Systematic desensitization with step-by-step visualization

Egbert Haynes
Systematic desensitization with step-by-step visualization

The systematic desensitization technique has been developed to gradually learn to cope with distressing, stressful and threatening objects and situations.

It can be practiced after having mastered a relaxation technique, as they are a good complement in these cases..


  • What is systematic desensitization?
  • The four stages of learning
    • Hierarchical list of distressing situations
  • Example case: Fear of flying
    • Item scenes and causes of fear of flying
    • What to do after you have the list

What is systematic desensitization?

Scenes that are generating anxiety are displayed, from lower to higher level. While it is being done, we must visualize them as something positive, until we achieve that it does not cause us anguish. This is especially helpful in fighting anticipatory and social anxiety. Also for various fears such as loneliness, rejection and shyness.

The four stages of learning

Mastering systematic desensitization is done in four learning stages:

  1. Relaxation. It is necessary to know how to relax the body at will.
  2. Make a list of anxious fears or negative thoughts.
  3. Build a list of distressing situations, from mild to most disturbing (a hierarchical list).
  4. Make a progressive visualization, to reduce anxiety, stress, shyness, etc..

Hierarchical list of distressing situations

If you have multiple distressing problems, pick just one to start with. To achieve your goal. Only in the event that several very anxious situations have to do with the same basic problem, will you be able to group them together.

  1. Choose 20 possible situations that can occur with what you fear, and rebuild them in your mind.
  2. Write them in order, according to the degree of anxiety they produce in you. And rate them from 5 to 100, at 100 is the maximum fear and 5 there is no fear.

Example case: Fear of flying

  • Write 20 scenes related to airplanes that cause you anxiety or fear. Rate them starting with the number 5 and increase the value from five by five to 100, in increasing order.
  • Write the scenes in between, increasing by 5 points each time.
  • Review the scenes and if necessary change them until you feel satisfied with the hierarchical sense. The sequence should make sense to you.

Item scenes and causes of fear of flying

Example list anxiety scenes with airplanes

  1. Watching a plane land or take off at the airport. 5 points
  2. Feel the noise of an airplane when it takes off. 10
  3. See a movie in which there is a plane crash. fifteen
  4. Watching a TV newscast with scenes from a plane crash. twenty
  5. Receive the news that for work I must travel by plane. 25
  6. Make the decision regarding the airline you are going to choose. 30
  7. Make the flight reservation. 35
  8. Pack your bags for travel. 40
  9. Take the taxi to the airport. Four. Five
  10. Check luggage. fifty
  11. Say goodbye to family and enter pre-boarding. 55
  12. Hearing over the loudspeaker that the flight is delayed for “technical reasons”. 60
  13. Get on the plane and find the seat. 65
  14. Take off the plane. 70
  15. Entering areas of turbulence during the flight. 75
  16. The pilot announces over the loudspeaker that there is congestion at the airport and that therefore he will have to fly over the city for another 30 minutes. 80
  17. At the time of landing the sky is closed and the runway cannot be seen. 85
  18. When the plane is about to land, a baby starts crying. 90
  19. The seatmate starts talking about the latest accident. 95
  20. The moment the plane touches the runway. 100

What to do after you have the list

After making your list of the 20 chosen situations in order of anxiety, sit in a place where you can relax completely and have no interruptions. Try to relax as best you can by breathing deeply or using one of the relaxation techniques that we have.

Close your eyes, without pressing your eyelids, breathe normally and view your television screen, imagine that in your hand you have control of the remote control, with all its buttons at your disposal. Think that you can use it mentally.

Project an image on the screen that is very pleasant, it is better if you see yourself on it too. Do not stop maintaining your state of relaxation and pleasure.

Now zap and project or visualize on the screen the first anxious scene that you have pointed out from your list. If you feel that you are distressed, take it out with your remote and visualize a pleasant scene on your television.

When you are relaxed again and your breathing has returned to normal, try to visualize that first scene again. Repeat the procedure as many times as necessary, until you can project it and verify that visualizing it does not cause you any anxiety.

Stay relaxed, move back to the pleasant scene, and when you're ready, play the second anxious scene. Keep the relaxation and if you feel that you are distressed, repeat the previous step, return to your pleasant scene as many times as necessary.

Do not propose to advance all situations in one day or two, do only those that you can do without getting tired. It does not matter how long it takes, as long as you move forward and in the end you are able to see your 20 scenes without anguish and without losing your state of relaxation.

Every time you go to start the process, project at the beginning the scenes that you have already mastered in the previous sessions and continue the procedure. Always maintain the state of relaxation that you have already achieved. There will come a time when you can visualize your 20 scenes without feeling anguish. And whenever tension or anxiety appears, remember to return to your calming scene. Only when you have achieved your goal, can you start another topic, if there is one.

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