approaching the terminal, boarding the plane--?-all made Bill nervous. One way to cope with this problem is to write down each situation (related to the general fear) in which you experience anxiety. It is important that you include even those situations in which you experience only mild anxiety. Work on one fear at a time.
Developing Your Hierarchy
A hierarchy is a ranked list of 10 to 20 situations that evoke anxiety. Order the situations you identified from the least to the most anxiety-producing. Don't worry about logic in your ranking-use your subjective experience of anxiety as your ruler. Think of your hierarchy as a kind of shaping ladder. Make sure the spacing between steps is about equal so that your progress up the hierarchy will be smooth. A step that is too big will cause you trouble-you will have difficulty exposing yourself to it while remaining relaxed.
The size of your steps can be checked with the SUDS technique. SUDS is shorthand for subjective units of discomfort. Assign a score of zero to a situation that would produce no anxiety whatsoever and a score of 100 to a situation that would produce panic or terror. Steps in your hierarchy should be no larger than 5 to 10 SUDS. If you have a large step in your hierarchy, break it into smaller steps by thinking of intermediate situations.
Developing a good hierarchy is crucial to the desensitization procedure. Make sure that you include the entire range of situations related to the general fear you are desensitizing. For Bill, an airline ad on TV might be mildly anxiety-provoking. Such mild situations are important in the beginning stages of desensitization. They are the first small steps in the ladder that will lead you out of your fear trap. Ruth experienced considerable anxiety when she had to give a directive to anyone who was older than she. Betty, her secretary, was older than Ruth's mother. Each time Ruth contemplated giving Betty a directive, she experienced anxiety and found ways to avoid giving the directive. Here is Ruth's hierarchy:
- Looking at a memo that requires giving Betty a directive.
- Making a list of things to do for the day, some of which re quire directing Betty.
- Directing Betty to give a specific message to people who call on the phone.
- Passing Betty's area and seeing her idle.
- Directing Betty to type rather than write out phone messages.
- Looking at a draft of a report that must be typed.
- Directing Betty to do routine photocopying.
- Buzzing Betty on the intercom to call her into the office.
- Entering Betty's area to give a directive.
- Directing Betty to do a routine typing task.
- Directing Betty to do a lengthy typing task.
- Directing Betty to complete a task before going home.
- Directing Betty to retype a letter containing an error.
- Repeating a directive when Betty makes an excuse.
- Directing Betty to be prompt in the morning.
The next step is to learn to relax. Your goal is to be able to recognize when you feel tense and to be able to relax your entire body. The success of your desensitization depends in large part on your ability to relax.
The procedure for developing a relaxing scene is the same as for managing stress (your anti-stress scene). In fact, you can use the same relaxing scene to desensitize anxiety and to manage stress.
Step-by-Step Reconditioning
To desensitize yourself, relax completely, then vividly imagine a situation from your hierarchy. It is important not to rush into the reconditioning stage prematurely. In order to desensitize yourself, you need to be able to identify small degrees of tension. As soon as you feel any tension whatsoever, you must begin to relax yourself completely.
Conduct your desensitization in a peaceful setting-the place where you did your relaxation training is best because it is already associated with relaxation. Each session should take about 20 minutes.
Begin by relaxing completely, then imagine the first item on your hierarchy. Use all your senses and actively participate in your fantasy. See yourself confronting the feared situation and doing whatever you can to remain relaxed. You might take a deep breath, give yourself specific instructions, or tense and relax particular muscles. Any or all of these coping behaviors would be appropriate. After about 10 seconds, switch off the fearful scene and switch on your relaxing scene.
Monitor your tension at all times, and if at any point you experience any tension, immediately switch to your relaxing scene. Continue to enjoy your relaxing scene for about 30 seconds until you are again completely relaxed. Then repeat the procedure by imagining the same situation from your hierarchy. When you can repeat the first hierarchy situation three times while you are completely relaxed, you will be ready to move to the next one. In this way, slowly proceed up your ladder. Begin each new session with the highest item on the hierarchy that you were able to imagine while relaxed.
Real Life Reconditioning
Desensitizing yourself in real-life situations is like desensitizing yourself in your imagination, except that here you place yourself in the midst of the feared situation. As I said before, real-life techniques are more powerful, but they are also more difficult. Approaching the feared situation in your fantasy is relatively safe, no matter how anxiety-producing it may be, because nothing can actually happen to you. Confrontation in real life, however, is another matter, because you must deal with the actual feared situation.
It is very important that you give your real-life hierarchy a lot of thought, because your success depends on it-a step that is too large could be disastrous. It will be hard enough to place yourself in the feared situation, but if you attempt to move too rapidly up the hierarchy by taking large steps, you are very likely to experience anxiety. This will only strengthen the fear and discourage you from trying again, so take only small steps and proceed very slowly. Make sure you move on to the next step only after you have been able to remain completely relaxed at the former step. The objective is to place yourself in the feared situation while engaging in a behavior that blocks anxiety (a behavior incompatible with anxiety). For example, Bill might eat dinner at the airport several times, or while he's in flight he might look at the pictures in an erotic magazine.
