Step by step Systematic Desensitizationwas developed for phobias,
but in a less structured form the technique is the basis for all successful
approaches to fear disorders.
Neil and I repeat the relaxation technique in my office. When
he is calm and comfortable, I ask him to picture himself stand-
ing on the walkway, watching his wife rake leaves. Then I ask
him to imagine walking toward her until he starts feeling afraid.
Then we stop and relax until he’s calm enough to take another
step. Eventually, Neil can imagine touching an actual spider.As you can imagine, this process is slow and requires many repetitions
before it has the desired effect. There are lots of ways to do desensitization.
Most therapists begin with imaginary spiders and move forward to the real
thing. Specialists have menageries of frightening animals in their offices
for what they call in vivo training.
Sometimes these therapists will expose phobics to spiders, snakes,
heights, or whatever in huge immediate doses designed to cause the fight
or flight response to burn itself out and extinguish. This is neverdone as
a surprise.
I refer some phobias to specialists, but treat many in my office with
imaginative techniques, which I teach them and their friends and family
members, who are the ones who actually take phobics out on in vivo
assignments.
Neil’s mission was no walk in the park. Well, actually it was.
After imager y training in my office, he and his wife were able to
go out and walk through a city park and even on trails in the
mountains. When they saw webs, or in one case an actual you-
know-what, he and his wife would back off to a safe distance,
relax, and move forward.
The end came about a month later when Neil stood poised,
ready to squash a hapless spider with his hiking boot, and
decided to let it live.Not all phobias are so easily treated as Neil’s. Some require medication,
elaborate strategies, and extensive work by skilled specialists. In many
120 ❧Explosions into Fear