Psychotherapy

Desensitization systematic, specific - methods, techniques

Desensitization is a psychotherapeutica method developed by F. Shapiro for the purpose of treating individuals suffering from disorders that could be caused by experiencing various incidents such as, for example, physical abuse. According to Shapiro's ideas, after the individual has suffered a trauma or distress, his experiences can "block" the possibilities of coping mechanisms, so that the memory and messages associated with the event are improperly processed and dysfunctional stored in inaccessible corners of memory. The goal of psychotherapy is to process such stressful memories and help the client develop more effective coping mechanisms. In other words, desensitization serves to relieve negative tension, anxiety,
to disturbing images, scary objects or frightening situations.

The method of desensitization

Desensitization serves to reduce negative tension, anxiety and fear of frightening images, objects or events.
If an event causes feelings of fear andreaction to it, this means that a muscle tension has formed in the human body. More often, as a response to fear, stress appears in the collar zone, the diaphragmatic area, in the muscles surrounding the eyes and in the hands. In cases where the pressure of fear repeats or lasts a long time, the tension in the muscles is transformed into a muscle clamp, which can be described figuratively as a repository of fear. Therefore, one must understand that fear is as if fit into the body, it lives in the muscle clamps of the body. Hence, the main task of desensitization is the erasure of such clamps.
The technique of desensitization is repeatedliving a frightening event on the bodily plane, erasing the negative experience. There are many methods of desensitization today. However, most of them differ only in the offered bodily background and the technology of its creation.
The simplest and most familiar variant of desensitization is the elimination of anxiety through relaxation. In the course of relaxation and immersing oneself in a sense of peace,
under the supervision of the therapist beginsto imagine those events or objects that formerly gave him anxiety or fear. Alternately, replacing the approach and distance from the cause of anxiety, making a rollback at the appearance of tension and returning to a state of rest, the subject sooner or later has the ability to imagine the fears caused by events or objects in the neutral state of the soul.
An effective technique for desensitization is consideredbreathing practices. By controlling his own breathing, keeping calm and even breathing when presenting a frightening object or during a real encounter with a terrible situation, the individual is able to erase previous clamps and regain inner calm and freedom of action.
Desensitization by eye movementtoday is considered one of the most effective areas of psychotherapy. It is used for short-term therapy. Its advantage lies in the ease of use, safety and versatility to work out all sorts of traumatic events.

Systematic desensitization

One of the first approaches that laid the foundation forthe spread of behavioral therapy, today is considered the method of systematic desensitization, proposed by D. Volpe. Developing the basic ideas of the method of desensitization, Volpe came out of several postulates.
Neurotic, interpersonal and otherNon-adaptive behavior of an individual, mainly, is caused by anxiety. The actions that the subject performs in the imagination are equated with the actions produced by the individual in reality. Even the state of relaxation of the imagination will not be an exception to this postulate. Anxiety, fears, can be suppressed if we connect in time the messages that cause fears and messages opposite to fear, as a result of which a message that does not cause fear will extinguish the preceding reflex. Thus, in the case of experiments with animals, such a quenching factor is feeding. And a person with such a factor, the opposite of fear, may be relaxation. Hence it follows that teaching an individual of deep relaxation and encouraging him to cause in this state in the imagination the promises that cause anxiety will lead to the patient's desensitization to real messages or situations that cause fear.
The method of systematic desensitizationrelatively simple. The patient, who is in deep relaxation, gets ideas about the events that give rise to the appearance of fear. Then, by deepening the relaxation, the individual eliminates the arising alarm. Mentally in the imagination, the patient draws various events, ranging from the easiest to the most difficult, generating the greatest fear. The desensitization session ends when the strongest message ceases to cause fear in the individual.
Specific desensitization is divided intothree stages, including mastering the methods of muscle relaxation, creating a hierarchy of events that cause fear and immediate desensitization - the union of the ideas of the events that cause fear and relaxation.
The training of progressive relaxation by the method of Jacobson is carried out in an accelerated mode and takes approximately 9 sessions.
The patient may have phobias of various types,therefore, all events that produce the onset of fear are divided into thematic groups. The individual for each such group must create a hierarchy from the lightest events to the very heavy ones, generating a pronounced fear. Ranking of events by the level of expression of fear is better spent together with the psychotherapist. A real experience of fear by an individual in such a situation is a prerequisite for creating a hierarchy of frightening events.
Specific desensitization isdiscussion of a feedback technique representing the patient's informing the therapist about the presence or absence of fear in him at the time of the event's imagination. For example, the patient informs about the presence of anxiety by raising the index finger of the left hand, and about its absence by raising the finger of the right hand. Representations of events occur in accordance with the hierarchy. The patient presents the event for 5 to 7 seconds, and then eliminates the resulting alarm through increased relaxation. This stage lasts up to 20 seconds. The imagination of events is repeated several times in a row, if the individual does not have anxiety, then the next, more serious event should be taken. In one session, no more than 4 situations are processed from the hierarchy. In the case of a pronounced anxiety that does not disappear with repeated representations of the situation, it is necessary to return to the development of the previous event.
Today, the desensitization technique is used forneuroses caused by monophobia, which can not be desensitized in real life situations due to the complexity or impracticability of finding a stimulus in real life, for example, fear of flying in airplanes. In the case of multiple phobias, the desensitization technique is applied alternately to each phobia.
Systematic desensitization will be less effective in cases where anxiety is supported by a secondary gain from the disease. For example, a woman with
, there is also a threat of leaving her husband from home. In such a situation, the phobia will be reinforced not only by lowering anxiety, when she does not leave the house and avoids the situations causing the phobia, but also by keeping her husband at home with her symptoms. In such cases, the method of systematic desensitization will be effective only if it is combined with personality-oriented areas of psychotherapy, focused on understanding the patient's prerequisites for their behavior.
Systematic desensitization in real lifeIt contains two stages: the creation of a hierarchy of events producing the appearance of fear, and directly desensitization, i.e. training in real conditions. Events that can be repeated many times in reality are added to the hierarchy of events that generate fear. The second stage is characterized by accompanying the patient by the therapist in order to encourage him to increase fear in accordance with the hierarchy.

Desensitization by eye movements

There is an assumption that eyeball movements or alternative types of stimulation used during the desensitization procedure include processes similar to what happens in a dream.
The foundation of desensitization isthe notion that each traumatic message is unconsciously processed by the brain and absorbed in the phase of sleep, when a person sees dreams or, in other words, a stage of sleep with fast movements of eyeballs. Severe mental traumas destructively affect the natural process of information processing, which leads to incessant nightmares with frequent awakenings, as a result of which the phase of fast sleep is distorted. Desensitization and processing by eye movements releases and accelerates the processing of traumatic experiences. The essence of the desensitization method is the artificial activation of the process of forced processing and neutralization of memories associated with trauma, and any other negative information blocked in the neurons of the brain. This method is able to provide quick access to separately stored traumatic information, which undergoes rapid processing. Memories, which are characterized by negative emotional charge, are transformed into neutral ones, and the corresponding representations and views of individuals acquire an adaptive character.

The advantage of desensitization is the receipt of rapid results. This is what distinguishes it from most other methods of psychotherapy. F. Shapiro explains this phenomenon by the following reasons:
- during the setting of the purpose of the impactnegative memories are combined into so-called clusters (ie, a series of similar events), so that only the most characteristic event from each cluster undergoes desensitization. This is often sufficient to generalize the consequences of transformation and neutralization of all similar memories;
- The method promotes direct access to dysfunctional data stored in memory;
- there is an activation of information and processing systems of the brain, which transforms information directly on the neurophysiological level.
Standard desensitization and processing of eye movements contains eight stages.
At the first stage,on which the therapist conducts an analysis of the clinical picture and outlines the specific goals of therapy. The use of the desensitization method is possible only with patients able to cope with a possible high degree of anxiety during therapy. It is because of this that the therapist at first helps to solve current problems, and then goes on to more long-standing mental traumas. In the end, the future is worked through by forming and fixing a positive example of behavior in the patient's imagination. At this stage, clients are also taught to reduce stress levels by: presenting a safe place, a method of luminous flux consisting of imagining a ray of light that has a healing effect that breaks through the body, self-applying eye movements or muscle relaxation.
At the next preparatory stage,painful symptoms and dysfunctional behavioral patterns. Also at this stage, a therapeutic contact with the patient is established and the essence of the method is explained to him. The therapist finds out which of the proposed eye movements are less painful.
At the third stage, thenegative self-presentation, in other words, the currently existing negative belief directly associated with a trauma that reflects the client's self-image. It is also characterized by the identification and positive self-presentation, in other words, the kind of belief that the client would like to have about himself. The stage also reveals the severity of negative emotional reactivity and bodily discomfort.
The fourth stage is directly indesensitization and processing. It is characterized by causing the patient to move the eye from one end of the optical field to the other. Such two-sided eye movements must be performed quickly while avoiding the feeling of discomfort. The therapist invites the client to follow his fingers with his eyes. The hand of the therapist is turned with the palm to the patient, the distance from the therapist's hand to the client's face should not be more than 35 cm. Usually one series consists of approximately 30 eye movements. In this case, for 1 movement is considered the movement of the eyeball back and forth. The direction of eye movements can vary. Initially, the patient should concentrate his attention mentally on the image of the traumatic event, negative self-presentation, negative and uncomfortable sensations associated with the memory. Then the therapist starts repeating sequences of eye movements. The patient after each series is proposed for a while to remove the traumatic image and negative self-presentation. The client should inform the therapist about any transformations in the picture of memories, emotions, perceptions and sensations. Sequences from the stimulating movements of the eyes are repeated many times, at times directing the individual's attention to the most oppressive associations that spontaneously arise in him during the procedure, and then again bringing him back to the original traumatic factor. The therapy session is conducted until the moment when the level of anxiety, anxiety, fear during the reference to the initial traumatic event does not decrease by 1 point on the scale of subjective anxiety.
The fifth stage is an installation. On it, the client reassesses the previous experience, while the patient becomes convinced that in reality he will be able to lead and feel himself in a new way.
At the next stage, the body is scanned. The patient at this stage is invited to close his eyes and mentally scan his body, starting with the crown and ending with the heels. During the so-called scan, the patient must keep his initial memory and positive self-image in mind. If any residual tension or bodily discomfort is detected, additional series of movements of the eyeballs should be performed before they are eliminated. This stage is considered a kind of verification of the results of the transformation, since with an absolute neutralization of the traumatic factor, it loses its negative emotional charge and ceases to give rise to the uncomfortable sensations associated with it.
The goal of the seventh stage is to achieveemotional equilibrium by the patient, regardless of the completeness of the treatment of trauma. To this end, the doctor can apply hypnosis or other techniques. After the session, an unconscious continuation of processing is possible, if it has not been completed. As a result, the client is invited to memorize or record disturbing memories, thoughts or events, dreams, since they can be transformed into new targets of influence in subsequent desensitization sessions.
At the eighth stage, a reassessment takes place. Its purpose is to check the effectiveness of the previous therapy session. Reassessment is performed before each therapy session. The psychotherapist must evaluate the client's reaction to previously developed goals, since it is possible to start processing new goals only if the old ones are recycled and assimilated.
On average, the duration of one therapy can range from an hour to two. A week is not recommended for more than two sessions.
Desensitization by eye movementequally proved effective in working with children and adults, individuals with traumas from the past and with excitement about the future. This method is easily combined with other areas of psychotherapy.

Desensitization in Psychology

In psychological practices, the techniquedesensitization is used almost everywhere. For example, desensitization occurs in sensory images through narration in autogenous relaxation, by controlling the movements of the eyes. Methods of desensitization are used much more often than even psychologists suspect.
Techniques of desensitization, most likely not veryconsciously, are also used in classical psychoanalysis. Usually an anxious patient, coming to a consultation with a psychologist, fits into a lying position on the couch. On it, it will lie for at least 10 minutes, during which there is relaxation. Then the patient is required to begin to pronounce free associations. Such associations arise in a person in a state of relaxation, therefore, in order to master the task, the patient has to relax even more. After this, the individual is returned to an event that can be an incentive to his tension. Each time, returning to this event, the individual permanently resides it against a background of calm relaxation. This technique is a typical behavioral approach in psychoanalysis, at the same time it is also a classical method of desensitization.
The method of systematic desensitization, developed by Volpe, is widely used in psychological practices to overcome the client's state of heightened anxiety and reactions to fear.
Also in psychology is no less in demand andthe antiparasitic desensitization method, the sensitization method, which includes two phases. In the process of the first phase, contact between the psychologist and the individual is established, details of cooperation are discussed.
During the second phase, the moststressful event. Usually such an event is produced in the client's imagination, when he is asked to present himself in a state of panic that covers him in the most frightening circumstances. After that, they give him the opportunity to experience a similar situation in real life.

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