Instructions are based upon the desensitization procedure
developed by Joseph Wolpe. (see his book, AThe
Practice of Behavior Therapy@).In
about 90% of the cases, persons completing desensitization are able to reduce
fears or anxieties to normal levels of the fears/anxieties one associated with
specific situations They were designed so that one person can administer
desensitization to himself.It
would also be possible to administer them to someone else.DS has been demonstrated by many experiments to be an effective way of
A Sample List of Common Phobias for Which
Desensitization has been successful in reducing anxiety and fear:
* Mysophobia - Fear of Germs * Trypanophobia - Fear of Needles * Acrophobia - Fear of Heights * Bathmophobia - Fear of Slopes * Illyngophobia - Fear of Vertigo * Thanatophobia - Fear of Death * Glossophobia - Fear of Public Speaking * Social Phobia - Fear of People * Stage Fright - Fear of Performing
* Agoraphobia - Fear of Open Spaces
* Arachnophobia - Fear of Spiders * Herpetophobia - Fear of Reptiles * Ophidiophobia - Fear of Snakes * Ornithophobia - Fear of Birds * Cibophobia - Fear of Food * Emetophobia - Fear of Vomiting * Dentophobia - Fear of Dentists * Hypochondria - Fear of Illness * Iatrophobia - Fear of Doctors
addition to using these instructions, it is
desirable to use a set of taped instructions by Tom G. Stevens, Ph.D.
Instructions@.(You may bring
your own C-90 cassette tape to the Learning Assistance Center, and they
will make a copy of it on your tape which you may keep.Ask for PST #11.)
the tape is not available to you, then get any tape that will cause you
to feel very relaxed. See if you can find a tape that uses the
"Jacobson Muscle Relaxation" procedure–it is the one proven
to work. You can even make your own tape from written instructions of
the Jacobson technique–or some other technique that works for you. The
Jacobson technique starts by having close your eyes, then you tense and
relax the muscles in your fingers and hands, then your arms, then your
feet and legs, then your back and neck, then your breathing and stomach,
then your face and jaw. At each stage you first tense the muscles, then
compare the feelings of tension with the feelings of relaxation and then
make the muscles as relaxed as possible. Repeat this process for each
muscle group until all muscles are very relaxed. After you make a tape,
substitute this tape for the relaxation tape called for below.
Over the years you have learned to associate the feelings of
anxiety, nervousness, discomfort, and the desire to avoid with your target
behavior.The techniques you will
learn from this manual will enable you to gradually learn a new set of
associations for your target behavior.The
new associations will be relaxation, calmness, comfort, and a willingness to
interact in your target behavior.
Using this manual, you will use the same techniques
professional therapists employ in helping people relieve their anxiety
reactions.The manual will be
divided into four major sections:constructing
an anxiety hierarchy; learning desensitization techniques; learning role
playing techniques; and keeping a record of your progress and your target
behavior when it occurs(asyou did when keeping records of your baseline).
When a person learns to feel anxious in a situation, he can be taught to
not to feel anxiousby
using a technique called desensitization.The purpose of this desensitization portion of the
manual is to teach you to do something that is incompatible with the anxiety
you feel in your target situation; that is, the purpose of desensitization
is to teach you to relax in your target situation by giving you repeated
experiences of imagining various situations that are related to your target
situation while you are relaxed.
Obviously, a state of deep relaxation is psychologically and physically
incompatible with fear, discomfort, and anxiety.Usually, when a situation bothers us, we avoid dwelling on it
or thinking about it frequently; and when we do think about it, we feel a
bit anxious and uncomfortable.Using
desensitization therapy, you will be able to think about your target
behavior and imagine it vividly without feeling anxious for you will be in a
totally relaxed state.After
you are able to imagine the situation in total relaxation, you will be well
on your way to decreasing the anxiety you feel in the real-life situation,
enabling you to feel more comfortable and confident.In other words, by following this process of relaxation while
imagining your target situation, you will become Adesensitized@to it,and the situation will lose much of its power to cause you
A final part of this desensitization process must be mentioned.If, at the beginning of desensitization, you were to imagine your
target situation in its most frightening form, you would probably not be
able to relax.An example of
this would be a boy, whose target situation is interacting with members of
the opposite sex, imagining himself with an attractive girl on a date.It would be difficult, if not impossible, to desensitize yourself to
your target situation all at once.Therefore,
what you must do is desensitize yourself to the situation bit by bit.You must approach the fearful situation very gradually, working on
its least anxiety-arousing components first so that desensitization will
proceed gradually enough that you won=t have to present an aspect of the fear that is too great to handle.It=s
like working one=s
way up to lifting a great weight by starting with very small ones.In order to work your way gradually through the target behavior, you
must construct what is called an anxiety hierarchy, which is a
list of component situations related to your target situation B arranged in order from least to most frightening, or situations leading
up to your target behavior.More
detailed instructions will be given later on in the manual.
Those, then, are the basic principles involved in
desensitization.Here is a
brief summary of the steps you will go through in desensitizing yourself:
Step 1. Anxiety
Hierarchy. First, you will construct an anxiety hierarchy, which is a list of
those situations involved in and leading up to your target situation ranked
in order from the lease disturbing to the most disturbing.
Relaxation Training. Then you will train yourself in deep muscle relaxation.
Sessions. You will then go through a series of desensitization sessions.At the beginning of a session, using what you=ve learned from your deep muscle relaxation training (to be explained), you
will relax.You will
then imagine a scene representing the weakest item on your hierarchy while
maintaining your relaxed state.A
given step on your anxiety hierarchy must be repeatedly imagined until you
no longer exhibit anxiety at the presentation of it.You will then imagine the next higher anxiety-producing step, and so
on.Thus, the anxiety cues are
gradually decreased until you can present the most frightening step without
feeling any anxiety whatsoever.
The desensitization procedure makes
use of the fact that a person=s
anxiety response (tensing of muscles, feeling of discomfort, uptightness,
etc.,) to the imaginedsituation
resembles his anxiety response to the real situation.So, when you can feel entirely comfortable and relaxed when thinking
of your target behavior, your real-life target situation will
shortly begin to be progressively less anxiety-producing.Experience with patients has proven this method of relaxing while
imagining to be quite effective in reducing anxiety.The purpose of the first half of this manual is to teach you
precisely how to construct an anxiety hierarchy, learn deep muscle
relaxation, and desensitize your self to the steps in your hierarchy,
thereby helping you reduce the anxiety you experience in your target
situation.Thus, the first half of the manual is divided into three
The anxiety hierarchy is a list of situations relating to your
target behavior to which you react with varying degrees of anxiety.The most disturbing item is placed at the bottom
of the list and the least disturbing at the top.In working on the hierarchy, you will begin with the top item on the
list (that is, the least disturbing item) and work step by step through the
hierarchy to the last item (the one which produces the greatest anxiety
affecting your target behavior).Thus, the hierarchy provides a framework for desensitization,
through relaxation, of progressively more anxiety-producing situations.
Construction of an anxiety hierarchy
can aid you in three ways:
1.It helps you verbalize your problem and set it down in terms of
concrete situations which you have, or perhaps will, come up against in real
2.You will begin to analyze your problem
further by breaking it down into situational components which will make it
easier for you to see what specific things about the target
behavior cause you anxiety; how they are related to anxiety-provoking
situations other than your target behavior; and how the problem may be
3.You will place the problem in a form that can be treated by this
method.Some people say that merely constructing the anxiety hierarchy has
therapeutic value.They have an
increased understanding of the problem and a clearer idea of how and why
they experience anxiety in certain social situations.
Constructing The Hierarchy
Constructing a good hierarchy is very important since it provides the
framework for approaching the problem.Time and care must be devoted to it.As was stated above, the hierarchy is a list of the situations
related to your target behavior which you react to with graded amounts of
anxiety.Such a hierarchy is
constructed in three steps.Now,
please get a pencil and some paper and follow the instructions closely.
1.Write down as many situations as you can think of in which the
problem occurs.If you are
nervous with strangers or members of the opposite sex, for instance, write
down these specific situations in which you experience
difficulty.Write down all you
can think of.Your list will
include some situations which are worse than others.Some will be very frightening, some hardly frightening at all, and
some in between.
2.Make a list of some of the VARIABLES that affect your anxiety
increase your insight into the causes of your anxiety and make
it easier to create a good hierarchy.
variables affecting the amount of anxiety in presenting a speech
to a class:class size; length
of speech; amount of preparation; importance of speech; how critical
instructor is; length of time before the speech (week before, night before,
walking to classroom, being called upon to give speech, etc.); how personal
the speech is; degree to which others will disagree with it; etc.
b)Other common variables
affecting anxiety levels; amount of rejection expected; sex of other person;
attractiveness of other person; difficulty of test; etc.
c)Look at some of the sample hierarchies and identify variables affecting the amount of anxiety in them.Of course each person is unique, but there are often similarities
1.Now arrange these items in order from the least
upsetting to the most upsetting by thinking about each one and
imagining just how bad it would be to be in that situation.
2.Now build your final hierarchy.Most people include about 10-20 items (you may have more) beginning
with items so mild that they are practically non-frightening.You might have to invent some very mild items such as
having someone say the word Agirl@ (for guys who are afraid of Agirls@),
or looking at the picture of a professor (for people who are afraid of those
with high status), etc.The ten
to twenty items should be chosen so as to contain very small jumps in
severity from one item to the next, so that when you have finished an item
you don=t have a very much harder item just in front of you.The final items, of course, should be the most severe items from the
This ranked list of anxiety evoking
items constitutes the hierarchy that you will use in your treatment.Modifications additions, combining of items, and further
breaking-down of items on the hierarchy may be made at any time during the
hierarchies require some modification as desensitization.
To aid you in constructing your hierarchy, we have included five
sample hierarchies below.Studying
these hierarchies will give you a good idea of how they are constructed and
should help you construct yours.These
are, however, samples only to show you the form.You must construct your own hierarchy which applies to your specific
when interacting with members of the opposite sex.
1.Being with a member of the opposite sex who is a member of my family.
2.Being with a member of the opposite sex I know very well, who is not a
member of my family.
3.Seeing a member of the opposite sex I know fairly well.
4.Smiling at a member of the opposite sex I know fairly well.
5.Talking to a member of the opposite sex I know fairly well.
6.Seeing a member of the opposite sex I know slightly or not at all on
7.Smiling at a member of the opposite sex I know slightly or not at all.
8.Saying hello to a member of the opposite sex I know slightly or not at
9.Meeting a very attractive member of the opposite sex for the first
10.Talking on the phone a short time with a member of the opposite sex.
11.Talking on the phone a short time with a member of the opposite sex.
12.Talking in person for a short time with a member of the opposite sex.
13.Talking for a long time (e.g., one hour ) with a member of the opposite
14.Asking out or being asked out by an attractive member of the opposite
15.Being on a date with a very attractive member of the opposite sex.
when interacting with my boss.
1.At home the night before I go to work, thinking about my boss.
2.Driving to work, thinking about my boss.
3.Walking into the building, thinking about my boss.
4.Entering the office or the room where I work.
5.Greeting and talking to those I work with about the boss.
6.Seeing the boss from afar.
7.Passing the boss.
8.Smiling at the boss.
9.Saying hello to the boss and exchanging greetings.
10.Asking the boss a short question about my job.
11.Asking the boss a more detailed question.
12.Listening to the boss give instructions and then performing them.
13.Talking with the boss on a more personal level.
14.Listening to the boss evaluate my work.
15.Talking to and taking an order from the boss when he=s
very rushed or brusque-acting.
when interacting with strangers or those I don=t
1.Seeing a stranger from a distance.
2.Walking through a group of strangers.
3.Seeing a stranger walking towards me.
4.Passing a stranger.
5.Looking at a passing stranger who is also looking at me.
6.Smiling or nodding to a stranger I=ve
7.Being spoken to be someone who sits near me in class.
8.Talking to a class member I don=t
really know abut the course material in a small classroom discussion.
9.Being approached by and talking to someone in my class.
10.Being approached by and talking on a more personal level with someone
I know slightly.
11.Meeting one stranger.
12.Meeting two or three strangers.
13.Meeting a group of strangers (5-15).
14.Talking briefly with a stranger I just met.
15.Talking at length with a stranger I just met.
16.Talking briefly with two or three strangers.
17.Talking at length with two or three strangers.
18.Talking briefly with a group of strangers.
19.Talking with a group of strangers I just met.
20.Introducing myself and initiating conversation with strangers.
when interacting with a certain person.
1.Smiling at the person.
2.Saying hello to the person.
3.Asking the person how he is.
4.Asking the person a short, factual question (e.g., about school).
5.Asking the person a more detailed question that takes longer to answer.
6.Telling the person a short experience I had.
7.Asking the person=s
opinion on a non-anxiety arousing topic.
8.Telling the person my opinion on a non-anxiety arousing topic.
9.Asking the person two or three questions and responding to his answers.
10.Telling the person something about myself, like my family.
11.Talking back and forth with the person for a long time about a
12.Talking back and forth with the person on a more personal level.
13.Approaching the person and beginning a long conversation.
Target Behavior:Fear of
speaking up in class.
1.At home, the night before I go to class.
2.Driving to school before the class.
3.Walking to my class.
4.Walking inside the classroom.
5.Looking around at the people in the room.
6.Walking in and saying hello to someone in the room.
7.Sitting down in the front row.
8.Catching the professor=s
eye and smiling.
9.Nodding or agreeing with a comment made in class.
10.Asking the professor a question from the front of the room.
11.Asking the professor a question from the back of the room.
12.Answering a short question from the front of the room.
13.Answering a short question from the back of the room
14.Answering a longer question.
15.Making a comment on a particular point to the class.
NOTE:This hierarchy was
designed by a student for himself.He
was 23 and had never had a date.Within
a few months, he had completed his hierarchy in REAL LIFE.
A Hierarchy Of Interacting With Opposite Sex
1.Being with a member of the opposite sex who is a member of the family.
2.Being with a member of the opposite sex who is not a member of the
3.Seeing a less attractive member of the opposite sex that I know not so
4.Smiling at a less attractive member of the opposite sex that I know not
to a less attractive member of the opposite sex.
6.Talking to a less attractive member of the opposite sex for a short
7.Conversing with a less attractive member of the opposite sex for a long
8.Capitalize on free information when conversing with a less attractive
member of the opposite sex.
9.Utilizing open-ended questions in a conversation with a member of the
opposite sex, who is less attractive.
10.Seeing a moderately attractive member of the opposite sex I know not
11.Smiling at a moderately attractive member of the opposite sex I know
not so well.
to a moderately attractive member of the opposite sex.
13.Talking to a moderately attractive member of the opposite sex for a
14.Listening to a moderately attractive member of the opposite sex for a
15.Conversing with a moderately attractive member of the opposite sex
for a long period.
16.Capitalizing on free information when conversing with a moderately
attractive member of the opposite sex.
17.Utilizing open-ended questions when conversing with a moderately
attractive member of the opposite sex.
18.Meeting a very attractive member of the opposite sex for the first
19.Seeing a very attractive member of the opposite sex that I know not
20.Smiling at a very attractive member of the opposite sex that I know
not so well.
to a very attractive member of the opposite sex that I know not so well.
22.Talking to a very attractive member of the opposite sex that I know
not so well.
23.Listening to a very attractive member of the opposite sex that I know
that so well.
24.Conversing with a very attractive member of the opposite sex for a
short time that I know fairly well.
25.Conversing with a very attractive member of the opposite sex for a
long period that I know fairly well.
26.Smiling at each other.
28.Asking for initiating activities together
I walk you out to your car.@
b.In asking for a phone number, give yours first.
c.Asking him or her for a date.
d.Asking him or her for a dinner date.
1.Putting your personal feelings forward.
have a warm and sensitive nature about you.@
are a very beautiful person.@
close with you sure makes me feel nice inside.@
would like to get to know you better.@
am beginning to like you a lot.@
would like to become a friend with you.@
1.Coming to grips withyour
feelings about him or her for the moment.
2.Opening up and saying what you feel about him or her.
3.Express compliments B feelings about the other person.
like the way you wear your long beautiful hair.@
have lovely eyes.@
1.Expressing physical B sexual approaches
a)Snuggling up close to him or her
b)Putting your arm around his or her shoulder
c)Touching his or her hands B
receiving positive vibes.
e)Touching his or her hair.
f)Holding his or her face within your hands.
a)On the hand.
b)On the face.
c)On the forehead.
d)On the lips.
1.A hug B
2.A caress B
a total body caress.
3.Being close to one another so as to share and enjoy each other.
4.Non-demand pleasuring of your partner.
_(When you have
constructed your hierarchy, write out each item on a separate index card and
number the cards in the proper order.This
will give you a convenient reference during the desensitization sessions.Please write your items on one side of the card only, as the other side
will be used for record keeping.)
_At this point, also
make 4 positive, very relaxing scenes. (One might be a positive
outcome scene related to your hierarchy situation).
As Discussed above in the introductory section of the manual, people
are desensitized to the anxiety-evoking items on their hierarchy by stopping
the anxiety with relaxation.In order to do this, you must first learn to relax completely,
and also learn how to achieve this relaxation at will.
The technique which
behavior therapists use to relax patients is known as deep muscle
relaxation.This technique will help you to achieve a very deep and
thorough state of relaxation, enabling you to progress through the
desensitization of your hierarchy.
Before beginning your desensitization sessions, you should spend at
least two half-hour sessions or two days, a half hour per day (beginning
tomorrow) practicing the relaxation technique.In order to receive the full benefit of deep muscle relaxation, you
should observe the following guidelines in relaxation training:
1.Spend at least one twenty-minute session, every other day, relaxing
and imaging the steps in your hierarchy.
2.Read and imagine acting out the steps in a setting in which you can
carry through the full twenty-minute session uninterrupted.
3.It is of the utmost importance that the relaxation training sessions
(as well as the desensitization sessions) be carried through without
4.It is also important that you concentrate completely on each of the
relaxation procedures and carry out the exercises as instructed.
5.Both the relaxation training sessions and the desensitization
sessions should be carried out in a quiet, semi-darkened room.Sit in a comfortable chair or lie down on a comfortable bed
or couch.It is important that you be comfortable and able to
concentrate throughout a training session or a desensitization session.
6.In addition to practicing the relaxation exercises during an actual
relaxation training session, it is helpful to practice the exercises at
other times as well.An
excellent time to practice is during the minutes in bed before falling
asleep.Many people find that
such practice not only increases the rapidity and effectiveness of achieving
relaxation during a session but also helps them to fall asleep earlier and
to snatch periods of relaxation during the day.
When you are able to relax yourself
completely in three or four minutes by briefly running through the
relaxation exercises, then you are ready to begin your desensitization
Many people need only 2 practice sessions.If you find you need more, stay with them until you feel that you
have achieved the ability to relax.
And Now: >>>
Use the relaxation procedure on the ASelf
tape (Side 2 B
about 3 minutes into the tape).Practice them for twenty minutes for two days or until you
can relax completely at will.
Having constructed an anxiety hierarchy of from ten to twenty items,
and having practiced deep muscle relaxation so that you feel you have
achieved the capacity to relax at will, you are ready to begin
desensitizing yourself to the hierarchy.
Briefly, an item
is desensitized by imagining it in vivid and realistic detail while
trying to maintain a state of complete relaxation.The item is repeatedly imagined until you are able to imagine it with
feelings of complete relaxation and comfort, i.e., without experiencing any
anxiety or tension.When you
are able to imagine a given item with complete relaxation, you then move on
to the next item and repeat the process:Imagine each item in vivid and realistic detail while remaining
relaxed.In this way, you
proceed through the hierarchy from less to increasingly more
anxiety-provoking items B desensitizing the hierarchy item by item.
Each item on your hierarchy describes a situation.For the desensitization to be effective it is extremely important
that when you imagine the situation described by an item, the image in your
mind be as realistic as possible B
as if you were actually experiencing the situation.An excellent way to make your image realistic is to imagine the
situation very vividly and in complete and minute detail.You should imagine all the accessory details of the situation B
all the sights, sounds, and smells B that you would be aware of were you actually experiencing the
situation.For example, if an
item involved your making a date with a member of the opposite sex, you
should have an image of the other person B his or her facial expressions B your gestures, etc.You
should notice all the aspects of the other person B his or her face, smiles, eye contact, etc.Make the other person seem real and alive.Hear your voices and the words you say and notice your emotions and
thoughts, etc.You should
imagine all these sensations vividly and make them an integral part of your
image of the situation.Or, if
an item involves your speaking with a high status professor, you should have
a very specific and complete picture of yourself and that person B
the clothes he is wearing B
the way he is standing B
his facial expressions B
the words that are said between you, and your own reactions and feelings
about the conversation.With
only a little practice in imagining all the details of a situation, you will
soon be able to make your images very realistic.
Completion of an Item
It is important for you to know when you have completed an item
and are ready to move on to the next item on the hierarchy.During your training sessions and practice of deep muscle relaxation,
you will learn what it feels like to be completely relaxed and at ease.An item is completed when you can experience the feeling of complete
relaxation while vividly imagining the item as you do when you
practice deep muscle relaxation without the item in mind.One pitfall in this progress is leaving an item before it is
order for an item to be completed, the degree of relaxation you can attain
while imagining it must be total.That
means that even if you feel the slightest bit of tension or nervousness, you
are not completely desensitized to that item.Stay with the item until you feel absolutely no nervousness, until
you feel just as calm as the relaxing exercises.
In desensitizing yourself to an item, you first relax completely
using what you have learned in the training session.When you are completely relaxed, you then imagine the item vividly.You will soon learn to perceive when tensions and anxiety enter into
the imagined scene and interfere with your relaxation.If you feel anxiety while imagining the scene, immediately stop
imagining the item and imagine a relaxing scene or just focus on relaxing
again.You may then try the
scene again or add new items to your hierarchy to fill in any Agaps@.
By Step Conduct of a Desensitization Session
The number of sessions necessary varies in accordance with many
factors.For relatively simple
problems, experience has shown that ten to twenty sessions is often
are necessary and sometimes many more.However, it is not wise to set a limit or expectations on the number
of sessions you will need to desensitize your hierarchy; just proceed
step-by-step through the hierarchy B
moving on to a new item when you have completed the previous one.
In the beginning, when you are working on the low-anxiety provoking
items, you may be able to complete several items in a single session.Later, as you reach items which provoke more anxiety it may take more
time to desensitize yourself to an item B
perhaps several sessions to complete a single item.
It is an excellent idea to set yourself a regular schedule for the
sessions.You will be
desensitizing every other day.Since
the sessions are only twenty minutes apiece, this should not be a great
The setting is basically the same for the sessions as that of the
relaxation training sessions:work
in a quiet, semi-darkened, private room where you will not be interrupted;
sit comfortably on a chair or lie on a bed or couch; work without
interruption for the duration of the twenty minutes.
Each session is conducted in the same basic way, according tot he
1.Sit upright or recline on the chair or couch, making yourself as
comfortable as possible.
2.Have two piles of cards placed conveniently so that you do not have
to reach for them.It is best
to have the cards immediately before you, on your lap.Memorize the first 3-4 items of each stack of cards.
3.Make sure your cassette recorder is within easy reach and locate
the beginning of the relaxation instructions on side 2 of the
yourself completely using what you have learned from the relaxation
4.When you feel relaxed,
start your desensitization session.Use
the following procedure to guide you:
a)Each time you imagine an item on your hierarchy, we will call this a Atrial@.Each trial lasts 25 seconds, during which you keep the image as
vividly before you as possible while trying to remain completely relaxed.At the end of each trial, take a 15 second rest, during which you
should think about your body getting more and more relaxed.(Imagine a positive scene from between each hierarchy scene).
b)The session is divided into blocks of three trials.You should stay with a given item until you can imagine it
three consecutive times (a block of three trials) with absolutely no
tension or anxiety of any kind.If
you successfully complete an item at the beginning of your desensitization
session, go on and work on another, but don=t
desensitize yourself to more than two items per session.Remember to stay with each particular item until you have gotten
through a complete block of three trials without any anxiety.
c)If you have tried a given item for nine trials (or three blocks) and
are still feeling anxiety when you visualize it, then go
back to the previous item and complete an anxiety-free block of
three trials on that one.Then try the difficult item again.If, after going through this three times, the difficult item
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.
d)You should begin each session with the last item you completed
in the previous session.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.
e)When you have completed the hierarchy, that is, when you are
desensitized to the most difficult item, go back through the entire
hierarchy once more just to make sure that you are in fact thoroughly
desensitized t each item.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 B 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.
1.ACTIVELY SEEK OUT
those situations which you are about ready for in your hierarchy.
2.AVOIDsituations very high on your hierarchy which you are not ready for.
3.If you end up in a situation that has a negative outcome,
you may experience a Aset-back@.In that case, just back
up a ways in your hierarchy and repeat steps and/or add new steps.PERSISTANCE is THE MOST IMPORTANT DETERMINANT OF ULTIMATE
SUCCESS ! ! !
4.SEEK encouragementand assistance from
those who can adequately provide it to you.Having family or friends, or a counselor routing for you can be very
1.Make sure your problem is not lack of SKILLS to
be successful.If it is, get
help with improving skills.
2.If you need a little more incentive to get you going, make CONTRACTS(written preferred).Example:AI
will have a (celebration, trip on Saturday, etc.) if I give the speech.I will eat dinner only after I ask Sara for a date,
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
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.-15 minutes.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 B role playing the item(s) you worked on in desensitization the day
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 Aact 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 Aacting
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
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 B 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:
1.(S)He must be a person with whom you are completely comfortable.
2.(S)He must be seriously interested in helping you succeed with your
3.(S)She must be available every other day for 15 minutes over a four
Briefly explain these points to
the person when you ask him to be your partner:
a)(S)He can learn a successful technique for modifying all kinds of
b)(S)He can help you improve an important aspect of your social
c)S)He can help you get a good grade in psychology.
d)It will only require about 15 minutes of his time every other day.
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 B
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 B
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
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
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 Asmiling 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 B
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
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 Ahave
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 Asmoothness@ and your skills.It will
also help you replace old habits with new ones by repetition.
ONCE YOU LEARN THE PROCESS OF SELF-DESENSITIZATION YU CAN
USE IT TO OVERCOME ALMOST ANY UNREALISTIC ANXIETY!SAVE THESE INSTRUCTIONS FOR USE IN THE FUTURE.
Web site created and maintained by: Tom G. Stevens PhD
California State University, Long Beach Counseling and Psychological Services. URL of this web site: http://www.csulb.edu/~tstevens