Systematic De-Sensitisation

Psychological .

Systematic De-Sensitisation

Overview & Background:

Systematic De-sensitisation is a type of therapy designed to help individuals overcome phobias, anxiety disorders, and other fear-related issues, by gradually exposing them to the source of their fear in a safe and controlled manner. This type of therapy aims to reduce or eliminate the excessive fear response and replace it with a more adaptive and relaxed reaction.

The concept of Systematic De-sensitisation was initially developed by South African Psychologist Joseph Wolpe in the 1950s. Wolpe believed that systematic exposure to fear-reducing stimuli, combined with relaxation techniques, could help individuals re-learn how to respond to these stimuli without experiencing overwhelming fear. This approach is based on the theory that fear responses can be unlearned and replaced with more adaptive behaviours through repeated exposure and relaxation.

How do the sessions work?

In a typical Systematic De-Sensitisation session, the therapist works closely with the client to identify the specific fear or phobia that is causing distress, such as a fear of spiders or a fear of heights. The therapist then teaches the client different relaxation techniques, such as deep breathing or progressive muscle relaxation, to help them cope with anxiety and fear.

Once the individual has mastered these relaxation techniques, the therapist and client work together to create a ‘fear hierarchy’. This hierarchy is a list of fear-inducing situations or stimuli, ranked from least to most anxiety-provoking. The client starts by imagining or being exposed to the least anxiety-provoking item on the hierarchy while practicing relaxation techniques. Once they are able to do so without experiencing overwhelming fear, they move on to the next item on the hierarchy and repeat the process. As the client progresses through the fear hierarchy, they gradually become ‘de-sensitised’ to the fear-inducing stimuli and are able to confront their fears with less anxiety. Through repeated exposure and relaxation, the client learns to associate these fear-inducing stimuli with feelings of relaxation and calm, rather than fear.

The therapists role is to guide the client through this process and provide support and encouragement along the way. They help the client to develop coping strategies, identify triggers for anxiety, and work through any negative beliefs or thoughts that may be contributing to their fear response.


Systematic De-Sensitisation has been shown to be effective in treating a wide range of anxiety disorders, phobias, and other fear-related issues such as a fear of spiders, heights, flying or social situations. Research has shown that this therapy is particularly effective for those who have tried other forms of therapy with little success, or for those who are unable to confront their fears in real life due to the intensity of their anxieties.

It is often used in conjunction with other therapeutic approaches, such as Cognitive-Behavioural Therapy (CBT) to help clients achieve long-lasting change and improvement in their symptoms. There are many benefits of the therapy, including a reduction in anxiety and fear, improved coping skills, increased self-confidence, and the ability to confront and overcome fears that were once debilitating. This therapy also helps clients to learn new ways to manage stress and anxiety in their everyday lives, leading to an overall improvement in their quality of life.

Number of sessions needed:

The number of sessions needed for Systematic De-Sensitisation therapy can vary depending on the individual and the severity of their anxiety. Typically, this therapy involves a series of sessions that gradually expose the client to their fear or anxiety, typically starting with weekly sessions and decreasing in frequency as the client progresses through the hierarchy of fear-inducing situations. Most individuals can expect to complete therapy within 10-20 sessions, although this can vary between individuals.

Overall, Systematic De-Sensitisation is a structured, evidence-based, and highly effective treatment therapy for individuals struggling with phobias, anxiety disorders, and other types of psychological problems. By combining exposure to fear-inducing stimuli with relaxation techniques, individuals can learn to re-interpret and manage their fear responses more effectively. Through the guidance of a therapist and the practice of relaxation techniques, individuals can gradually de-sensitise themselves to their fears and learn to cope with anxiety in a more adaptive and effective way.


  1. Friedman, D.E.I. and Silverstone, J.T., 1967. Treatment of phobic patients by systematic desensitisation. The Lancet289(7488), pp.470-472.
  2. Wolpe, J., & Lazarus, A. A. (1966). Behavior therapy techniques: A guide to the treatment of neuroses. Oxford, England: Pergamon Press.
  3. Berman, J.S., Miller, R.C. and Massman, P.J., 1985. Cognitive therapy versus systematic desensitization: Is one treatment superior?. Psychological bulletin97(3), p.451.
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