Systematic desensitization is an evidence-based therapy approach that combines relaxation techniques with gradual exposure to help you slowly overcome a phobia.

在系统脱敏期间，也称为毕业曝光疗法，您可以通过恐惧程度来工作，从最少可怕的曝光开始。这种方法还涉及使用弛豫技术。

Both of these features make it different from other desensitization techniques, such as flooding.

Systemic desensitization involves three main steps. First, you’ll learn muscle relaxation techniques. Then, you’ll create a list of your fears, ranking them in terms of intensity. Finally, you’ll begin exposing yourself to what you fear.

Classical conditioning, sometimes associative learning principles, is the underlying theory behind this process. The goal is to overcome a phobia by replacing feelings of fear and anxiety with a state of calm.

当你通过你的恐惧列表工作时，你会在面对每种新情况时继续关注放松，直到它不再导致不适。

学习放松技巧

您可以在系统脱敏中学到一些不同的放松练习。这些练习可以彼此自行或结合使用。

您可以学习的技术包括：

  • Diaphragmatic breathing。With this technique, you’ll learn to regulate your breathing by breathing slowly and deeply through your nose, holding the breath for one to two seconds, then breathing out through your mouth.
  • Visualization.You’ll focus on a relaxing scene, picturing it in your mind and concentrating on sensory details, such as sights or smells. This includes引导图像, which involves someone describing a scene to you.
  • 进步肌肉放松。你会学会在整个身体中紧张和释放肌肉。这种技术可以减少肌肉张力，并帮助您认识到紧张和轻松的肌肉之间的差异。这样，当你的肌肉开始以响应焦虑或恐惧开始紧张时，你将能够更好地识别。
  • Meditation and mindfulness techniques.学习冥想may help you become more aware of your thoughts and feelings as you face a fearful situation. Mindfulness helps you notice what you’re experiencing in the present moment, which can reduce anxious thoughts.

创造恐惧的层次结构

After learning relaxation techniques, you’ll develop a fear hierarchy for the phobia or feared situation. This hierarchy typically involves 10 levels of fear.

您可能会通过以下步骤来执行此操作：

  1. First, you’ll identify the most frightening level of your fear, or the “level 10” fear.
  2. Next, you’ll identify the least frightening level of your fear, or the “level 1” fear.
  3. Then, you’ll list the levels in between and rank them by the amount of fear they trigger. For example, seeing a photo of what you fear might be a level 3, but actually touching the thing you fear could be a level 8 or 9.
  4. Next, you’ll develop ways to expose yourself to each level of fear. This is usually done with the help of a therapist.
  5. 最后，您将开始向您的恐惧开始暴露，从您列表上的最少可怕的项目开始。

慢慢地揭露自己害怕

Once you have relaxation techniques and a hierarchy of fears, you can start gradually exposing yourself to your fears.

一个典型的第一步是考虑你害怕的事情。一旦你开始感到害怕或焦虑，请使用放松的技术来重新获得平静的感觉。重复这个过程，直到你不再感到焦虑。

当您可以舒适地满足特定的恐惧程度时，继续前进到一个下一级。

You can work through your fear hierarchy in therapy, but you can also do it on your own.

The process of systematic desensitization differs for each person.

Some people move through low levels quickly and have a hard time overcoming higher levels. Others may take a long time to work through lower levels, but they find the fear easier to face once they’ve succeeded at the lower levels.

The most helpful relaxation technique can also vary. You might find visualization helps you relax the most, for example.

无论您的恐惧还是使用每个级别的时间，原则都保持不变。

Here’s how systematic desensitization might look for different conditions.

Social anxiety

你是一名大学生social anxiety。当你想到在课堂上给出错误的答案或不得不要求使用洗手间时，你会感到恶心和你的心灵比赛。您避免在课堂上演讲或参与大学活动以避免令人尴尬的情况。

当您决定尝试系统的脱敏时，您可以确定与您不知道的人交谈是一个级别的恐惧。你开始想象自己衷心问候人，当你感到焦虑时，练习深呼吸，直到你可以保持冷静。

Next, you move on to greeting strangers in real life. After a week of doing this daily, you start to feel more at ease.

然后，你开始在谈话期间开始担心下一个恐惧 - 在谈话期间接触。你通过层次结构工作，最终介绍自己并在课堂上点头。你继续使用深呼吸和肌肉放松，以透过不适的时期。

最后你的恐惧水平层次涉及到上海aring in class. It takes a few tries, but eventually you’re able to answer questions in class, though your heart still begins to race once you put your hand up. You take a deep breath, release the tension in your muscles, and begin to speak.

Dog phobia

当你看到一只狗在远处朝着你来看，你的手掌汗水，你的心脏比赛，你呼吸困难。您的phobia特别是咬伤，但在狗周围也让你感到害怕和焦虑。

To get started on your hierarchy of fears, you begin by imagining you’re near a dog on a leash in a passing car. The next day, you drive by a dog park several times. It doesn’t seem to affect you much, so you park somewhere where you have a full view of the park.

You feel yourself tense up every time a dog starts barking. To combat this, you concentrate on relaxing your muscles and imagining yourself on a beautiful beach — one without dogs. You open your eyes and repeat this process for the next 30 minutes.

Next, you spend time with a friend who keeps her dog in a different room of her home while you’re visiting. You practice relaxation exercises each time you think about the dog getting out.

As you prepare to conquer your level 10 fear — walking through a dog park — you decide to spend some time in the puppy area of your local animal shelter.

小狗对你来说不太可怕，但他们的想法仍然如此接近，让你感到焦虑。你必须走出几次，做一些深呼吸和可视化练习。

Finally, after months of work, you head back to the dog park. This time, you park your car and walk through the gates. You sit on a bench and practice deep breathing as you watch the dogs playing.

即使你仍然感到害怕，你也专注于你面临着恐惧的事实。

可以自己尝试系统的脱敏，但请记住缓慢，渐进的曝光是这种方法的关键组成部分。如果低级曝光让您感到焦虑，请继续练习您的放松技巧并致力于这种恐惧。

There’s no right pace for working through your hierarchy of fears. You might spend months on a single one, only to blast through the next two over the course of a few weeks.

Take as much time as you need. If you move too fast, you may put yourself through unnecessary discomfort.

If you’d like to try this approach on your own, the following tips can help:

  • Familiarize yourself with relaxation techniques. If you’re already feeling tense and anxious, thinking about relaxing may be harder, so it’s important to learn these techniques first.
  • List at least two items for each level of fear on your hierarchy. This allows for more exposure to your phobia.
  • 每天练习将自己暴露在你的恐惧中。甚至每天几分钟都可以提供帮助。
  • Remember to stop and use a relaxation exercise when you feel anxious. The goal is to replace the anxious feeling with a relaxed state. You might have to try each step multiple times, and that’s OK.
  • Try to continue the exposure exercise until you feel about half the fear or anxiety you typically would. This can be hard to gauge, but you’ll likely become better able to track it as you become more familiar with exposure.

If you’re unsure about trying systematic desensitization on your own, a therapist can answer any questions you have and offer support. If the approach doesn’t work well for you, you can explore other approaches in therapy.

HOW TO FIND A THERAPIST

寻找治疗师可以感到令人生畏，但它不一定是。首先询问自己一些基本问题：

  • What issues do you want to address? These can be specific or vague.
  • Are there any specific traits you’d like in a therapist? For example, are you more comfortable with someone who shares your gender?
  • 每次会话都能现实地支付多少钱？您想要一个提供滑模价格或付款计划的人吗？
  • Where will therapy fit into your schedule? Do you need a therapist who can see you on a specific day of the week? Or someone who has nighttime sessions?

接下来，开始制作您所在地区的治疗师列表。如果您住在美国，请前往美国心理协会的therapist locator。

如果成本是一个问题，请查看我们的guide to affordable therapy.

It’s often difficult to face fears. It can be even harder if you have a mental health condition, such as a phobia, anxiety, or panic disorder. Systematic desensitization can help you overcome your fears at a pace that works for you.