hey there everybody and welcome to today's presentation on systematics
desensitization this is part of the cognitive behavioral therapy nuggets
series and i'm your host dr dawn elise snipes
what is systematic desensitization well basically it's exactly what it sounds like you
are systematically or in a step-by-step fashion becoming less sensitive to a particular trigger
or stimulus systematic desensitization helps you alter your reactions to triggers or stimuli
in the environment so you can kind of think of them like allergy shots for cognitive allergens
you know if you've got allergies you may go to the doctor and get a shot once a month and by
exposing yourself a little bit at a time to those things that you're allergic to your body
starts developing the understanding that it's not something that it needs to get all fired up about
and trigger your allergic reaction so this is sort of what we're talking about with systematic
desensitization the first thing first thing that you're going to do with systematic desensitization
is create an environment where you feel safe and empowered you certainly don't want to be start
starting to try to deal with things that are stressful if you don't feel like you're
in a safe place if you don't feel like you have options so if you start feeling overwhelmed you
have the ability to get back to safety you're empowered to leave that stressful situation
so create an environment of safety and empowerment for some people this means doing
systematic desensitization activities with their or when they're rehearsing at home doing it when
there is somebody else around at least in the house so they know that if they start to spiral
that they've got somebody there that they can rely on whatever it is for you it's important that you
feel safe and empowered when you start you need to feel really grounded before you take the next step
then you need to master the ability to use breathing relaxation and distress tolerance
skills to down regulate your stress response you don't want to start trying to figure out
how to do this when you are practicing systematic desensitization you want to learn these skills
in day-to-day life before you launch into this so when you start to feel stressed during the day
practicing slow focused breathing in order to down regulate your stress response practicing
different relaxation skills to down regulate that stress response and your distress tolerance skills
remember these are the mnemonic tags thoughts that are empowering stopping thoughts that are
distress intolerant and replacing them with empowering thoughts so thoughts activities that
can help either distract you from what you're going through until you can get into your wise
mind or that actually trigger the opposite emotion that trigger a sense of happiness or safety and
empowerment g stands for guided imagery and guided imagery can be used to see yourself successfully
completing the task or getting through something that's difficult and s is for sensations and
sometimes sensations like a smell like essential oils or even just a wax tart that you particularly
like the smell of can help you feel more grounded and more relaxed either way you want to have a
toolbox of tools that you can use in order to help you when you start feeling stressed to down
regulate that stress response to slow your heart rate to slow your breathing to relax your muscles
to tell your body that there is no threat thanks for letting me know but really there is no threat
once you have mastered the ability to use these skills to regulate your emotions to
down regulate that stress response then you can start launching into systematic desensitization
when i work with clients one of the first things i do is i have them learn about the
trigger and then as they're learning about it you know they start thinking about a trigger
and i'm going to use the example of snakes because lots of people are afraid of snakes
so i will have them start learning about snakes and while they're learning about it
because they're reading about something that they're afraid of they're going to experience
an enhanced stress response so while they're learning they're also going to be
mindful and take breaks to down regulate that stress response using breathing relaxation
distress tolerant thoughts those sorts of things so they're going to learn about this
trigger in other videos we've talked about facts control and probability one of the things that's
important in systematic desensitization is to help your brain make decisions based in fact not based
in emotion which is why i start with let's learn about this trigger why is it that it triggers you
and what is it related to if it's related to a prior experience a past memory a trauma
okay knowing that is important and gathering fact-based information about the threat that
this particular thing whatever it is poses in the present now you may have no history with snakes
so it may not be related to anything in the past you just always assumed that they were dangerous
so the fact-based information is what's important there for other people and for
other issues that are triggering it may be a phrase somebody says or a cologne that they wear
you want to think about why does that trigger you what is it related to and what do you need to do
in order to recognize that in the present you are safe secure and empowered
once people uh have gone through learning about the trigger and i've gotten to the point where
they can think about it objectively you know this is a smell this is a snake whatever and
not get stressed out then we move to the next step and it's really important with systematic
desensitization to take what i call micro steps because if you jump forward too quickly
it could overwhelm your stress response so take the next step and what i usually start out with
is in a safe environment uh generally in session imagine the trigger or remember
a recent time when you were triggered so with the snake you're imagining seeing a snake on a path
on a hiking path for example or if it's a sound or a smell remembering a recent time when you've
heard that phrase or that sound or smelled that smell when you're transporting your memory back
that way it's kind of using guided imagery kind of using memory whatever you want to label it
as it's not really important but that again will trigger the stress response because it's taking
your brain back to a time or putting your brain in a place where it says oh this thing is present
imagine that situation and down regulate the stress response get to the point and you don't
just do this once and done you want to get to the point where you can imagine
the snake you can imagine seeing a snake and it doesn't bother you it actually doesn't trigger
your stress response anymore just like an with an allergy shot after a while you have gotten
enough exposure to it that when you encounter the allergen in real life it doesn't trigger your
histamine response this is the same thing we're going for and then moving on to exposure in a
safe situation or from a distance and i'm going to give you some examples in just a minute the final
step can be it doesn't have to be but the final step can be what i call immersion or ownership
when you're regularly exposed to something and you realize you are able to manage your response
it loses much of its power you can own it or make it yours i had one person that i worked with who
there was a particular phrase and actually there are a couple of phrases that i can think of
that when i hear them it triggers that stress response and i'm like oh don't say that
even though it has nothing to do with the current situation you know somebody's just using a turn of
phrase it reminds me of a time in the past that was very stressful when somebody habitually used
that phrase so you can own it instead of avoiding the phrase and trying not to hear it say it start
using that phrase as much as possible and for me one of those phrases is at the end of the day
that gets under my skin so i took ownership of it and i started using that phrase so now when
i say it you know i'm used to saying it i'm used to hearing it and i associate that phrase now with
me saying it not with that prior time so you can own it and that can be really helpful especially
for phrases that are triggering because somebody used to say them to you in a stressful situation
the same thing can be done for smells and you do want to recognize that smells are our strongest
memory trigger so it's important to not overwhelm yourself but if there's a particular smell like
somebody a prior relationship that you were in the person wore a particular aftershave or lotion
exposing yourself to that and being around it and even associating it with positive things
can help you switch your association and reduce your stress response to it
you can't associate it with positive things holidays for example can be very triggering for a
lot of people my stepfather is a perfect example he had a very traumatic christmas one year and
christmas decorations and christmas songs and christmas anything can be very triggering for him
however once the grandkids came along that started creating new memories that were now associated
with the holidays and it became less potent yes his trauma was not obviously completely relieved
by associating it with new things you know he had to do a lot of work in therapy but um
he was able to now be in a room with a christmas tree and not be completely triggered
regularly expose yourself to it while regulating your stress response i've
talked in other videos before about my somewhat irrational fear of bridges and when we lived in
florida there was a particular bridge going to my grandmother's house in st petersburg that we
would have to go over um when we lived in virginia there were bridges we had to go over and even here
in tennessee there's a bridge that we go over and just regularly going over that bridge and noticing
hey nothing bad happened helps desensitize my reaction my stress response when i see a bridge
now i don't think oh my gosh and my stress response doesn't kick off nearly as intensely
so here are some examples these are examples only and not suggestions again if you take steps that
are too big it can actually contribute to your anxiety so it is best with systematic
desensitization to start low go slow and ideally do it under the supervision or guidance of a
of a professional so you don't over overwhelm yourself but in terms of snakes you know again
i said that's a really common concern for some people learn about snakes here in tennessee there
are really only five poisonous snakes and they are very um identifiable so learning about those
so now when i see a snake when i'm out hiking or working in the barn or working in the on the farm
if i see one i can look at it and go that's not a poisonous snake and that can be the first step
getting that knowledge so you can make fact-based judgments can help you feel empowered
and then thinking about seeing a snake you know not holding it or anything just thinking about
coming coming across a snake whether it's when i'm cleaning the barn or hiking or whatever getting to
the point where i can imagine encountering a state snake and not getting stressed out
then think about being in a room with a caged snake
obviously a snake in a cage is not going to be able to access you but for some people
being that close even though they are you know locked up can be intimidating
so think about being in a room with a caged snake and then move to being in a room with
a caged snake think about being in a room with someone else holding a snake and then think about
petting a snake somebody else is holding and then think about holding a snake and then you can move
once you are able to think about these things you can also then start moving to doing them
but ideally you want to envision it first and be able to see it in your mind's eye going
successfully you want to be able to envision it or imagine it or think about it whatever
you want to call it and down regulate your stress response you want to get to the point where you
can think about it and it doesn't stress you out before you move to trying to expose yourself to
it for smells and phrases identify the smell or phrase and the memory that it's related to
remember a recent time that you've encountered that and stressed you out
so get to the point where you can think about pastimes when somebody has
worn that cologne or said that phrase and you can think about those times and it's like eh whatever
in the safety of your chosen space expose yourself to that smell or phrase
which can mean if it's a phrase just saying it to yourself or having somebody else that you trust
use it in conversation and then ownership you know expose yourself to that phrase
you know repeatedly you start using it yourself so now it's yours and you can choose how you use
it and you can choose when you use it and you feel empowered those are some steps that you can take
systematic desensitization should be undertaken with care to prevent moving forward too
quickly and causing additional anxiety it always starts with ensuring you feel safe
and empowered before beginning any type of exposure even imaginal imagination type exposure
it's essential to have mastered the skills of distress tolerance and emotion regulation because
that's what you're going to have to do when you start to get stressed out you're going to have to
override that stress response and convince your body to down regulate your stress response
you're going to teach train your body that your brain your that nervous system whatever you want
to call it that this is not something that you need to be concerned about in the moment