Now that we've discussed the Anger Diary technique,
let's turn to another approach regarding anger that masks depression. To unmask
the anger, they hide his depression, with Neil, whom you remember from the previous
track, we also tried "Systematic Desensitization." This strategy works
by exploring a client's anger hierarchy to help him relax during anger-provoking
Eight Steps in "Systematic Desensitization"
I used this technique with Neil after he began keeping his Anger Diary
and realized his anger was a problem. The basic thrust of Systematic Desensitization
is that it enables your client to decrease the intensity of his anger by teaching
him to be more relaxed in certain anger-provoking situations. By doing so unmasking
the depression that lies below the anger. Let's now review the steps to "Systematic
Desensitization." There are eight steps in this process, developed by Dr.
Joseph Wolpe. As I read the list, think of a client you are treating for whom
you might consider using this technique.
Selecting a topic for your anger hierarchy
I told Neil to look through
his "anger diary" and make a list of five situations that most frequently
provoked his anger. Then, I asked him to pick one of those situations, one that
often caused him intense anger. Neil chose to examine meetings at work that aroused
Step Two: Choosing situations for your
Next, I asked Neil to write down, on separate index cards, ten
to twenty anger-provoking situations within the broad category of work meetings.
Neil chose situations like "a co-worker comes to the meeting unprepared"
or "the boss makes unrealistic demands on me and my group."
Step Three: Arranging your anger hierarchy
I asked Neil to
arrange his cards in a hierarchy, with the least anger-provoking situation on
top of the stack and the most anger-provoking situation on the bottom.
Step Four: Confirming the order of your hierarchy
Neil it was important that he had correctly arranged his situation cards. I suggested
that he close his eyes and briefly visualize each situation individually. He was
to watch specifically for how angry he was as he imagined each situation. Then
he was to compare his reactions with a range of emotional intensity from one to
five, one being annoyed, and five being enraged. Ideally, his emotional reactions
would become increasingly intense as he progressed through the hierarchy he had
established. Here's part of Neil's hierarchy:
-- Intensity #1. A meeting
was supposed to start five minutes ago and three co-workers amble into the
-- Intensity #2. You're supposed to listen to a presentation
of a co-worker and he's clearly unprepared, searching for information and bumbling
around as you and others wait.
-- Intensity #3. You need information from
a co-worker before you can move on in your project, but she tells you she's
going to have it later than expected.
-- Intensity #4. You're supposed
to give a presentation, but moments before the meeting you dropped your papers,
and they fell into an incoherent mess.
-- Intensity #5. Your boss sees
an inadequacy in a group project, and she blames you, even though the mistake
was the fault of your co-workers,' not yours.
The list goes on of items that
Neil recognized as anger-provoking situations, each of increasing intensity.
Step Five: Learning to relax
Before we began
the actual desensitization process, I asked Neil to relax. We went over the "Power
Technique" and the "Counting Technique," which you remember from
earlier in the course. Any relaxing technique will do for this step. The important
thing is to find a tranquil place to "let go."
Six: Selecting a positive mental image
After Neil had relaxed
his body and mind, I told him, "Now paint a mental picture of the most restful,
relaxing, and rejuvenating place you can think of." In Neil's case, that
place was a secluded sunny beach. Other clients say they picture a remote mountain
cabin, or a social gathering with some of their favorite people. Any of these
will do; what's important is that you select an image that truly makes you feel
relaxed and one that you can call forth many times.
Beginning to desensitize yourself to anger-provoking situations
ready to begin desensitizing himself from the situations that had always made
him angry. He was completely relaxed, and I told him to look at the first situation
card. He looked at it for about twenty seconds and reported no increase in tension.
Then he moved onto the next card. I told Neil that if he began to feel tense,
to immediately replace the anger-provoking image with his positive mental image
of a secluded sunny beach.
After picturing his pleasant image, it took Neil awhile
to fully relax again. He then looked at the first card and then the second, but
he felt the tension again. I told him to use his positive mental image to relax
himself, and then to stop the exercise. I find that it's most useful to do only
a few of the situations at a time, so Neil and I resumed the Systematic Desensitization
exercise during our next session.
Step Eight: Progressing
through your anger hierarchy
Neil eventually worked through his list of
anger-provoking situations, moving onto the next and more intense situation only
if he had endured the previous one and remained relaxed. At times, he would really
struggle with certain situations. If this occurred, we would go back to the previous
situation, and he would gain control of his anger there. By the end of our exercise,
weeks later, Neil was able to visualize almost 20 situations that had always made
him angry before. Now, he could minimize the anger with concentration and relaxation.
Neil gradually applied what he learned using Systematic Desensitization to
new anger-provoking situations. Along with the Anger Diary, this technique helped
Neil better understand and control his anger. Do you think the Systematic Desensitization
technique would help a depressed male client of yours who is hiding his depression
behind a mask of anger? Could you start with the steps in your next session?
that I've discussed systematic desensitization as a way to help clients assist
your depressed possibly suicidal client, in the next track, we'll look at costs
and pay-offs to batterers, whose depression and anger result in physical violence.
Peer-Reviewed Journal Article Reference:
Cole, B. P., & Davidson, M. M. (2019). Exploring men’s perceptions about male depression. Psychology of Men & Masculinities, 20(4), 459–466.
Davis, H., & Turner, M. J. (2019). The use of rational emotive behavior therapy (REBT) to increase the self-determined motivation and psychological well-being of triathletes. Sport, Exercise, and Performance Psychology. Advance online publication.
Dyar, C., Feinstein, B. A., Zimmerman, A. R., Newcomb, M. E., Mustanski, B., & Whitton, S. W. (2020). Dimensions of sexual orientation and rates of intimate partner violence among young sexual minority individuals assigned female at birth: The role of perceived partner jealousy. Psychology of Violence, 10(4), 411–421
Gaylord-Harden, N. K., So, S., Bai, G. J., & Tolan, P. H. (2017). Examining the effects of emotional and cognitive desensitization to community violence exposure in male adolescents of color. American Journal of Orthopsychiatry, 87(4), 463–473.
Triscari, M. T., Faraci, P., D'Angelo, V., Urso, V., & Catalisano, D. (2011). Two treatments for fear of flying compared: Cognitive behavioral therapy combined with systematic desensitization or eye movement desensitization and reprocessing (EMDR). Aviation Psychology and Applied Human Factors, 1(1), 9–14.
Online Continuing Education QUESTION
What is the purpose of "Systematic Desensitization?" To
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