Batman co-creator, writer Bill Finger, was celebrated for his well-researched thrillers. Here he showcases a legitimate therapy for phobia and anxiety disorders. Perhaps he had first-hand experience.
Systematic desensitization is a type of behavioral therapy based on the principle of classical conditioning. It was developed by Joseph Wolpe during the 1950s. This therapy aims to remove the fear response of a phobia, and substitute a relaxation response to the conditional stimulus gradually using counter-conditioning. There are three phases to the treatment:
First, the patient is taught a deep muscle relaxation technique and breathing exercises -- .e.g. control over breathing, muscle detensioning, or meditation. This step is very important because of "reciprocal inhibition," where one response is inhibited because it is incompatible with another. In the case of phobias, fears involve tension and tension is incompatible with relaxation.
Second, the patient creates a "fear hierarchy" starting at stimuli that create the least anxiety (fear) and building up in stages to the most fear-provoking images. The list is crucial as it provides a structure for the therapy.
Third, the patient works their way up the fear hierarchy, starting at the least unpleasant stimuli and practicing their relaxation technique as they go. When they feel comfortable with this (they are no longer afraid) they move on to the next stage in the hierarchy. If the client becomes upset they can return to an earlier stage and regain their relaxed state.
The client repeatedly imagines (or is confronted by) this situation until it fails to evoke any anxiety at all, indicating that the therapy has been successful. This process is repeated while working through all of the situations in the anxiety hierarchy until the most anxiety-provoking.
Thus, for example, a "spider phobic" might regard one small, stationary spider fifteen feet away as only modestly threatening, but a large, rapidly moving spider three feet away as highly threatening. The client reaches a state of deep relaxation, and is then asked to imagine (or is confronted by) the least threatening situation in the anxiety hierarchy.
The number of sessions required depends on the severity of the phobia. Usually 4-6 sessions, up to 12 for a severe phobia. The therapy is complete once the agreed therapeutic goals are met (not necessarily when the person’s fears have been completely removed).
Exposure can be done in two ways:
In vitro -- the client imagines exposure to the phobic stimulus.
In vivo -- the client is actually exposed to the phobic stimulus.
Research has found that in vivo techniques are more successful than in vitro (Menzies & Clarke, 1993). However, there may be practical reasons why in vitro may be used.
