By Jennifer Copley (Last Updated 27 January 2015)
Systematic Desensitization for Phobia
Systematic desensitization involves breaking a feared situation down into small, manageable steps and then progressing systematically through this fear hierarchy, ideally with the support of a therapist or trusted companion. For example, if you were afraid of riding in elevators, you could conquer your fear by working through the following steps:
- Learn about elevator safety (for example, how low the risk of getting trapped is and how quickly help would come in response to an alarm).
- Several times each day, for a week or two, visualize entering an elevator while engaging in calm, slow breathing until you can imagine riding in an elevator while feeling relatively calm.
- Alone or with a support person, approach an elevator on multiple occasions; when you can do this without anxiety, try stepping inside and standing there without letting the doors close.
- When you can stand in an elevator without panicking, practice riding up a single floor with a support person, then multiple floors with a support person.
- When you can ride in the elevator comfortably with support, practice riding a single floor and then multiple floors on your own, but with a support person waiting nearby.
- Practice riding an elevator on your own, without a support person nearby.
The great thing about systematic desensitization is that it gives you greater control over your responses. Instead of waiting fearfully for some anxiety-provoking situation to arise, you directly face your fears, controlling the pace and timing and choosing to move courageously through the fear and out the other side. This approach, which is proactive rather than reactive, increases empowerment, a feeling of control and self-efficacy, and ultimately, the likelihood of conquering your fears completely.
Systematic Desensitization for Exercise
Cardio exercise among the most effective treatments for anxiety and depression. Many people want to start exercising but are held back by fears that they are too unfit or that an increase in heart rate will trigger a panic attack. Rather than trying to start a running program right away, it’s best to work up to it by completing the following steps, doing each activity until you’re comfortable with it and then moving on to the next:
- Go for a walk around the block each day.
- Go for a 20-minute walk at a normal pace each day.
- Go for a 20-minute brisk walk each day.
- Go for a brisk 20-minute walk each day and jog for 1-2 minutes out of each 5 minutes.
- Jog for 10 minutes and walk for 10 minutes each day.
- Jog for 20 minutes each day.
- Jog for 20 minutes each day and add a couple of quick sprints.
- For 20 minutes each day, alternate jogging and running at a higher speed.
- Run for 20 minutes each day.
- Run for 30 minutes each day
Some people prefer to do the series on their own, whereas others do better with support. You can do the entire series with a support person initially if you need to and graduate to solo excursions as you gain confidence. It can help to visualize successful completion of the tasks and positive long-term outcomes before beginning each new step.
The most important aspect if this process is to work on it every day, or almost every day. Repetition is what creates benefits such as desensitization to threatening feelings and increased ability to relax your body and mind through various techniques.
Also, keep in mind that progress is often two steps forward and one step back. Some days you’ll have breakthroughs; others you may struggle. It’s important not to feel hopeless or give up just because you have a bad day during which everything is more difficult or you miss a day of training. Remind yourself that it’s just one day, one practice session – it doesn’t reflect your overall progress, and it doesn’t mean that you have stopped moving forward overall. Working toward your goals is practice; it’s not a test. By simply making an attempt, you’ve moved closer to success.
Systematic Desensitization for Panic Disorder
Sometimes, rather than having a specific phobia, people fear the physical sensations of panic itself (dizziness, racing heart, feeling unable to get enough air, etc.). There are a number of exercises such as spinning in a chair for 30 seconds (to learn to deal with nausea and dizziness), breathing through a straw for 30-60 seconds (to desensitize to breathlessness, rapid heartbeat, dizziness, etc.), or running up and down the stairs for 30-60 seconds (to desensitize to rapid heart rate and breathlessness) that you can do, ideally, with a supportive companion. Anxiety BC provides a full list of desensitization exercises (see references at the bottom of this article for a link). The organization recommends:
- Starting with the least scary exercise and working your way up
- Doing one exercise until you can complete it without anxiety on multiple occasions before moving on to the next
- Doing at least one practice session each day
Systematic Desensitization for Agoraphobia
If you’re tackling a wide variety of fears due to panic disorder with agoraphobia, set small incremental goals, such as being able to enjoy a movie without being anxious in the theater, driving in traffic without feeling panicky, and others relevant to your situation. The achievement of large goals is the sum of many small, attainable goals. Reward yourself each time you achieve a goal (purchase of something you want, go out for a meal with friends, have a long bubble bath – whatever you enjoy).
See Expand Your Comfort Zone for more information on facing fears as part of daily life practice. See also Anxiety BC’s Facing Your Fears: Exposure fact sheet for more detailed systematic desensitization instructions (see the link below in the reference list).
For a full list of natural anxiety therapies, visit the main Natural Anxiety and Panic Treatments page.
This article is provided for informational purposes only and is not intended as a substitute for medical or psychiatric advice. Medical concerns should be referred to a qualified doctor.
- AnxietyBC. (n.d.). “Self-Help Strategies for Panic Disorder,” “Exposure Exercises for Panic Disorder” and “Facing Your Fears: Exposure.” AnxietyBC.com.
- Dryden-Edwards, R., MD (Author), Conrad Stoppler, M., MD (Editor). (25 March 2010). “Panic Attacks.” EMedicineHealth.com.
- Maertz, K. (2014). “Panic/Anxiety Attacks.” University of Alberta, UWell.UAlberta.ca.
- Smith, M., MA; Segal, R., MA; & Segal, J., PhD. (2012, January). “Therapy for Anxiety Disorders.” HelpGuide.org.
- Wilson, R., Dr. (n.d.). “Panic Attacks.” Anxieties.com.