Hockenbury Discovering Psychology 5th txtbk

590 CHAPTER 14 TherapiesThe third step involves the actual process of desensitization. While deeply relaxed,the patient imagines the least threatening scene on the anxiety hierarchy.After he can maintain complete relaxation while imagining this scene, he movesto the next. If the patient begins to feel anxiety or tension, the behavior therapistguides him back to imagining the previous scene or the control scene. If necessary,the therapist helps the patient relax again, using the progressive relaxationtechnique.Over several sessions, the patient gradually and systematically works his way upthe hierarchy, imagining each scene while maintaining complete relaxation. Verysystematically, each imagined scene becomes paired with a conditioned response ofrelaxation rather than anxiety, and desensitization to the feared situation takes place.Once mastered with mental images, the desensitization procedure may be continued inthe actual feared situation. If the technique is successful, the feared situation no longerproduces a conditioned response of fear and anxiety. In practice, systematic desensitizationis often combined with other techniques, such as observational learning(Bandura, 2004b).Let’s consider a clinical example that combines systematic desensitization andobservational learning. The client is Michael, a 60-year-old man afraid of flyingon airplanes. To overcome this phobia, he’s seeing a behavior therapist. Thetherapist first teaches Michael progressive relaxation so he can induce relaxationin himself. Then, she and Michael move through the anxiety hierarchy they hadcreated. In Michael’s case, the hierarchy starts with imagining airplanes flyingabove high in the sky, then moves on to viewing pictures of airplanes at a distance,then viewing the interior of airplanes, and ultimately actually boarding anairplane and taking a flight. There were other, smaller steps in the hierarchy aswell, to make sure Michael could progress from step to step without too muchof a “jump.”Michael is able to move through the hierarchy by experiencing relaxation inconjunction with each consecutive stimulus that might have produced anxiety.Because relaxation and anxiety are incompatible, the relaxation essentially“blocks” Michael’s anxiety about flying, just as Peter’s enjoyment of his milkand cookies blocked his anxiety about the rabbit. Another important aspect ofthe behavior therapist’s treatment of Michael involves observational learning:She shows Michael videos of people calmly boarding and riding on planes. Together,systematic desensitization and observational learning help Michael overcomehis phobia, and he is ultimately able to fly with minimal discomfort.The In Focus box, “Using Virtual Reality to Conquer Phobias,” describes theuse of computer technology to treat phobias and other anxiety disorders.aversive conditioningA relatively ineffective type of behaviortherapy that involves repeatedly pairing anaversive stimulus with the occurrence ofundesirable behaviors or thoughts.Aversive ConditioningThe psychologist John Garcia first demonstrated how taste aversions could beclassically conditioned (see Chapter 5). After rats drank a sweet-flavored water,Garcia injected them with a drug that made them ill. The rats developed a strongtaste aversion for the sweet-flavored water, avoiding it altogether (Garcia & others,1966). In much the same way, aversive conditioning attempts to create anunpleasant conditioned response to a harmful stimulus, such as cigarette smokingor alcohol consumption. For substance abuse and addiction, taste aversions arecommonly induced with the use of nausea-inducing drugs. For example, a medicationcalled Antabuse is used in aversion therapy for alcoholism. If a person takingAntabuse consumes any amount of alcohol, he or she will experience extremenausea (Owen-Howard, 2001). Although aversive conditioning techniques havebeen applied to a wide variety of problem behaviors (Cain & LeDoux, 2008),mental health professionals are typically very cautious about the use of such techniques,partly because of their potential to harm or produce discomfort for clients(Fisher, 2009; Francis, 2009). In addition, aversive techniques are generally notvery effective (Emmelkamp, 2004).