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Case illustration
In the middle 1960's, I started giving my psychotherapy patients
little lecturettes about how to help themselves with rewards,
desensitization, etc. One of these clients was a graduate student in
zoology who had a fear of heights. The fear was life-long and, indeed,
it was a family trait. She was so bright and motivated that I explained
the idea of desensitization (or counter-conditioning) to her in 10
minutes or so. She immediately understood the concept and thought
she could use it on her own. Her fear had restricted her a lot: she
couldn't walk up a fire escape or climb a ladder. It was stressful to
look out of windows above the first floor, ride an elevator, and fly.
Most difficult were climbing towers and walking on boat docks one can
see through.
By the next session one week later, she had been relaxing and
imagining climbing the fire escape in her dorm. As soon as she could
imagine climbing half a flight of stairs without being tense, she
immediately went out to the fire escape and did it! During that week
she had climbed up one and a half flights. She felt fantastic about her
accomplishment. By the end of the second week, she was climbing the
fire escape to a friend's room on the fifth floor and looking out her
window! These accomplishments were not easy for her but she
became confident she could do it. She was delighted with herself--and
with desensitization.
The third week was spring break and she was going to Florida.
Before going, she imagined walking on docks while relaxing. She came
back gleeful; she had walked on and looked through every dock she
could find in Florida. She was also writing all her relatives about how
to overcome their fears of heights. She hadn't done desensitization
exactly like the textbooks say but she grabbed the idea and ran with
it. She changed herself...and she changed me too (I became much
more interested in self-help).
Self-desensitization in the real situation (in vivo)