ORIENTATION TO THE MODEL

Nearly everyone experiences anxiety in some tasks or situations, and at times the anxiety is severe
enough to inhibit effective problem-solving behavior. Acute anxiety inhibits effective performance in
ordinary tasks, such as taking tests, and common social situations, such as expressing disagreement with
someone else’s ideas.

In the behavior therapy stream of clinical psychology, the most common general procedure for dealing
directly with stress is called desensitization and is one example of the process called counter-
conditioning. Rimm and Masters have provided a very clear description of the technique along with a
current review of research into its effectiveness. Counter-conditioning is essentially substituting a more
positive or appropriate emotional response than anxiety within a given situation, such as when taking a
test, when encountering a rodent, or in any other situation of threat. In desensitization deep muscle
relaxation techniques such as the type described in chapter 22 and visual imagery that induces
relaxation are used as the competing response to anxiety.

It is generally agreed that anxiety is accompanied by muscular tension such as a feeling of discomfort in
the stomach or the clenching of the jaw. If the tension is reduced, the anxiety will also be reduced. The
variety of possible physiological bases for this are discussed in Rimm and Masters, and they point out
that “while each has some degree of plausibility, at the same time none has attained anything
approaching universal acceptance.” In other words, the reason that desensitization works in reducing
anxiety is not fully understood but there is a fairly large body of empirical literature documenting its
effectiveness. However, many behavior theorists assume there is a physiological basis for the inhibition.
Rimm and Masters cite Albert Bandura’s suggestion that “it can be speculated the muscle relaxation in
some way activates an antianxiety mechanism in the brain and that external stimuli correlated with
activation of the mechanism lose their ability to evoke anxiety.” Whatever the physiological basis, it is
known that desensitization reduces anxiety.

The goal of desensitization is to reduce maladaptive anxiety through pairing deep muscle relaxation with
imagined scenes that the student has said cause him or her to feel tense. The idea is to help students
identify the situations in which they feel tension or anxiety, ask them to visualize the situations (one at a
time in ascending order of anxiety production), and when their anxiety rises, teach them to employ
muscle relaxing techniques so that the feelings experienced are relaxation rather than tension. For
example, a student may imagine walking in a zoo knowing the reptile building is close to the entrance. As
he feels rising tension and anxiety about the snake, he is taught to relax his muscles, thus substituting
relaxation for the muscular tension that usually accompanies the viewing of the snake. For the next
picture the student is asked to imagine the conversation in which his friends suggest visiting the reptile
house. Finally after a series of images, the student may imagine touching a snake or getting quite close
to it. Over time, the snake phobia ceases to arouse as much anxiety, or it may be entirely extinguished
and he is able to approach the object to which he has previously had an aversion.

Recent developments in desensitization procedures integrate cognitive and assertive techniques with
visual imagery and relaxation. Thus, instead of simply relaxing and visualizing the anxiety-provoking
scene, the student is also asked to imagine and alternate activity or a different assertive means of
relating. She may be asked to identify the irrational, fear-provoking thoughts and to stop them,
substituting positive self-statements. The appropriateness of the technique depends on the particular
fear-producing situation. If the student is fearful of authority figures, imagining alternative assertive
behaviors and positive selfstatements are suitable additions to the imagery. (For example, “so what if he
says no. At least I had the courage to ask”)

It has been found that combining traditional desensitization practices of relaxation and imagery with
coping strategies such as thought stopping, thought substitution, or meta -communication, assertive
communication, and behavioral substitution further increases the effectiveness of desensitization.