The 5 Differences Between Systematic Desensitization And Exposure
There are a large number of psychological treatments developed in order to respond to the psychological problems and disorders that exist. Some of them have demonstrated proven effectiveness in improving symptoms or even eliminating the problem, as is the case with two of the most used treatments in therapy to treat phobias: systematic desensitization and exposure.
These are highly effective techniques and very similar to each other, to the point that they are often confused with each other. However, the truth is that There are differences between systematic desensitization and exposure as we will see throughout this article.
Exposure therapy and systematic desensitization are two of the major treatments used in a wide variety of disorders.
Yes ok They are especially known for their success in treating phobias, there are various variations of these techniques that are used in problems such as post-traumatic stress disorder (exposure to interoceptive sensations, for example, or desensitization due to reprocessing by eye movements). Even techniques such as behavioral experiments used in behavioral problems or to combat beliefs (as in obsessive-compulsive disorder or major depression) are largely based on the same principles. Let’s see a brief definition of each of the terms.
Exposure
Exposure is a basic but very powerful technique, which bases its operation on place the subject or patient face to face with the stimuli they fear It is about making the subject remain in the frightening situation long enough for his anxiety to decrease naturally, to the point of becoming imperceptible. Thus, habituation to the stimuli occurs.
This exhibition can and is usually graduated in such a way that the process is not excessive for the patient creating a hierarchy of exposure from which the subject will be exposed to different stimuli until the level of anxiety is reduced until it becomes imperceptible.
There are multiple variants of the exhibition (in fact, from a certain perspective, systematic desensitization could be considered as such), and it can be applied both live and in imagination or even in recent years through virtual reality.
Systematic desensitization
This is a technique similar to exposure, aimed at achieving the reduction of anxious and aversive emotional responses for the patient while limiting and avoiding avoidance of situations.
On this occasion, it is based on the idea that if fear is learned, it can also be learned to eliminate it: therapeutic efforts will focus on the subject being able to actively eliminate the anxiety that stimulation generates. The aim is to actively carry out responses that are contrary and totally incompatible with the anxious ones, in such a way that one learns to eliminate the association between stimulus and fear to generate another one between the stimulus and relaxation, indifference or another alternative. In other words, it is based on counterconditioning.
In this case, too, the subject will have to expose himself to the stimuli that generate anxiety, the hierarchization of stimuli being essential in such a way that the counterconditioning process can be carried out little by little and with increasingly anxiety-inducing stimuli. Traditionally and habitually, this technique tends to be performed in imagination, although it is possible to perform it with live stimulation or in virtual reality.
Although a superficial observation may show that there is a great similarity between desensitization and exposure and even cause us to confuse them, a more in-depth analysis of how they work reveals that they have some notable differences. Among them, the following five stand out.
1. Slightly different goals
One of the main differences between exposure and systematic desensitization is the fact that they have objectives that, although similar, are different: while in exposure the objective is for the subject to reduce their anxiety levels by remaining in the aversive situation. yes, systematic desensitization seeks that it generates responses that do not leave room for the appearance of anxiety
2. Different operating mechanisms
Deeply linked to the previous point, in addition to the objectives they also differ in the methods. Although in both cases the patient has to face the stimulus that causes anxiety, while the exposure is based on habituation to the stimulation as a method to reduce the anxiety it generates, counterconditioning is used in desensitization seeking for the subject to carry out a response incompatible with anxiety that replaces his previous response.
3. Structuring and gradualness in the exhibition
Another element that can mean a difference between both techniques is the mandatory nature of graduation. Systematic desensitization is always carried out in a very structured manner, requiring a clear hierarchy of exposure. However, although exposure can also be (and is indeed recommended) graded, it is also it is possible to find variants such as implosion and flooding in which exposure to the most feared stimulus is very immediate. The pace will also depend on the patient’s preferences and possibilities and how he or she reacts to the exposure.
Relaxation techniques such as diaphragmatic breathing and Jacobson’s progressive relaxation are very useful elements and frequently used to reduce the level of anxiety, frequently being incorporated into both techniques.
However, the use made of them is different: while in systematic desensitization they are used as a mechanism for counterconditioning, using them as a response incompatible with anxiety, in exposure their use is limited to lowering the level of tension when exposed to the phobic stimulus in those cases where anxiety is excessive for the patient.
5. Different levels of generalization
Although both techniques are very effective for the treatment of phobias when they are applied correctly by trained professionals and taking into account the needs and particularities of each patient and situation, the truth is that another difference can be found regarding their level. of generalization.
The exposure makes it possible to reduce the level of anxiety towards the phobic stimuli agreed upon between therapist and patient in a very efficient way, but although habituation to these stimuli can be generalized to other similar stimuli, the effect of the technique can be slightly restricted. However, by allowing systematic desensitization to generate an alternative response, it is possible that in this second response there may be greater generalization to other situations and stimulations that generate anxiety, applying the same incompatible response.
