Implosive Therapy: Characteristics And Applications
There are various psychological techniques for the treatment of phobias although it is known that the most effective are the techniques that expose the subject to the phobic stimulus (exposure techniques).
Today we will know one of them, implosive therapy a mass exposure technique proposed by Thomas Stampfl in 1961.
Exposure techniques are used to treat especially fears and phobias They consist of exposing the subject to the phobic object or situation, so that he becomes accustomed to the anxiety (he learns to tolerate it) that he feels when exposed to it.
The objective is to learn that there is no harm and that therefore the stimulus is not dangerous
For example, it would be about exposing a person to darkness and having him understand that it is not dangerous, or exposing a person with a phobia of dogs to one and seeing that it does not bite him.
In any case, in most phobias, the person knows that the fear is irrational, and that the phobic stimulus (or situation) is not really dangerous; However, the person is unable to eliminate the phobia spontaneously if he is not exposed to it and understands that “non-association.”
Item Hierarchy
Let’s see the first step of exposure techniques.
To apply an exposure technique, First, a hierarchy of stimuli must be designed based on the level of anxiety they produce
Subsequently, the patient should be exposed first to the items that cause the least anxiety, and move up the item scale (from least to most anxiety). The hierarchy will be developed by the patient together with the therapist.
Difference with systematic desensitization
Unlike systematic desensitization techniques (where the patient applies a response incompatible with anxiety, such as relaxation, when exposed to the phobic stimulus), in exposure exposure to stimuli is less gradual (the hierarchy is more abrupt).
Mass exposure techniques
Within the exhibition techniques, we find various types depending on the type of exhibition (live exhibition, symbolic, through virtual reality…).
On the other hand, implosive therapy is within the mass exposure modality, where therapeutic sessions are 1 or 2 hours a day for 7 consecutive days In this sense, massive exposure techniques are more effective techniques than spaced exposure techniques (for example with sessions 1 or 2 days a week).
In turn, we find two types of mass exposure techniques: implosive therapy and flood therapy.
Implosive therapy
Implosive therapy was created by Thomas Stampfl in 1961. Its theoretical basis is based on psychoanalysis and experimental psychology (unlike the flood, which we will see later, and which is based solely on experimental psychology).
Exposure to aversive stimuli is done solely through imagination, and the escape response is not allowed. In the flood, however, the exposure can be live or imagined, and the escape response is possible. The content of the stimuli is dynamic content.
On the other hand, the hierarchy of stimulus presentation is less gradual than in flooding, i.e. it is easier to move from a low aversive stimulus to a more aversive one the change is more abrupt.
Similar to the previous one, but with the differences mentioned, is flood therapy, created by Baum in 1968. As we have seen, here the theoretical bases focus on experimental psychology, and exposure to stimuli. It can be both live and in imagination An escape response may or may not occur during exposure, and the content of the stimuli is realistic.
Both implosive therapy and flooding therapy can use the hierarchical presentation of stimuli, but this is less demanding and graduated than in systematic desensitization (SD), which is more abrupt.
Exposure Guidelines
When a subject is exposed to a phobic situation through implosive therapy and continues to present anxiety at the time of its application, the phobic stimulus must continue to be maintained In the event that the phobia is excessive, then escape to a calm situation will be allowed (only in the case of flooding).
In the case of implosion, the presentation of the stimulus will continue until the anxiety is reduced, and in the next session we will start with an earlier item in the hierarchy, since the last one will not be considered overcome.
Variants and their level of effectiveness
Depending on the characteristics of the exposure technique that we are going to use, differences appear in terms of the degree of effectiveness Let’s see them:
Live and symbolic exhibition
As we have seen, in implosive therapy the phobic stimuli will always be presented in the imagination. However, it should be noted that the maximum effectiveness of exposure techniques are those that present the stimulus in vivo (in a real way).
It is known that the maximum efficiency occurs when the gradient or intensity of exposure to the stimuli is as abrupt as the patient can tolerate ; In this case, implosive therapy would be a good therapeutic option to eliminate phobias, especially if you want to eliminate them quickly.
In any case, a gradual intensity will also be effective, although if it is abrupt it will offer faster results (but it does not have to be more effective; that will depend on the type of patient).
Interval between sessions
When defining massive exposure techniques, we have also seen that implosive therapy is applied daily (the interval between sessions is short). Therefore It will be more effective than if the interval between sessions is long (weekly session frequency, for example).
Duration of sessions
In implosive therapy, sessions last between 1 and 2 hours. It is known that the effectiveness is maximum when the duration is as long as necessary to facilitate habitation (between 30 and 120 minutes). Therefore, in this sense this technique will be one of the most effective.
However, it should be noted that applying overexposure from the moment the fear does not disappear does not improve the results.
