Systematic Desensitization as a treatment for phobias

One of the topics that has interested me the most in psychology is the treatment of phobias. Perhaps this is because it is an area that we can point to and say that it is effective. I've read various research on the topic and the studies I've read have concluded that systematic desensitization is effective about 90% of the time for treating simple phobias. A simple phobia is one that is only triggered by a specific stimulus, for example, a fear of dogs or a fear of flying in an airplane. The reason that these phobias are easier to treat as opposed to say Generalized Anxiety Disorder or agoraphobia is because they can be treated with systematic desensitization using a combined method of biofeedback and relaxation techniques. Systematic desensitization is a mouthful, but the treatment approach is as you would expect. You gradually and systematically unlearn the phobia. I say unlearn because simple phobias are something learned through reinforcement and a reduction of anxiety by avoiding the stimulus that is causing the phobia. An example will make it clearer:

June is 7 years old and she comes into contact with a stray dog. June attempts to pet the stray dog and the dog bites her. June is frightened and runs away. The next time June sees a dog, June fears she may get bit again and so she avoids the dog. Each subsequent time June sees a dog she avoids it and each time she avoids a dog, her anxiety is reduced. It is this reduction in anxiety by avoiding the dog that produces the learned phobia. Many people think of the phobia as the fear of the dog. That is correct to a point. After all a phobia is defined as an irrational fear. However, the debilitating part of the phobia really has nothing to do with fear as it has to do with a reduction in anxiety. This is what keeps the phobia going, is the person's avoidance of the dog in this example that is reinforced through a reduction in anxiety.

So in using systematic desensitization we can step-by-step unlearn the client's phobic reaction. For example, lets say June comes to me in my office and asks me to cure her of her phobia. The first thing I'm going to do is hook June up to my biofeedback machine which measures heart rate, blood pressure and galvanic skin response. We will use these numbers to establish a baseline reading of her anxiety levels. Then I would ask June to imagine a scenario where she is walking in the park and she encounters a dog on a leash. Lets say that dog is a relatively non-threatening poodle. I would then ask June what her anxiety level is in this scenario based on a scale of 1-10, with 10 being the most anxious. As I note her self-reported anxiety, I would also note the biofeedback readings.

I would then ask June to imagine that the poodle is not on a leash, but is running towards her. Again I would note June's self-report of her anxiety level along with the biofeedback levels. After the poodle scenario, I would ask June to imagine the dog running towards her is a Rottweiler. You probably get the point now that we are trying to establish a hierarchy of June's phobia. Taking accurate biofeedback readings along with June's self reports to establish a baseline of her phobic hierarchy is a key first step.

More to come...