Systematic desensitization


This technique for reducing anxiety in the anticipation of a dreaded event has solid research backing its effectiveness. Using this procedure, you arrange a hierarchy of images associated with the procedure or treatment you fear, moving up from the least upsetting aspects to the most intensely disturbing, such as lying on the radiation table or seeing chemo drugs drip through a tube into your body. You may want to learn this technique with a therapist before practicing it on your own, using the sequence of images I give as the basis for your image hierarchy.

You begin this technique by inducing deep relaxation using relaxed abdominal breathing, progressive muscle relaxation, focused imagery or possibly self-hypnosis – a technique that you have previously practiced and found effective. As you call up detailed mental images at each level of your hierarchy, couple your disturbing sensations with the sense of relaxation, using the relaxation technique you have chosen. With each successive scene—moving up in gradual steps to the most dreaded moment—allow the images to develop in your mind until they seem as vividly real as the actual scene.

For example, you might begin with:

  1. the ride to the treatment clinic,

(2) the moment you step inside the medical center,

(3) announcing your arrival and writing your name on the roster,

(4) entering and seating yourself in the chemo room,

(5) smelling the alcohol as the nurse opens the packet, and

(6) watching the nurse start the infusion.

Repeat and practice the entire sequence until the intensity of anxiety provoked by the images has faded to a "3" or lower if rating it on a scale from "1" to "10."

By maintaining relaxation while mentally experiencing -- in precise detail -- each step before and during chemo administration or whatever medical intervention lies ahead, you can turn down the voltage of your anxiety, since fear and relaxation are psychologically and physically incompatible. (You can’t be both anxious and relaxed at the same time.) When feeling greater ease about upcoming treatments, procedures, a medical scan, or a report of your test results, the conditioned links between your nervousness and queasy sensations will lose their hold. And training yourself to feel less uptight and nervous prior to a medical event in order to disconnect the ANV response will surely boost your sense of control and make the upcoming treatment less formidable.


Below you will find a chart that you can use to help you evaluate and refine this method on your own.

Detailed Description of Each Step

Tension before relaxation (1-10)

Relaxation Practice Used

Tension after relaxation