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Phobia Busters: Treating Phobias with Exposure Therapy

written by: Audrey F. Henderson • edited by: Paul Arnold • updated: 5/10/2011

If left untreated, phobias can have a negative impact on quality of life. Phobias rarely improve on their own, however, patients often respond well to short-term therapy, many times achieving a complete cure. Exposure therapy for phobias is especially effective, and requires no medication.

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    Introduction

    Spider -- Rhys Piece Is Intellectually, you realize that most spiders aren't poisonous or that flying is statistically safer than driving. Nonetheless, arachnids give you the creeps and you stubbornly refuse to get on a plane -- even when it ruins potential vacation plans or impacts negatively on your career. Exposure therapy for phobias employs principles of cognitive-behavioral therapy (CBT), focusing on changing the patient's thinking and coping processes through a short-term course of treatment.

    CBT has a success rate of more than 80 percent in treating phobias, and often involves total therapy time of 12 hours or less, according to the University of Washington Human Interface Technology (HIT) laboratory. Virtual reality (VR) therapy offers a high-tech alternative to in vivo (first-hand) exposure to treating phobias. However, although CBT and exposure therapy are highly effective, they sometimes fail to dislodge deeply-ingrained phobias.

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    Immersion and Implosion Therapy

    Immersion therapy is a type of exposure therapy for phobias that works on the principle that the most effective way to unlearn instinctive responses to phobia is through forced, prolonged exposure to the source of the fear. Immersion therapy allows patients to sort through the emotions behind their fears in a safe setting. For example, someone who had a fear of snakes would be put in a room with nonpoisonous snakes until they realized they were not in any actual danger.

    A related alternative is implosion therapy, the brainchild of Thomas Stampf, who developed the technique during the 1960s. With implosion therapy, patients are subjected to prolonged, detailed descriptions of the sources of their phobias for up to nine hours at a time. Through this process, patients become desensitized to the phobia and therefore less fearful.

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    Systematic Desensitization

    Systematic desensitization combines relaxation techniques with exposure to the source of the phobia in a controlled environment. This process accomplishes the same goal as immersion or implosion therapy -- teaching the patient that although exposure to the source of a phobia may be unpleasant, such exposure poses no actual danger.

    Systematic desensitization to relieve phobia of snakes might begin with looking at drawings of snakes or even reading about snakes along with a therapist or a friend. Subsequent steps in the process would include viewing videos of snakes, then observing live snakes behind a glass enclosure. Eventually, the therapist may bring a live snake to therapy sessions, encouraging the patient to touch it.

    Observing a therapist calmly dealing with the source of a patient's phobia is an integral component of desensitization. These observation sessions are designed to provide reassurance for patients as they work toward dealing with the phobia themselves. For instance, patients who are afraid of driving may accompany the therapist while he or she drives, hopefully accident-free.

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    Virtual Reality Therapy

    Virtual reality exposure therapy for phobias provides patients with an "in-world" experience with a minimum of trauma. VR therapy has proven itself to be useful in treating fear of flying, fear of heights, post-traumatic stress disorder (PTSD), fear of public speaking and other phobias.

    Researchers at the University of Washington HIT Lab have developed a "mixed reality" approach designed to help individuals overcome spider phobia.

    One particular patient nicknamed "Miss Muffet" had developed a fear of spiders so extreme that she sealed all her windows with duct tape and hesitated leaving her house. The researchers combined visual interactions with "spiders" in a virtual environment called Spider World with tactile exposure to fuzzy toy spiders. By the 9th of 12 therapy sessions, "Miss Muffet" was able to pet the virtual "spiders," and eventually overcame her phobia of real spiders.

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    References

    • Damien Cave. The Virtual Reality Shrink, in Salon, retrieved at http://www.salon.com/technology/feature/2001/01/09/schizophrenia
    • Mayo Clinic: Phobias -- Treatment and Drugs, at http://www.mayoclinic.com/health/phobias/DS00272/DSECTION=treatments-and-drugs
    • Melinda Smith with Robert Segal, M.A. and Jeanne Segal, Ph.D. Phobias and Fears: Symptoms, Treatment and Self-Help, in Helpguide.org, retrieved at http://www.helpguide.org/mental/phobia_symptoms_types_treatment.htm
    • PsychologistWorld.com: Flooding, at http://www.psychologistworld.com/behavior/flooding.php
    • Science Daily Editorial Staff: Touch Doubles the Power of Virtual Reality Therapy for Spider Phobia, in Science Daily, retrieved at http://www.sciencedaily.com/releases/2003/10/031031062843.htm
    • Tim Murphy with Michele Monteleone. For Fear of Flying, Therapy Takes to the Skies, in The New York Times, retrieved at http://www.nytimes.com/2007/07/24/health/psychology/24fear.html
    • University of Washington Human Interface Technology (HIT) Lab: VR Therapy for Spider Phobia, at http://www.hitl.washington.edu/research/exposure/

    Photo Credit

    • Flickr. Spider; by Rhys Asplundh; from RhysAsplundh's photostream