Desensitization: What's Your Understanding?

T wants me to try desensitization, and I'm not at all clear what it involves. I thought I understood it, but now I don't think so. I had thought for years that it just meant forcing yourself to stay in places and/or with people that freaked you out, hoping that somehow exposure to them would just grind away the anxiety or discomfort. From some comments of T's, I think I may have had that wrong. "Desensitization" may be a little more complicated, but I'm not sure how.

Over the past thirty years I've forced myself (sometimes for years and years) to be in the kinds of situations to which I'm allergic, without the slightest decrease in anxiety or dissociation. I guess you could say that was using brute force. Are there any more sophisticated desensitization techniques that you folks have learned about that go beyond brute force? I'd love to hear about them and hear about your experiences, if you'd share them. Take care.

I think you are referring to flooding - where someone is just exposed to the triggering "thing" and then deals with their anxiety. The other technique I have heard of is graded exposure, where the "thing" is introduced very gradually at a level which you can easily deal with initially, then a bit more etc. etc. so you gradually become desensitised to it. Actually now you mention it I think this is T's cunning plan in gettting me to talk about some difficult stuff that leads to me disconnecting. Good luck ygrec23

I agree with SoupDragon. Generally exposure will be done very gradually. It depends also on what works fo ryou. For me flooding (the throwing you in at the deep end technique) works best in some situations, but not others. You may ask your therapist what she means.

This is generally referred to as flooding, and is in most cases a fairly ineffective way of learning to tolerate something you find uncomfortable.

Desensitization is a more gradual process in which you slowly introduce the uncomfortable thing, while staying at or under your stress threshold. My T and I are doing this as a way to help me talk about certain uncomfortable things. It started with her simply asking me about it...which resulted in panic and dissociation...and then we changed the subjected. Slowly, we worked up to me being able to tell her "one true thing," then talking for 1 minute, 3 minutes, 5 minutes, etc.

I use desensitization a lot in dog training, and the priciple is sound for both dogs and people. In dog training....say a dog is afraid of car rides...we'd start by having the dog sit next to the car and get rewarded for that. Once the dog is happily sitting next to the car, we'd sit IN the car and reward for that. Then, we'd sit in the car, turn on the engine, let it run for just a few minutes, reward. Then, increase the duration of having the engine run....then, we'd back out of the driveway and reward for that...then drive around the block, then a 5 minute drive, etc. The whole time, you're watching the dog to make sure that they are staying below their stress threshold, or just at it, but not going over. Thinking can't occur when the dog (or person) is significantly over their stress threshold. You keep each session short, and don't move on to the next step until comfortable with the current one. If you move too quickly, and it results in going over the stress threshold, then you just back up a step and give a little more time at that step before moving on.

I think the situations get replaced with less intense images through visualization first, before one does the situations one dislikes?

http://www.guidetopsychology.com/sysden.htm

I got better by understanding what was triggering me and why so I would get in a situation, collect my reaction and then analyze what was being triggered from my past and then work on that.

Dear Rhiannon,

Thank you for your explanation. The matter came up between T and I in the following circumstances: I drove up to her office and, after parking in the parking lot, sat in the car for five or ten minutes reading a book that required a lot of attention to follow. Then I got out of the car, with the book, and went and sat in the waiting room. There were another five people there, none of them known to me, and when I sat down, I continued trying to read my book. After a while I realized that unlike the situation in the car, I had to read every sentence in the book over and over again to try to understand the meaning. I realized that the large majority of my attention was abstracted by the simple fact of being in a room with five other people. So, unconsciously, I was constantly scanning for danger signals, and that took up so much of my mind that I wasn't as able to comprehend what I was reading as I had been in the car.

This is standard for me, but it was the first time I'd been conscious of such a clear-cut difference. I'm really frightened of everyone except my wife and T. Even when there's no possible threat, the mere presence of others, strangers or not, is very uncomfortable and takes up most of my mind. T says that by "desensitizing" she means for me to be able, in such situations, to understand and accept that the source of the anxiety and threat was way back in my infancy and then to understand and accept that the present situation (wherever it may be) has nothing at all to do with what happened before I was three, and that in fact there is no threat to me at all in the current situation. She says that after doing this a sufficient number of times the automatic connection made by my mind between the current situation and way back at the beginning will start to loosen or (her word) "modulate." I believe this is what she means by desensitization, rather than what you and others describe as "flooding," which I've tried many times and which has never worked for me.

She further says that at my age we can't hope to entirely reconstruct my personality. That what happened when I was small just happened, that's the way it was, and the best we can do is attack the psychological link between then and now. I'm willing to do this, but I have no conviction one way or the other as to whether it will work. I feel so threatened so much of the time that I think I'll be "desensitizing" all day every day. What do you think? Can it work? Is this serious stuff? Take care!

Thanks, Perna, that was a very interesting article. T did not mention visualization, but that sounds like a very good addition to what she suggested. Take care.

The only experience I have to draw from on whether or not desensitizing works is my own personal experience and dog training! Since the dog training won't help much except as a way to explain the concepts, I'll have to draw on my own experiencese. (It does work for dogs, though...lots of success there!)

The work my T and I have been doing does help...but I've found that it's hard to generalize it right now. For example, I am becoming comfortable talking with my T about certain things, but just the thought of talking to anyone else sends me in to a tailspin of panic. My T assures me that as I become comfortable with the topic and gain more positive experiences in talking with her, that will fade. I'm not sure I believe it, so I'm borrowing her confidence in the process for now.

I also tend to panic when I'm surrounded by people, especially in waiting rooms. I think desensitizing could work in those situations, depending on the source of the panic. If it's related to past trauma, then building a history of positive experiences through desensitization should prove helpful and you would be able to draw on that positive history in each new situation. For myself, the panic is due to simply feeling the pressure of other people and for that, mindfulness has been more helpful...bringing awareness to my own body and breathing and the fact that even when I feel croweded, my space is still my space and I can focus on my own body rather than the pressure I feel from others around me.

Ygrec, have you talked to your T about these traumatic past experiences so that you can release the emotions about them that you still hold?

Hey, I am scared of everyone including T! I have no idea whether what your T is suggesting will work, but can't see if will make things worse so if you trust T, I would just have faith and go with the flow.

Let us know how it goes though, I would be really interested in the results. Soup

Well, Sannah, what we've done is "triangulate" back from (1) "normally" remembered things (i.e., after the age of 3), including my brothers' lives and our parents' (pretty much constant) characters, which didn't ever change much, and from (2) the pervasiveness of the terror, the dissociation, the schizoid withdrawal, etc., to an earlier time, really "attachment time," pretty much pre-verbal.

There seems to have been something quite wrong with our mother throughout her life, though T doesn't want to diagnose her now. Mom didn't really like closeness or intimacy with anyone whatsoever at any time in her life, babies and husband included. Get close to her, indicate a need, and she left, somewhere inside her head, she just wasn't there, except physically. You could see her "awayness" in her eyes. So even for tiny babies it was pretty much "knock, knock, no one's home!" She did this consistently with everyone until she died at age 86.

The emotions from those early days permeate my being all the time. I don't think I'll ever be able to "vent" them or get rid of them entirely. The best I can do is tamp them down and start separating them from present-day life, to which they're really not relevant. Thanks for asking!

My understanding of desensitization instead of flooding is that you take things slowly and build up towards being desensitized. Like if your phobia is other people; you might start initially with looking at pictures of other people in a book and noting how you feel. Becoming aware of your response and practising grounding skills to feel safe. Working on coping and changing your beliefs about why the pictures are scaring you until you get to where you feel safe with it. Then you move on to something a bit "bigger" like looking at people moving around on tv. Repeat the process of noticing how you feel; grounding; looking at and challenging beliefs and reworking them, reminding yourself you are safe etc. Then increase the exposure, moving it up to looking at people in the distance. Repeat the process of noticing, grounding, reviewing and adapting beliefs, all the while moving at a pace where you don't get too overwhelmed but do keep moving forward. Then it might be seeing one person up closer for a short period of time - repeating the rest of the process. Then having that one person stick around for longer - repeating the rest of the process. You might then talk to them for a few minutes - repeat the process. Introduce a second person - repeat the process. Basically you work out with a T what the fear or phobia or situation is that needs desensitizing, and then work out a plan of gradually introducing you more into that situation all the while staying safe and becoming desensitized. In contrast, flooding would be more like throwing you into a room of 100 people and expecting you to stay there and work things out. Desensitizing can take time because you are building up from being terrified to being safe; and sometimes needing to retake steps .... flooding, if used for the wrong thing and by the wrong person can be dangerous; but in some situations is helpful (sounds scary to me though). One of my T's worked with me on desensitizing a phobia and it is helpful

Have you shared these emotions in therapy?

To the extent I'm able to access them. I've been able to feel the anger, which is overwhelming. But they're probably all overwhelming. If they hadn't been then they wouldn't have given rise to my pathology. I think there's quite a bit of terror and aloneness and desperate craving for another person to take care of me. As well as shame (I must have done something wrong to deserve being ignored) and hopelessness from after the time I realized that nothing was going to change. Like that. Take care.

I did a course of desensitization. I got to a certain point where the terror was too much and T decided it was not appropriate to continue the procedure, but it definitely decreased my anxiety about certain situations. I went from being unable to think about the person who caused my trauma to being able to think about some of the traumatic incidents without feeling excessive anxiety.

The key is that you are supposed to go slow. I kept trying to rush things and it didn't help me. Good luck!

Did it help when you shared these emotions in therapy?

Sannah, if that question was directed to me (it could have been directed at another poster), then I'd have to say yes. When I shared these emotions in therapy, they became MINE. Part of ME. Who I am. Whereas before, I would never, ever have defined myself, even in part, as an angry person. Some of these feelings are so devastating that I can't just take them out and park them in the sunlight, as with anger. Desolation is something I can peep at now and then, but some part of me feels that if I were to fully "own" the desolation I'd just die. I know where it lives, I know how to peek at it, but I just can't have it out all the time. It's just too awful. Take care.

Sounds like you are just getting started with this. You have plans to continue to work with this in therapy Ygrec?

Yes, I do.