A. Lazarus (2000) describes a case of therapy when a hospital patient, who is afraid of becoming overweight due to bodily contact with overweight people, is placed (with his consent) in a ward with very overweight patients who will inevitably touch him. After some time, the fear of bodily contact with obese people disappeared. Since the behavior of flight or avoidance in this case is impossible, then there is an addiction to stimuli that cause fear, and the flight itself becomes unnecessary (V.G. Romek. Behavioral therapy of fears part 2)
Implosion therapy, flooding — a method (Method proposed by Stampfl TG in 1967) of treating phobias (fears) by immersing the client in a situation of maximum tolerable fear for a sufficiently long time until the client gets tired of being afraid and realizes that being afraid is stupid and useless. It is clear that the situation should be really safe: there should not be any reinforcement of fear with something real.
The implosion technique includes several stages. At the first, diagnostic stage, the therapist compiles a list of the client’s fears, compiles their hierarchy (the worst fear is usually left for last), after which the mechanism of the therapeutic effect of the method is explained to the client, the importance of his active participation in the treatment is emphasized; it is said that he will have to imagine a series of scenes in which he needs to be emotionally involved as much as possible, visually represent the situation or object as accurately as possible, feel it tactilely, remember the sound and other characteristics of the situation or object that previously caused fear.
The second stage is the presentation of the situation. The client imagines situations that previously caused the greatest fear. The task of the psychotherapist is to maintain a sufficiently intense level of fear. If the level of anxiety decreases, he introduces additional descriptions of the situation to increase fear.
Men are taught to go through fear without paying attention to it.
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Nobody cares about your fear: there is only a task. You can be afraid as much as you like, the main thing is that the task is completed. Die but do!
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For example, in rat phobia: «Imagine you are touching a rat in a lab… It snaps and starts biting your fingers… then runs down your arm… Suddenly bites your hand hard and then you can already feel it on your body… It sneaks onto your neck and bites her … You feel her tail on your face … She climbs on your head … gets tangled in your hair … You try to grab her with your bleeding hand, but she resists … Suddenly slips out, goes down her face and jumps into her bosom, etc.
This level of tension is maintained by several sessions lasting 40-45 minutes — until the client gets tired of being afraid and gets bored of being afraid↑. Usually, several sessions from half an hour to an hour are enough for the most stubborn. It’s hard to be afraid for half an hour, but in reality nothing happens anyway, everyone is alive and well. Sometimes, if the client is ready for this, he is given a home task: the task is to do this procedure on his own, once a day.
If the psychologist (therapist) believes that a particular fear is not alone, he may suggest that the client work with the entire group of similar fears. In this case, the therapist may suggest the following popular topics related to fears.
- Aggression. Scenes centered on significant persons for the patient (parents, spouse, brothers, etc.) are presented. The level of aggression ranges from the expression of hostility to high, uncontrollable degrees, leading to injury or even death of the object of aggression.
- Punishment. The patient presents himself as a victim of aggression or other hostile acts. Punishment is the result of committing some forbidden act.
- Loss of control. Scenes of loss of control of sexual or aggressive impulses are set. Patients who are afraid of going insane are offered situations in which they imagine being hospitalized in psychiatric institutions, locked up there for life, and so on.
- Sexual themes. Scenes related to the Oedipus complex, the Electra complex, scenes of castration, homosexuality, fellatio are presented.
When the client has dealt with various of his current fears, the therapist moves on to the main, basic fear. Everything that the client is afraid of should be presented to him in his language, in his pictures, from this point of view — as impressively and realistically as possible. The client usually cries, he can shake, and here you should be careful.
The third stage is living fear in a real situation. The client, together with the therapist, if possible, finds himself in a situation that causes fear (for example, on a bridge, in a closed room, in a supermarket, etc.). The patient must stay in this terrible situation for him until the fear begins to go away. Typically, it’s an hour and a half. Important: the client must be internally present in the situation, he must not sabotage what is happening: you must not fall asleep, be distracted, think about strangers, etc. As a rule, one session is not enough, but the problem is solved in 3-10 sessions.
accident prevention
If desensitization is a gentle method of treating fears, then implosion therapy is hard, like a collision with reality.
How environmentally friendly implosive therapy is is debatable. In a large number of situations, this type of therapy is very effective, but it is not uncommon for the presentation of scary scenes to load the client with even more fears … If the fear presented by the client with the help of the therapist exceeds the client’s coping capabilities, the client may become really ill, after which other specialists will be required . Since therapists do not want to take risks, despite the effectiveness of the method, it is rarely used in domestic practice. In summary: as usual, everything depends on the individual skill of the specialist, his ability to feel the client and act flexibly.
Implosion therapy in real life
What was discovered in psychotherapy as a technique of implosive therapy has been used in real life for many centuries, if not millennia. What is Courage Training in the Army? A person goes towards a terrible situation and goes through it as many times as necessary to stop being afraid of it. And the worse the situation, the better. Difficult to learn, easy to fight. Difficult in life — easy later … See →
Are there any softer methods of releasing fear of some creatures or events? Of course have. See Shake a paw to a cockroach and wider Desensitization.