Systematic Desensitization in Addiction: Phobia Treatment

Systematic Desensitization in addiction is a therapeutic approach aimed at helping individuals overcome addictive behaviors. The key premise is that relaxation and anxiety cannot coexist, making it an effective method for treating phobias, anxiety disorders, and post-traumatic stress disorder.

The benefits of systematic desensitization extend beyond its application in anxiety-related conditions. It has been found to have a notable impact on addiction, particularly in addressing the persistent mindset that persists even after substance use stops. 

This therapy contributes to combating addiction-based thinking patterns, facilitating the reformation of thought processes. By systematically exposing individuals to anxiety-provoking situations, systematic desensitization equips them with coping skills, promoting relaxation and eventual comfort in the presence of once-feared stimuli.

Origin and Development of Systematic Desensitization

Systematic desensitization is a behavioral therapy developed by South African psychologist Joseph Wolpe in 1958. Wolpe introduced the Subjective Units of Disturbance Scale (SUDS) to assess subjective discomfort and created the Subjective Anxiety Scale (SAS) and Fear Survey Plan for behavior research. The technique involves gradual exposure to feared stimuli, based on reciprocal inhibition, positing that relaxation and anxiety cannot coexist. 

Systematic desensitization has proven effective in treating phobias, anxiety disorders, and post-traumatic stress disorder through graded exposure and relaxation techniques. Wolpe’s work laid the foundation for this therapeutic approach, contributing significantly to the field of behavioral therapy.

How Systematic Desensitization Helps in Addiction Treatment

Systematic desensitization also known as graduated exposure therapy, assists individuals in overcoming fears, phobias, anxiety disorders, and post-traumatic stress disorder by systematically exposing them to feared stimuli. Based on the principle of reciprocal inhibition, which posits that relaxation and anxiety cannot coexist, the therapy involves graded exposure and relaxation techniques to mitigate anxiety responses.

In addiction recovery, systematic desensitization addresses the mindset that persists even after substance use stops, helping individuals combat addiction-based thinking patterns. It enables the reformation of thought processes, redirecting negative self-talk and feelings of inadequacy that may threaten progress in recovery. By gradually exposing individuals to anxiety-provoking situations, the therapy equips them with coping skills, promoting relaxation and, over time, comfort in the presence of once-feared stimuli.

Systematic desensitization involves three main steps: learning relaxation techniques, creating an anxiety hierarchy, and practicing relaxation strategies while visualizing situations in the anxiety hierarchy. This process breaks down conditioned fear responses associated with specific stimuli, helping individuals manage fear and anxiety without resorting to substances. The therapy’s effectiveness is evidenced by its application in treating anxiety disorders, phobias, and post-traumatic stress disorder, with documented scientific testing supporting its efficacy.

How Can Desensitization Serve as A Tool in Treating Alcoholism and Drug Addiction? 

Desensitization serves as a tool in treating alcoholism and drug addiction, as evidenced by a study published in the J R Coll Gen Pract in 1969. The study, conducted by T. Kraft, explores the successful treatment of two male patients addicted to alcohol through systematic desensitization. The desensitization hierarchy involved various situations, including conversations with friends and strangers, demonstrating that patients could lose their addiction to alcohol and engage in social drinking without the desire to drink excessively.

Desensitization techniques, such as those employed in Cognitive-Behavioral Therapy (CBT) and Cue Exposure Therapy (CET), are designed to break the connection between cues associated with craving for alcohol and relapse into drinking.

These therapeutic approaches help clients resist urges to continue drinking in the presence of alcohol and other drinking cues, contributing to the overall success of alcohol addiction treatment.

Systemic Desensitization Therapy Vs. Exposure Therapy

Yes, Systematic Desensitization is similar to another form of therapy known as Exposure Therapy. Both are behavioral techniques used primarily to treat phobias, anxiety disorders, and other stress-related conditions. Here’s how they are similar and how they differ:


  1. Gradual Exposure: Both therapies involve gradually exposing the individual to the feared object, situation, or thought. The idea is to slowly build up their tolerance and reduce their anxiety response.
  2. Relaxation Techniques: Systematic Desensitization and Exposure Therapy often incorporate relaxation techniques to help manage anxiety. This can include deep breathing, progressive muscle relaxation, or mindfulness.
  3. Hierarchy of Fears: In both approaches, a hierarchy of fears is typically created. This means starting with situations that provoke the least anxiety and gradually working up to more challenging scenarios.
  4. Cognitive-Behavioral Roots: Both are grounded in cognitive-behavioral principles, focusing on changing the individual’s reactions and thoughts about the feared stimulus.


  1. Imaginal vs. Real-life Exposure: Systematic Desensitization often begins with imaginal exposure, where the individual visualizes the feared object or situation. In contrast, Exposure Therapy more commonly involves real-life exposure, although it can also start with imaginal or virtual exposure.
  2. Use of Relaxation: Systematic Desensitization places a stronger emphasis on learning and using relaxation techniques as a key part of the therapy. In Exposure Therapy, while relaxation strategies might be used, the focus is more on habituation to the anxiety itself.
  3. Pace of Exposure: Systematic Desensitization typically progresses at a slower, more controlled pace, carefully calibrated to the individual’s anxiety levels. Exposure Therapy can sometimes involve more rapid exposure to the feared stimulus.

Role of Desensitization in Preventing Relapse

The Role of Desensitization in Preventing Relapse

Desensitization plays a crucial role in preventing relapse across various contexts.

The Motivation-Skill-Desensitization (MSDE) intervention, which combines relapse prevention strategies, shows promise in preventing relapse. Systematic desensitization, a method that can help overcome addiction, contributes to the recovery process by assisting individuals in managing addiction-related thoughts and behaviors. Genetic predisposition plays a role in the development of hypersensitivity reactions to certain drugs.

Desensitization methods, spanning from EMDR and systematic desensitization to drug desensitization protocols, contribute significantly to preventing relapse in addiction and hypersensitivity reactions, offering tailored therapeutic strategies for improved patient outcomes.

How Does Systematic Desensitization Help People Cope with Irrational Fears? 

Systematic desensitization is an effective behavioral intervention for treating phobias and anxiety disorders. It helps individuals cope with and overcome irrational fears through exposure hierarchy, replacing fear with a state of calm. The therapy counters anxiety levels with relaxation techniques, aiding in fear reduction and behavior modification. Studies confirm its effectiveness in treating specific phobias and managing overwhelming fears associated with dentistry.

In a 2020 paper published in Cureus, a team of researchers led by Fazida Karim from the California Institute of Behavioral Neurosciences and Psychology confirms the effectiveness of systematic desensitization in treating specific phobias, highlighting its role in aiding the process of fear reduction and behavior modification.

Additionally, in another study underlines the importance of systematic desensitization or exposure therapy in managing overwhelming and irrational fear associated with dentistry, as discussed in a 2016 article by DP Appukuttan in the Journal of Dental Research.

What Are the Main Components of Systematic Desensitization?

The main components of systematic desensitization are as follows:

  1. Identification of Fear Hierarchy: The process begins by identifying a hierarchy of fears associated with the phobia or anxiety, providing a structured approach to treatment.
  2. Relaxation Training: Individuals learn relaxation or coping techniques to manage anxiety and fear effectively during exposure to feared stimuli.
  3. Reciprocal Inhibition: The therapy incorporates reciprocal inhibition, where relaxation counters anxiety, allowing individuals to confront and manage anxiety-causing stimuli.

The aim of systematic desensitization is to break down faulty maladaptive learning and help the person re-learn a more functional response. This is achieved using the principles of classical conditioning, with the goal of replacing the fear with a more functional response, such as relaxation.

What Is Systematic Desensitization For OCD?

The systematic desensitization therapeutic approach involves applied relaxation during gradual exposure to feared items and situations, making it effective not only for OCD but also for various phobias and anxiety disorders.

For individuals with OCD, systematic desensitization acts as a slow and gradual process of exposing themselves to fears that control symptoms, helping to reduce anxiety, stress, and avoidance through exposure therapy. The therapy combines relaxation techniques with gradual exposure to situations that induce high levels of stress and fear.

In systematic desensitization for OCD, therapy involves practicing tolerance of anxiety as a means to strengthen the individual’s ability to resist compulsive actions driven by fear.

How Long Will Systematic Desensitization Treatment Take?

The duration of systematic desensitization therapy varies, typically involving four to six sessions, with severe phobias possibly requiring up to twelve sessions. 

How Does Systematic Desensitization Work

How Does Systematic Desensitization Work?

The process of systematic desensitization involves several steps that are crucial for its effectiveness. These steps are designed to gradually expose individuals to their anxiety-provoking stimulus and help them overcome their fears or anxieties. Here are the three main steps of desensitization:

  1. Learn Relaxation Skills: The first step in systematic desensitization is to learn and practice relaxation techniques. These techniques help individuals manage and reduce their anxiety during the exposure process. Some common relaxation techniques include deep breathing exercises, meditation, muscle relaxation, and focusing on body sensations. By mastering these skills, individuals can effectively calm themselves down when faced with their anxiety triggers.
  2. Create an Anxiety Hierarchy: In this step, the individual works together with their therapist to create an anxiety hierarchy. An anxiety hierarchy is a list of situations or stimuli related to the fear or phobia, ranked from least anxiety-provoking to most anxiety-provoking. This hierarchy helps establish a systematic approach to exposure therapy. The individual and therapist collaborate to identify specific situations or stimuli that trigger anxiety, and they assign a numerical value to each item on the hierarchy based on its level of anxiety-inducing power.
  3. Gradual Exposure to Fears: The final step involves gradually exposing the individual to anxiety-provoking stimuli or situations in a controlled and gradual manner. The exposure can be done in two ways: in vitro exposure and in vivo exposure. In vitro exposure involves imagining the feared situation, while in vivo exposure involves physically experiencing it. The individual starts with the least anxiety-inducing item on the hierarchy and gradually progresses to more anxiety-provoking items as they become comfortable. The exposure sessions are repeated over time, allowing the individual to become desensitized to the stimulus and gradually reduce their anxiety response.

By following these steps, individuals can gradually overcome their fears or anxieties through systematic desensitization therapy. It is important to note that the process may vary depending on the individual and their specific needs, so it is essential to work closely with a qualified mental health professional throughout the therapy.

Who Benefits Most from Systematic Desensitization?

Systematic desensitization is a behavior therapy technique designed for individuals with conditioned fears or anxiety responses. Primarily beneficial for those experiencing anxiety-related disorders, PTSD, the therapy involves learning to stay relaxed during the visualization of increasingly stressful situations. Beneficiaries include those with phobias, fears, anxiety disorders, and post-traumatic stress disorder, aiming to replace fear with a state of calm.

Understanding Cognitive-Behavioral Therapy in Conjunction with Systematic Desensitization

Systematic desensitization is a form of exposure therapy used in cognitive-behavioral therapy (CBT) to gradually expose individuals to anxiety-provoking stimuli, aiming to reduce anxiety, stress, and avoidance.

Research suggests combining CBT with systematic desensitization is effective, as seen in studies on fear of flying, where significant improvements were observed with this integrated approach. Systematic desensitization, integrated with CBT, emerges as a valuable therapeutic approach, supported by research findings and historical roots in behavior therapy.

Limitations of Systematic Desensitization in Addiction

The limitations of systematic desensitization in addiction treatment may stem from factors such as heritability, child-rearing practices, and the maladaptive coping view of alcohol dependence, asnoted in a 2016 paper published in PMC. A 2016 study on eye movement desensitization in addiction treatment also recognizes limitations, including small sample sizes and drop-outs. Despite these challenges, systematic desensitization remains a valuable technique in counterconditioning and behavioral therapies.

Welcome to The Grove: Your Partner in Addiction Recovery

At The Grove, we specialize in offering personalized addiction treatment, tailored to meet the unique needs of each individual. While our informational articles cover a range of therapies, such as Systematic Desensitization, it’s important to note that our treatment center may not offer this specific method. Instead, we focus on a holistic approach, combining various proven therapies to support your journey to recovery. Our dedicated team is committed to helping you find the most effective path to healing and wellness. Contact The Grove today to explore how we can assist you in overcoming addiction with compassion and expertise.

The Grove Editorial Team is a dynamic group of professionals at The Grove, a leading addiction treatment center in Indianapolis, Indiana. Comprising experienced therapists, medical experts, and dedicated support staff, this team brings a wealth of knowledge and compassionate insight into the complexities of addiction and recovery. Their collective expertise shines through in each article, offering readers valuable guidance, the latest in addiction science, and inspiring stories of healing and transformation. The Grove Editorial Team is committed to educating, supporting, and empowering individuals and families on their journey toward a healthier, substance-free life.

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