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Systematic desensitization therapy: How does it work?

Systematic desensitization therapy: How does it work?

Whether it’s for OCD, trauma symptoms, or another condition, systematic desensitization therapy can help make triggers manageable, or even allow you to overcome them altogether.

Read on to learn more about how systematic desensitization therapy works, how it differs from exposure therapy, and whether it might be right for you.

What Is Systematic Desensitization Therapy?

Systematic desensitization therapy is a type of exposure therapy used to treat high levels of anxiety and symptoms that can be tied to post-traumatic stress disorder (PTSD), anxiety disorders, OCD, as well as other mental health conditions. This type of therapy works to reduce the levels of distress that triggers cause. Triggers can be anything from an environment to a memory, an action, or any other source of anxiety. 

Systematic desensitization therapy can be used in a number of ways to reduce levels of anxiety, help increase a person’s ability to function with anxiety, and improve a person’s overall well-being. 

How Does Systematic Desensitization Therapy Work?

Essentially, systematic desensitization therapy exposes you to an anxiety or fear trigger in a controlled and graded way to teach your body that the trigger is not harmful or life-threatening. Alongside this exposure, a clinician will guide you through relaxation techniques to help further prevent feelings of anxiety.

This approach, created by Joseph Wolpe, is based on the idea that someone cannot feel both anxious and relaxed at the same time. By incorporating the use of relaxation techniques with gradual exposure to a trigger, people can desensitize themselves to triggers and decrease their anxious responses over time.

While systematic desensitization therapy is similar to exposure therapy, they are not exactly the same. Systematic desensitization therapy uses many of the principles and techniques of exposure therapy, namely gradual exposure to triggers. However, exposure therapy has less of an emphasis on including relaxation techniques in treatment.

What Are the Three Steps of Desensitization?

To set you up for success and ensure you have the tools you need, here are three steps your clinician will guide you through before beginning exposure therapy:

  1. Practice grounding tools. Grounding tools are exercises that help decrease anxiety as it’s happening. These can look like taking measured breaths for a certain amount of time (breathing techniques) or engaging the senses by naming your surroundings (333 technique). Each of these is meant to draw focus away from your building anxiety to help calm you down.
  2. Identify the trigger. This process is important for getting to the source of the issue. By figuring out what’s causing t your anxious reactions, you can start to figure both why it’s occurring and how best to care for that part of yourself.
  3. Create an exposure ladder (ranking triggers by severity of response). This is a list of triggering or anxiety-inducing scenarios created by the client and ranked from least distressing (at the bottom) to most distressing (at the top). Once these fears are laid out, you and your therapist can start working your way through each of these fears, eventually making it to the one with the highest-intensity reaction.

Conditions Treated with Systematic Desensitization Therapy

Systematic desensitization therapy can be used to treat a variety of anxiety- and fear-related disorders and conditions, including: 

  • Trauma-related disorders, such as PTSD
  • Anxiety disorders
  • Obsessive-compulsive disorder (OCD)
  • General phobias

Systematic desensitization therapy works on each of these disorders by gradually working through feared scenarios and stimuli, slowly exposing the client to the triggers their mind is reacting to and giving them tools to help them relax as they move through their fear. Over time, the exposure and relaxation techniques should work together to lessen their reactions to triggers, allowing them to live their life with decreased levels of anxiety.

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Are Systematic Desensitization Therapy and EMDR the Same Thing?

No, systematic desensitization therapy and EMDR are not the same thing. While EMDR (eye movement desensitization and reprocessing) can focus on desensitization and reducing responses to triggers, it uses this tool as part of its wider protocol. EMDR works by exploring past events and using eye movement to help the brain process the experience fully. It does not involve direct exposure to feared stimuli and is most often used to treat those with trauma or trauma-related disorders, such as PTSD.

Systematic desensitization therapy can also be used to treat symptoms of PTSD, but like standard exposure therapy, it’s mainly used to decrease responses to specific stimuli.

Benefits of Systematic Desensitization Therapy

Systematic desensitization therapy can radically change people’s lives. Triggers stemming from anxiety, PTSD, OCD, or other fear-inducing disorders often lead people to avoid common places or environments and can make it difficult to see friends, do enjoyable activities, or even leave the house. It can feel isolating and draining to manage on one’s own. 

Approaches like systematic desensitization therapy and exposure therapy can help free people from their intense anxiety and fear, allowing them to live the life they want to live. If it’s a phobia, people can do things they couldn’t before, like driving, seeing loved ones with dogs, or feeling calm stopping at a stoplight. People with PTSD can lessen the occurrence of flashbacks, panic attacks, and other negative symptoms.

If you struggle with anxiety, trauma symptoms, or any other mental health issues that feel out of your control, consider speaking with a mental health professional about your symptoms. They can help you get diagnosed, discover the root of your symptoms, and create a treatment plan that works for you.

  • Medical writer
  • Editorial writer
  • Clinical reviewer
Kate Hanselman, PMHNP in New Haven, CT
Kate Hanselman, PMHNP-BCBoard-Certified Psychiatric Mental Health Nurse Practitioner
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Kate Hanselman is a board-certified Psychiatric Mental Health Nurse Practitioner (PMHNP-BC). She specializes in family conflict, transgender issues, grief, sexual orientation issues, trauma, PTSD, anxiety, behavioral issues, and women’s issues.

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Theresa Lupcho, LPCLicensed Professional Counselor
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Theresa Lupcho is a Licensed Professional Counselor (LPC) with a passion for providing the utmost quality of services to individuals and couples struggling with relationship issues, depression, anxiety, abuse, ADHD, stress, family conflict, life transitions, grief, and more.

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Hannah DeWittMental Health Writer

Discover Hannah DeWitt’s background and expertise, and explore their expert articles they’ve either written or contributed to on mental health and well-being.

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