SYSTEMATIC DENSITIZATION

A procedure credited to Wolpe in which:

o Relaxation techniques are taught

A hierarchy of anxieties is created

Involves both the practitioner and the client

Client goes through each stage of hierarchy, only moving on to the next level of anxiety producing stimuli
when the current level no longer feels threatening.

This therapy aims to remove the fear response of a phobia, and substitute a relaxation response to the
conditional stimulus gradually using counter conditioning. There are three phases to the treatment:

i)First, the patient is taught a deep muscle relaxation technique and breathing exercises. E.g. control over
breathing, muscle detensioning or meditation. This step is very important because of reciprocal inhibition,
where once response is inhibited because it is incompatible with another. In the case of phobias, fears involves
tension and tension is incompatible with relaxation.

Wolpe taught his patients relaxation responses because it is not possible to be both relaxed and anxious at the
same time. In this method, patients practice tensing and relaxing different parts of the body until the patient
reaches a state of serenity.
Another means of relaxation is cognitive reappraisal of imagined outcomes. The therapist might encourage
subjects to examine what they imagine happening when exposed to the anxiety-inducing stimulus and allowing
for the client to replace the imagined catastrophic situation with imagined positive outcomes.
ii)Second, the patient creates a fear hierarchy starting at stimuli that create the least anxiety (fear) and building
up in stages to the most fear provoking images. The list is crucial as it provides a structure for the therapy.

iii)Third step: Connect the stimulus to the incompatible response or coping method through counter
conditioning. In this step the client completely relaxes and is then presented with the lowest item that was
placed on their hierarchy of severity of anxiety. When the client has reached a state of serenity again after being
presented with the first stimuli, the second stimuli that should present a higher level of anxiety is presented.
Again, the individual practices the coping strategies learned. This activity is completed until all items of the
hierarchy of severity of anxiety is completed without inducing anxiety in the client. If at any time during the
exercise the coping mechanisms fail or the client fails to complete the coping mechanism due to severe anxiety,
the exercise is stopped. When the individual is calm, the last stimuli that was presented without inducing
anxiety is presented again and the exercise is continued.

Treats the symptoms not the cause(s) of the phobia. SD only treats the observable and measurable symptoms of
a phobia. This is a significant weakness because cognitions and emotions are often the motivators of behavior
and so the treatment is only dealing with symptoms not the underlying causes.
Exposure can be done in two ways:
In vitro the client imagines exposure to the phobic stimulus.
In vivo the client is actually exposed to the phobic stimulus.

Counterconditioning (also called stimulus substitution) is a form of respondent conditioning that involves the
conditioning of an unwanted behavior or response to a stimulus into a wanted behavior or response by the
association of positive actions with the stimulus. In counterconditioning, the unwanted response does not just
disappear, it is replaced by a new, wanted response

Mary Cover Jones was the first to show the effectiveness of the counter conditioning process in
her rabbit experiments. She was able to eliminate the fear of rabbits from a young boy. The rabbit was first kept
away from the boy and then moved closer and closer, while the boy was able to eat his favorite foods. The boy
was allowed to touch the rabbit and then was able to eat his food to reduce the nervousness touching the rabbit
induced. Eventually the boy was able to pet the rabbit without any sign of fear because of the unpleasant and
feared stimulus of the rabbit was now replaced by the pleasant stimulus of the food.
This also can be thought of as stimulus substitution. The weaker stimulus will be replaced by the stronger stimulus

(but unless you increase the relaxation also proportionately, how will it continue to be effective in lessening
anxiety as we move up the heiratchy?