If, after going through this three times, the difficult item still doesn ' t yield, this means that the jump is too great between it and the previous item. You should then modify your hierarchy by inserting one or two items between these two. These new items should be less anxiety-provoking than the one which gave you trouble but slightly more anxiety-provoking than the last one you completed. One good way to invent such intermediate items is to consider the situation of the difficult item and then think up ways to make that situation slightly less fearful.
If the difficult item appeared very early in the hierarchy, this means that you are starting off with items that are too difficult, and that you should begin the hierarchy with a couple of very easy items and then work up very slowly. Thus, if you were working on item 6, for instance, and had not completed it when the session ended, you should start the next session with item 5 and stay with it until you have again imagined it three consecutive times without anxiety.
Then go on to 6. On this run-through you should be able to imagine each item on the list three consecutive times without the slightest tension or nervousness.
If any item still evokes the slightest bit of anxiety, stay with it until it is completely anxiety-free. You may reach the end of your hierarchy before the end of the four weeks or you may not a nd just work at your own pace. The completion of an item on your hierarchy in desensitization sessions indicated that you are making progress toward the alleviation of your problem.
The real test that you are solving the problem, however, is that your ability to imagine a situation without anxiety is followed by an ability to experience the real-life situation without anxiety. For some people, such transfer is almost immediate: some people take longer to achieve the ability to experience the analogous real-life situation without anxiety.
The lag may range from a few days to several days or weeks, depending on the person and the particular item. Should you have progressed a good way into your hierarchy without noticing any significant transfer to analogous real-life situations, that is, situations related to your target behavior, it is likely that you are not desensitizing the items completely.
This can often be remedied by spending a full session on relaxation between each group of 5 to 8 desensitizing sessions. Then be sure you are completely anxiety-free before leaving one item and proceeding to the next. After you have completed a few items successfully in your hierarchy , begin to follow this important rule. AVOID situations very high on your hierarchy which you are not ready for.
If you end up in a situation that has a negative outcome , you may experience a "set-back. SEEK encouragement and assistance from those who can adequately provide it to you.
Having family or friends, or a counselor routing for you can be very helpful. If it is, get help with improving skills. Example: A I will have a celebration, trip on Saturday, etc. I will eat dinner only after I ask Sara for a date, etc.
Role Playing. The other technique you will be using in this project is role playing, and the remainder of this manual deals with that technique and that of record keeping. Since you have read a substantial amount, you might want to take a break and continue reading in about ten minutes.
Don ' t get too tired. But be sure to read and understand this entire manual! NOTE: Most of the role playing techniques can be done in your imagination. This is also an effective way to do it if you cannot find a group partner. You will be working on desensitizing yourself to the steps on your hierarchy every other day.
In order to maximize your success, you may combine the desensitization procedure explained above with another procedure, role playing. Therefore, you will be alternating desensitization and role playing, doing desensitization every other day and role playing every other day. After you have spent two days learning how to relax yourself start on Friday so these days would be Friday and Saturday.
Spend one day working on the first one or two items of your hierarchy. Then, on the fourth day, role play the item with another person for 1. The next day, of course, you would be back to desensitization and work on completing the items on your hierarchy which are the first and second step with positively no anxiety in desensitization. To repeat, then, on Friday and Saturday you ' ll be practicing relaxation, role play, on Tuesday you ' ll desensitize, etc.
You will be alternating these two procedures throughout the experiment a nd role playing the item s you worked on in desensitization the day before. Role playing is one successful technique that can aid you in unlearning the anxiety you ' ve learned to experience with your target behavior and can help you feel more calm and comfortable in your target situation.
Briefly, role playing is simply acting out a behavior that makes you feel anxious with someone you feel calm and comfortable with. Using role playing, then, you will act out each step on your hierarchy. Role playing each step will help you to become less anxious about those situations related to your target behavior. You will be using the hierarchy you have constructed and will slowly work your way from step to step by acting each one out until you feel calm and comfortable in the role playing situation.
You will go through this acting out process with someone who you feel very comfortable with, someone who can pretend is a person involved in your target situation but who does not make you anxious. Role Playing Partner. It is very important that your role playing partner be someone your are completely comfortable with. This way you can continue to associate a comfortable, relaxed feeling with each step in your hierarchy.
His or her characteristics, such as sex and age, can be largely determined by your own preferences. Be sure the person is interested in helping you and willing to work with you about 15 minutes every other day for four weeks.
Stress the importance of completing the project to your partner a nd that the project is important to you and to your psychology grade. Be sure that your partner will stay with you through the experiment. It would be very disappointing to you and the experimenters if you were proceeding well with your modification plans and then had to forfeit valuable time in looking for another partner.
Often family members or close friends are ideal role playing partners. They are already concerned with your welfare, easily available, and usually the most relaxing people for you to be with. You can present the experiment as a project for your psychology course and tell the partner how he too can benefit from the experience. He will learn a technique for modifying some of his own anxieties, help you get a good course grade, and be pleased at your progress with your target behavior.
Most of all, make sure the person you pick is someone who takes your project seriously and really wants you to improve. To repeat, then, when picking your role playing partner, make sure that he or she has these characteristics:. S He must be a person with whom you are completely comfortable.
S He must be seriously interested in helping you succeed with your modification plan. S She must be available every other day for 15 minutes over a four week period.
Briefly explain these points to the person when you ask him to be your partner:. Try to pick up your role playing partner by Monday, March 15, so you can begin to role play the first one or two steps on your hierarchy that day a nd after successfully desensitizing the item s the day before.
To repeat, you will be pretending that your role playing partner is someone connected with your target behavior. Therefore, since you are role playing, the sex or age of your partner does not matter. For example, if you are a male who is modifying his anxiety around women, you wouldn't have to pick one to be your role playing partner. You could pick your mother or your father, your next door neighbor and any one person who cares about your progress and who you feel very much at ease with.
If you are modifying anxiety around groups or more than one stranger, your role playing partner would play the role of the group of strangers. Role playing is a technique which simulated a real life situation, therefore, your role playing partner can be of great help to you in this project.
As stated above, you should pick your role playing partner and begin to role play the first step on your hierarchy on Monday. On Monday, get together with your partner and find a quiet, private place where you can role play for about 15 minutes without being interrupted. Begin with the first item on your hierarchy. Before the session begins, carefully explain to your partner the characteristics of the person or people he ' ll be acting out. Make sure you both understand the parts you ' ll be playing.
If, for example, you are role playing step one in a hierarchy that deals with anxiety about interacting with members of the opposite sex, and your first step simply is to look at a member of the opposite sex, you will just pretend that your role playing partner is a member of the opposite sex. If your target behavior is talking to your boss and your first step is saying hello to the boss when he looked like he ' s in a grumpy mood, your role playing partner would play the boss by looking gruff and acting like he ' s in a bad mood.
You will have told him how to act before you start the session, of course, so you won ' t have to stop in the middle of role playing and explain something to your partner, thereby breaking the effect. Of course, you are to feel very comfortable, confident, and at ease when you are role playing. If you role play an item and feel at ease, role play it two more times so you ' ll be roll playing the item three consecutive times without feeling any anxiety at all.
If, however, you feel anxiety when you role play a particular item, role play it three more times. If you still feel anxiety on the fourth role playing trial, return to the previous item on your hierarchy and role play it three times without feeling uncomfortable or anxious.
Go on to the difficult item and try role playing it again. If you still don ' t feel at ease role playing the difficult item, you probably need to insert one or more steps in your hierarchy between the two items.
If this happens, insert the new step s and begin role playing it them. Be sure to always role play an item three times without feeling any anxiety before you go on to the next item. Try to achieve the relaxed state you use in your desensitization sessions. The length of time it takes for you to role play different items will be different for various items. Some items like, for example, the first ones on your hierarchy will take only a few seconds or minutes to role play.
An example of this would be a man who is modifying his anxiety around women and who was role playing a step on his hierarchy that said " smiling at a woman". That step would only take a few seconds to role play. If he role played the step three times without feeling anxiety during a session, he could go on in his hierarchy and role play one more item.
If you complete an item and have 5 or 10 more minutes left in your role playing session, go on to the next item, but do not role play more than two items per day same as for desensitization. But try to complete at least one item per session. As you come to the last items on your hierarchy, you may find that your items take longer to role play than the beginning ones on your hierarchy. For example, you might be role playing an item that says A have a 10 minute conversation with my boss.
In that case, you may have to spend a few half hour role playing sessions on each step near the end of the study. If this happens and you cannot complete the item in one day, continue role playing it the next session. As we said before, You ' ll be role playing every other day. Between each trial, or each time you role play the item, take a 15 second break during which you and your partner relax. During this time, you can return to your normal relationship, but be prepared to resume your roles.
When you complete the role playing of an item three times without feeling any anxiety in the role playing situation and you ' re ready to go on to the next item, take a break and tell your partner the role he will be playing next. Be sure that you and your role playing partner take the role playing sessions seriously. Concentrate on the roles you are playing. Imagine the situation vividly, as you do in desensitization. The role playing technique should help you relax when you are in the real life situation; it will help make you aware of the various components of the situation you will encounter in real life.
It will help you improve your smoothness and your skills. If the experience of seeing people dying, in real life or the media, becomes normalized, you may no longer experience an emotional reaction to it. You may not cry; you may not feel sad or angry.
You may continue with your day as if nothing even happened. Those who are more susceptible to death desensitization are soldiers, medical professionals, frontline workers, drug users, those in recovery, and those living in areas with high crime rates.
Watching violent movies and playing violent video games can also lead to the desensitization of violence, but exposure to real-life violence has a greater impact. One study found that youth exposed to high levels of violence may experience more trauma and avoidance , escape to fantasy, and express less empathy.
For those in situations where death is inevitable, such as trauma units or war, desensitization can benefit survival. Avoiding the emotions associated with death may make it easier to deal with the constant exposure. If you live in a crime-prone neighborhood, you may witness violence and death on a routine basis.
You may not have the option to avoid death, but you can practice coping mechanisms to deal with it. If you want to prevent desensitization or practice coping mechanisms, Eiseman recommends the following suggestions:. Attending therapy can also help, Eiseman explains. You can work with a professional on letting go of difficult images, memories, thoughts, or other traumas. One common therapeutic intervention uses "regression," he explains.
This includes creating a therapeutic experience in which desensitized feelings can become re-connected to experiences and circumstances.
Though it brings negative emotions along with the positive ones, this can help people with death desensitization return to a healthy relationship with loss. Cognitive-behavioral therapy CBT may help. So if exposure to death has created certain neural pathways, then working with a trained therapist can help to counteract this by challenging your thoughts and behaviors and generating new pathways in your brain.
Eiseman also recommends internal family systems IFS , which can help you reengage your emotions and learn to become sensitive to death again. If you are constantly thinking about death or have death anxiety, therapy may help. The first step is preparation. This involves both mental preparation and crafting a plan. First, you need to make sure you're ready for this and you need to make sure you can commit to it.
It's actually possible to increase your fear if you expose yourself to the trigger and don't follow through with your desensitization plan.
You also need to make sure you know in advance what you're going to do and how you're going to do it. Once you're ready, it's time to get started. There are two different techniques used for desensitization therapy, which we will describe below, but before you begin make sure you've written down on paper your view of how much the triggers bother you.
Most people have more than one trigger, and you'll want to solve one before you move on to another. Use a 1 to 10 scale, where 10 is "severe anxiety" and 1 is "no anxiety. Always start with your worst, because your worst fear often contributes to other fears. Then do one of the following:. Remember, only do one trigger at a time.
Your end goal is to make sure that the trigger only causes a 1 or 2 on the anxiety scale before you move on to the next one. Every day or whenever possible , continue exposing yourself to the fear.
If you're using the progressive desensitization technique, wait until each individual cause of fear stops causing as much anxiety. Let's use the spiders as an example:. Progressive desensitization involves ramping up towards what causes you the most fear. It's not always a great idea to skip right to the end, because the fear can be too pronounced.
Gradual - especially for imagined fears, is much better. For real fears, or those that benefit better from controlled desensitization, continue the same controlled technique making yourself dizzy, in this case until it simply stops causing you anxiety.
You feel yourself tense up every time a dog starts barking. To combat this, you concentrate on relaxing your muscles and imagining yourself on a beautiful beach — one without dogs. You open your eyes and repeat this process for the next 30 minutes. You practice relaxation exercises each time you think about the dog getting out. As you prepare to conquer your level 10 fear — walking through a dog park — you decide to spend some time in the puppy area of your local animal shelter.
Puppies are less frightening to you, but the thought of them being so close still makes you feel anxious. You have to step outside a few times to do some deep breathing and visualization exercises.
Finally, after months of work, you head back to the dog park. This time, you park your car and walk through the gates. You sit on a bench and practice deep breathing as you watch the dogs playing.
If low-level exposure makes you feel anxious, keep practicing your relaxation techniques and working on that fear. You might spend months on a single one, only to blast through the next two over the course of a few weeks. Take as much time as you need. If you move too fast, you may put yourself through unnecessary discomfort.
Start by asking yourself a few basic questions:. Next, start making a list of therapists in your area. If cost is an issue, check out our guide to affordable therapy.
It can be even harder if you have a mental health condition, such as a phobia, anxiety, or panic disorder. Systematic desensitization can help you overcome your fears at a pace that works for you.
Don't face mental health challenges alone.
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