Systematic Desensitization Therapy For Treating Phobias

Medically reviewed by Andrea Brant, LMHC
Updated February 29, 2024by BetterHelp Editorial Team

When severe anxiety disrupts daily life, it could signal a more serious issue, like anxiety disorders or a severe phobia, such as a fear of flying. Various treatments, including systematic desensitization and virtual reality exposure therapy, are available for diverse phobias. In this article, we will delve into the evidence-based systematic desensitization process and its components.

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Phobias can make daily life a struggle for some

What is a phobia?

A phobia is defined as an irrational fear or an aversion to something. There are a wide variety of phobias, from insects and death to numbers (aritmophobia) and natural disasters. A phobia, regardless of its specific object, can disrupt daily life and potentially result in panic disorders, depression, and other mental health issues if left untreated.

An effective behavioral therapy for addressing phobias is systematic desensitization, which utilizes the classical conditioning and counter conditioning process. This treatment involves gradually exposing the individual to the feared object or situation in a controlled and safe environment while simultaneously engaging in relaxation techniques to counteract the anxiety response. Experimental desensitization is a form of this therapy involving real-life exposure, while imaginal desensitization involves visualizing the feared object or situation. This therapy has been shown to be particularly effective in PTSD treatment and can help individuals regain control over their lives by reducing the severity of their phobic reactions.

There are three common types of phobias in the realm of abnormal and social psychology:

  • Specific: These phobias tend to have a very specific “trigger,” such as seeing a spider, experiencing test anxiety, or seeing the color blue.

  • Social: Fear of public humiliation or social gatherings is sometimes considered a social phobia or social anxiety.

  • Agoraphobia: Agoraphobia is a fear of being in open or crowded places or a place that you can't escape from. People with agoraphobia may also fear leaving their homes.

People with any of these types of phobias may experience uncontrollable anxiety when encountering their fear. They may do everything that they can to avoid that fear in their life. 

In general, these individuals may recognize that their fear is irrational or exaggerated, but they often still can't relax or stop the intense feelings associated with thinking about their fears. Panic, anxiety, nausea, dizziness, rapid heartbeat, staggered breathing, chest pain, flushing, trembling, and dry mouth are just a few of the unpleasant symptoms that might occur with a phobia. When this occurs, it may help to seek phobia therapy from a licensed therapist with experience treating phobias.


What is systematic desensitization?

Systematic desensitization treatment is designed to gradually expose an individual to their phobia while they engage in relaxation response techniques and deep breathing exercises. The concept is that combining these elements may help the person learn to stop associating their phobia with the physiological symptoms of fear, aiming to ultimately eliminate the symptoms altogether.

The work is facilitated by a therapist trained in exposure therapy. The process typically begins with gradual exposure, starting with situations that provoke minimal anxiety and progressing to more anxiety provoking scenarios. The treatment can be extensive, particularly if the fear is more intense or has persisted for a longer duration.

The process of systematic desensitization 

The therapist typically initiates the process by instructing the client on muscle relaxation techniques to employ when confronted with a situation that triggers their phobia. These techniques can encompass progressive muscle relaxation, meditation, deep breathing, visualization, and more. After the individual learns to calm themselves under stress, the therapist may carefully help them in discussing their fears and anxiety in detail. This could involve gradually exposing their phobias using a fear hierarchy or anxiety hierarchy.

Phobias can make daily life a struggle for some

For instance, if a person experiences childhood water phobia, the first and least fear-inducing aspect may be looking at a picture of a pool. Watching a swimming scene on TV or in a movie might be next, and that may progress to being near a pool without getting in.

The next step may involve the patient dipping their feet in the water, and then gradually progressing to swimming. Each of these steps builds on the previous one, bringing the individual closer to confronting their initial fear. This modality works effectively in helping people overcome various types of phobias.

During therapy sessions, the therapist often encourages the person and carefully pushes them to reach slightly beyond their comfort zone. They may assist them in focusing on relaxation techniques both before and during treatment.

Fear vs. phobia

Some people may wonder why a phobia can create significant distress given that everyone is afraid of something. However, most people have what are considered fears rather than phobias. 

Fears typically don't interfere significantly with a person's daily life. For instance, a fear of spiders implies the individual dislikes them and avoids their presence, but when encountering a spider, they can usually cope and exhibit a response prevention strategy that's proportionate to the actual threat or danger posed by the spider.

However, for someone with a phobia of spiders (arachnophobia), just seeing one can trigger a panic attack. A person with a spider phobia may exhibit obsessive compulsive disorder-like behaviors to avoid even the potential exposure to spiders, such as insisting their clothing is stored in vacuum bags or freshly laundered before wearing. They might request frequent insect treatments in their home or completely avoid hiking for fear of encountering a spider.

In other words, a phobia may significantly impact a person's life, but clinical psychology and behavior research suggest that behavior therapy may help them take essential steps toward recovery.


If you’re experiencing a phobia and you're not sure what to do, you don’t have to face it alone. There are licensed counselors with experience helping people overcome their phobias via systematic desensitization. While visiting a therapist in person is a common way to treat phobias, the rise in popularity of online therapy is rapidly replacing the need for individuals to travel to an office to receive therapy. Studies show that internet-based treatment is just as effective in treating phobias as in-person therapy, and you can receive treatment online from anywhere with an internet connection at any time.

With BetterHelp, you can be matched with an online therapist with training in phobia treatment methods. You can also contact your therapist via in-app messaging in between sessions, and they’ll get back to you as soon as they can. Take the first step and contact BetterHelp today. 

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