Psychological Self-Help

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Learning to relax may take two to five hours. Another one or two
hours for making up your own unique hierarchy. Some people get
results after only a few hours of desensitization; others require three
hours a week for a couple months. If you don't get results in that time,
see a professional. Don't expect instant cures; the professionals take
months too. Most fears have occurred many times in the same
situation, i.e. fear has been paired with a stimulus and/or reinforced
perhaps thousands of times. It isn't unreasonable to expect 1/10th as
many unlearning trials as were involved in the original learning, so if
you have gotten a little anxious in class a thousand times while
preparing to speak up (even if you didn't go through with it), it may
take 100+ fantasies of speaking without fear to extinguish the fear. 
It also takes time to "test out" the fears in real situations.
Sometimes the test situation is hard to arrange. A plane trip in rough
weather isn't easy to schedule. How often do you get to give a speech?
You will just have to wait until the real occasion arises. When it does,
prepare well and desensitize yourself again right before testing out
your reactions. At other times, the opportunity to test oneself is
readily available and can be done in a few minutes (like calling
someone for a date). 
Common problems
Several problems have already been mentioned: some people can't
relax, others have trouble fantasizing, some hierarchies have gaps
between items, sometimes actually dangerous or harmful scenes are
included at the end of the hierarchy. Some people are afraid of fear;
they worry and fret when they think about having fears and would
prefer to believe they have no concerns at all. 
Sometimes what appears to be the major fear is not the real
problem. Joseph Wolpe (1958) gave an example of a man who thought
he was afraid of open places who was really afraid of dying (and being
unable to get help). Another patient, who avoided all social interaction,
was basically afraid of being trapped in her marriage. These are
unusual cases, but it would be naive to assume that we are aware of
the true sources of all our fears. 
In step one, it was mentioned that some emotions are the result of
our thinking and expectations and misunderstandings. In these cases,
our thoughts and views need to be corrected (Burns, 1980, for
depression). Other emotions yield payoffs; it is unlikely that
desensitization will extinguish an emotional response that is being
highly reinforced, such as one person's jealousy that keeps his/her
partner from associating with any attractive competitors. You may
have to give up the payoffs first. 
Desensitization is not a fast cure. It takes hours spread over weeks
or months. And in the end you have to do whatever you are afraid of--
fly in a plane, ride in an elevator, give a speech, ask for a date, etc.
That involves some stress, so why not just "bite the bullet" and
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