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Overcoming Phobias – A Step-by-Step Guide to Systematic Desensitization

What is Systematic Desensitization?

“Systematic desensitization is a therapeutic technique used in psychology to treat phobias, anxiety disorders, and other fear-related conditions. Developed by Joseph Wolpe in the 1950s, this approach is grounded in the principles of classical conditioning, a psychological theory developed by Ivan Pavlov.

Classical conditioning involves learning through association, where two stimuli are linked together to produce a new learned response in a person or animal. For example, Pavlov’s famous experiment demonstrated that dogs could learn to associate the sound of a bell (a neutral stimulus) with being fed (an unconditioned stimulus), causing them to salivate (an unconditioned response) even when they heard the bell alone (leading to a conditioned response of salivation).

In the context of systematic desensitization, the process involves systematically exposing individuals to their feared stimuli in a structured and controlled manner, gradually reducing their emotional response and anxiety. This is achieved by creating a new association between the feared stimuli and relaxation instead of fear.(1,2)

The process involves creating a hierarchy of fear-inducing stimuli, ranging from least to most anxiety-provoking. The individual is then guided through a series of relaxation exercises while imagining each item on the fear hierarchy, starting from the least anxiety-inducing and progressing towards the most distressing ones. By repeatedly pairing relaxation with the feared stimuli, the individual learns to associate the previously anxiety-provoking situations with a sense of calmness, leading to a reduction in fear response over time.(3)

This therapeutic approach is particularly effective for addressing phobias and anxiety, as it empowers individuals to confront their fears in a gradual and controlled manner, fostering a sense of mastery and confidence.

Step-by-Step Guide on How to Practice Systematic Desensitization

It’s certainly possible to practice systematic desensitization on your own, but it requires patience, dedication, and a well-structured approach. Here’s a guide to help you through the process: 

  • Identify your fear: Clearly define the fear or phobia you want to overcome. Be specific about the situations or objects that trigger anxiety or panic.
  • Create A Fear Hierarchy: Develop a list of fear-inducing situations or stimuli, starting from the least anxiety-provoking to the most distressing.
  • Learn Relaxation Techniques: Familiarize yourself with relaxation exercises such as deep breathing, progressive muscle relaxation, or guided imagery. These techniques will help you induce a state of calmness during the exposure process.(4,5)
  • Start With The Least Feared Item: Begin with the first item on your fear hierarchy – the situation or stimulus that causes the least anxiety. Engage with this situation in reality or imagine yourself in it while applying your relaxation techniques. Stay in this relaxed state until you feel comfortable and the anxiety decreases.(6)
  • Gradually Progress Up The Hierarchy: Once you can confront the first item without significant anxiety, move on to the next one in your hierarchy. Repeat the process, applying relaxation techniques and maintaining a sense of calmness until the fear diminishes.
  • Practice Regularly: Consistency is key in making progress. Engage in systematic desensitization regularly, ideally several times a week.
  • Be Patient And Persistent: Overcoming fears takes time and effort. Celebrate each small success along the way. If you encounter setbacks, don’t be discouraged as it is a natural part of the process.
  • Seek Professional Support If Needed: While systematic desensitization can be an effective self-help technique, there can be moments when professional guidance is beneficial. If you find a particular step in your hierarchy too challenging or if you feel overwhelmed, consider reaching out to a licensed therapist or counselor experienced in this approach. They can provide personalized support and feedback to ensure your progress. (9,10)

Situations Where Systematic Desensitization Can Help

Systematic desensitization can be applied to various fears and phobias. Here are some examples of how this technique might be used:

  • Fear of Public Speaking: If someone has a fear of public speaking, they could create a fear hierarchy that includes activities such as speaking in front of a mirror, practicing in front of a trusted friend or family member, delivering a short speech to a small group, and eventually giving a presentation to a larger audience. They would practice relaxation techniques while progressively moving up the hierarchy.(7)
  • Fear of Heights: For someone afraid of heights, the fear hierarchy might involve looking at pictures of heights, standing on a low step stool, climbing a short ladder, and eventually going to higher places like a balcony or observation deck.
  • Fear of Dogs: If someone is afraid of dogs, their hierarchy might start with looking at pictures of dogs, watching videos of dogs from a distance, being in the same room as a calm and controlled dog, and eventually petting or interacting with a friendly dog while using relaxation techniques.
  • Fear of Flying: For individuals with a fear of flying, the hierarchy might include activities like watching videos of planes taking off, visiting an airport without boarding a flight, sitting in an airplane on the ground, and finally taking a short flight while practicing relaxation.(8)
  • Fear of Spiders: A fear of spiders might be addressed with a hierarchy including looking at pictures of spiders, observing a spider from a distance, being in the same room as a non-threatening spider, and eventually holding a harmless spider while practicing relaxation techniques.

As you can see, in each of these examples, the key is to start with a situation or stimulus that causes minimal anxiety and progressively work up to more fear-inducing scenarios, all the while maintaining relaxation.

Key Takeaways 

  • Systematic desensitization is an effective therapeutic technique based on the principles of classical conditioning. It empowers individuals to confront and overcome their fears and phobias in a gradual, controlled manner.
  • The process involves creating a hierarchy of fear-inducing situations and pairing these with relaxation exercises, effectively reducing anxiety and fear responses over time.
  • Consistency, patience, and persistence are essential for success in systematic desensitization. Celebrate small victories and don’t be discouraged by setbacks.
  • While this technique can be practiced independently, professional guidance can be beneficial, especially when dealing with more severe or complex fears.
  • Systematic desensitization can be applied to a wide range of fears and phobias, demonstrating its versatile use in fear and anxiety management.


Systematic desensitization is a powerful therapeutic technique that can help individuals overcome their fears and phobias through a process of gradual exposure and relaxation. This approach is based on the principles of classical conditioning and empowers individuals to confront their anxieties in a controlled and safe manner. By creating a fear hierarchy and using relaxation techniques, individuals can systematically work through their fears, starting with the least anxiety-provoking situations and progressing towards more challenging ones.

With time and effort, this technique can lead to a reduction in fear responses and an increased sense of empowerment.


  1. Rachman, S., 1967. Systematic desensitization. Psychological Bulletin, 67(2), p.93.
  2. McGlynn, F.D., Mealiea Jr, W.L. and Landau, D.L., 1981. The current status of systematic desensitization. Clinical Psychology Review, 1(2), pp.149-179.
  3. Goldfried, M.R., 1971. Systematic desensitization as training in self-control. Journal of Consulting and Clinical Psychology, 37(2), p.228.
  4. Lomont, J.F. and Edwards, J.E., 1967. The role of relaxation in systematic desensitization. Behaviour Research and Therapy, 5(1), pp.11-25.
  5. Agras, W.S., Leitenberg, H., Barlow, D.H., Curtis, N.A., Edwards, J. and Wright, D., 1971. Relaxation in systematic desensitization. Archives of General Psychiatry, 25(6), pp.511-514.
  6. Wilson, G.T. and Davison, G.C., 1971. Processes of fear reduction in systematic desensitization: Animal studies. Psychological Bulletin, 76(1), p.1.
  7. Vanni, F., Conversano, C., Del Debbio, A., Landi, P., Carlini, M., Fanciullacci, C. and Dell’Osso, L., 2013. A survey on virtual environment applications to fear of public speaking. European review for medical and pharmacological sciences, 17(12), pp.1561-1568.
  8. Howard, W.A., Murphy, S.M. and Clarke, J.C., 1983. The nature and treatment of fear of flying: A controlled investigation. Behavior Therapy, 14(4), pp.557-567.
  9. Lazarus, A.A., 1957. The use of systematic desensitization in psychotherapy. South African Medical Journal, 31(37), pp.934-937.
  10. Paul, G.L. and Shannon, D.T., 1966. Treatment of anxiety through systematic desensitization in therapy groups. Journal of Abnormal Psychology, 71(2), p.124.
Team PainAssist
Team PainAssist
Written, Edited or Reviewed By: Team PainAssist, Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:July 31, 2023

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