Pyschopathology L7

Question 1

Systematic desensitisation (SD) definition

Answer 1

• It is a behavioural therapy developed by Wolpe (1958) to reduce phobias by using classical conditioning
• SD replaces the fear & anxiety, caused by a phobic object, with relaxed responses instead
• It is impossible to experience 2 opposite emotions at the same time (e.g: fear & relaxation)
• This is called reciprocal inhibition
• If the patient can learn to remain relaxed in the presence of their phobia, they can be cured (this is called counter conditioning)

Question 2

What are the 3 stages of systematic desensitisation (SD)?

Answer 2

1. Anxiety hierarchy
2. Relaxation training
3. Gradual exposure

Question 3

Describe anxiety hierarchy

Answer 3

• A hierarchy of fear is constructed by the therapist & the patient
• Situations involving the phobic object are ranked from the least fearful to the most fearful
• e.g: If a person has a fear of snakes, the therapist might get the patient to first look at a photo of a snake, then a snake in a tank, then to hold a snake

Question 4

Describe relaxation training

Answer 4

• Patients are taught deep muscle relaxation techniques, such as progressive muscular relaxation (PMR) & the relaxation response
• PMR is when you tense up a group of muscles so that they are contracted tightly & you hold them in a state of tension for a few seconds
• Then you relax the muscles to their previous state
• Then, consciously relax the muscles even further so that you are as relaxed as possible
• During this, patients sit quietly with their eyes closed & breathe deeply and imagine relaxing situations

Question 5

Describe gradual exposure

Answer 5

• The patient is introduced to their phobic object and they work their way up the anxiety hierarchy, starting with the least frightening stage
• They use their relaxation techniques while they are exposed to the phobic object
• They move onto the next stage of the hierarchy when they feel comfortable with the current stage
• Eventually, the phobia is eliminated

Question 6

What are 2 advantages of systematic desensitisation (SD)?

Answer 6

• Jones (1924) supports the use of SD to eliminate “Little Peter’s” phobia
• A white rabbit was presented to Little Peter at gradually closer distances, and each time his anxiety levels decreased
• He eventually developed affection for the white rabbit
  ——————
• Klosko et al (1990) supports the use of SD
• He assessed various therapies for the treatment of panic disorders and found that 87% of patients were panic-free after receiving SD, compared to 50% on medication, 36% on a placebo, and 33% receiving no treatment at all

Question 7

What are 3 disadvantages of systematic desensitisation (SD)?

Answer 7

• SD is time-consuming when compared to alternatives such as flooding, as the person with the phobia needs to be trained in relaxation techniques, and gradual exposure can take many sessions
  ——————
• SD may not be appropriate for more generalised phobias, such as social phobia, where there is no obvious target behaviour, so it is difficult to devise a hierarchy
  ——————
• Progress in SD may not generalise outside of the clinical setting when the person with the phobia must face their fear without the support of the therapist

Question 8

Flooding definition

Answer 8

• It involves directly exposing the patient to their phobic object
• Beforehand, the patient would be taught relaxation techniques such as muscle relaxation, deep breathing & meditation
• Unlike the anxiety hierarchy, flooding involves immediate exposure to a frightening & extreme situation
• It stops phobic responses quickly because the patient doesn’t have the option for avoidance
• They quickly learn that the phobic object is harmless, and therefore extinction occurs
• The patient may achieve relaxation in the presence of the phobic object because they are so exhausted by their fear response
• Patients have to give fully informed consent
• The sessions usually last 2-3 hours (much longer than SD sessions)

Question 9

What is an advantage of flooding?

Answer 9

• Wolpe (1960) used flooding to remove a patient’s phobia of being in cars
• The girl was forced in a car & driven around for hours until she became too exhausted to feel scared
• This shows how effective flooding is as a treatment for phobias

Question 10

What are 2 disadvantages of flooding?

Answer 10

• It is a highly traumatic experience & many patients may be unwilling to continue with the therapy until the end
• Time & money might be wasted preparing the patients for the flooding experience & then the patient decides they don’t want to proceed, and their phobia remains uncured
• Flooding is unsuitable for children as it is traumatic
  ——————
• Behavioural treatments address the symptoms of phobias
• However, some critics believe the symptoms are only the tip of the iceberg and claim that the underlying causes of the phobia will remain
• In the future, the symptoms will return or symptom substitution will occur (this is when other abnormal behaviours replace the ones that have been removed)