Arnold A. Lazarus
Rutgers University and Center for Multimodal Psychological Services
I. Description of Treatment II. Theoretical Bases III. Empirical Studies IV Summary
in vivo desensitization Instead of just imagining feared situations, in vivo desensitization gradually and systematically presents the actual feared stimuli or events. For example, a client who fears dogs would be encouraged to approach the animal closer and closer, and eventually be willing to touch it and pet it and thus conquer the fear. reciprocal inhibition Based on C.S. Sherrington's observation that certain nerve impulses cease firing when others are elicited, J. Wolpe proposed a model of psychotherapy wherein anxiety is diminished or extinguished when paired with more powerful anti-anxiety responses. systematic desensitization A counterconditioning procedure in which unpleasant (anxiety-provoking) stimuli are presented when clients are pleasantly relaxed. Less threatening events are presented first, and gradually, more frightening circumstances are introduced. Treatment continues until the most anxiety-generating event on the hierarchy no longer elicits anxiety.
Emotive imagery is the use of positive emotion-arousing mental pictures (imagery) to counterbalance fear or anxiety. Thus, an exciting, pleasant, enjoyable image is introduced to offset the negative feelings generated by disturbing events. Repeated pairings of this kind may completely neutralize the anxiety.
Children's phobias had been treated mainly by exposure (gradually feared objects or situations would be introduced to the child) or by feeding (the child would be given ice cream or candy while the feared items were brought closer and closer—as in the famous case by Mary Cover Jones in 1924 wherein a child overcame his fears of rabbits and furry objects). The search for clinically effective anxiety-inhibiting responses added deep muscle relaxation to the aggregation, but it proved time-consuming and difficult or impossible to achieve with many children. Feeding has obvious disadvantages in routine therapy. Consequently, Arnold Lazarus and Arnold Abramovitz explored the possibility of inducing anxiety-inhibiting emotive images in place of relaxation and published a report in 1962. Emotive images refer to those classes of "mental pictures" that are assumed to arouse feelings of self-assertion, affection, pride, mirth, and similar anxiety-inhibiting emotions. Although Lazarus and Abramovitz first used the procedure with children, it was subsequently found to be equally applicable to adults.
With children, the technique of emotive imagery covers the following steps: (a) The range, circumstances, and intensity of the child's fears are established, and a graduated hierarchy is drawn up, from the least feared to the most feared situation. (b) The therapist establishes the nature of the child's hero-images
(usually derived from television, movies, and fiction). (c) The child is asked to imagine a sequence of events, within which a story is interwoven concerning his or her favorite hero or alter ego. (d) As a natural part of the narrative, the least anxiety-provoking items are first introduced. The child is instructed to signal by raising a finger if he or she feels afraid or unhappy or uncomfortable. In response to a raised finger, the phobic stimulus is withdrawn from the narrative and the child's anxiety-inhibiting emotions are aroused once again. The procedure is repeated, usually over several sessions, until the highest item on the hierarchy is tolerated without distress.
A case in point concerns a 9-year-old boy who became afraid of going to school. A sadistic teacher had subjected him to unfair criticism, and although this teacher had left the school, the boy nevertheless developed a full-blown school phobia. The lad was tested and scored very high in intelligence: his mental imagery pertaining to the school environment revealed pictures of receiving unfair punishment at the hands of nasty teachers. His negative images persisted despite the fact that his present teachers were kind and understanding.
The boy's favorite heroes were Batman and Robin. Emotive imagery was woven into the following story:
"Please sit back, get comfortable, take in a deep breath, hold it, and now exhale. Just breathe normally in and out. Now I want you to imagine that Batman and Robin have asked you to help them catch a criminal. Can you imagine that?" The child nodded affirmatively, and judging by his overall demeanor and facial expression, he was fully invested in the drama. The narrative was continued. "Robin hands you a special wrist radio so that he and Batman can contact you whenever necessary. Nobody must know the secret, that you are going to help Batman and Robin solve a crime right in your own school. Then Batman tells you that he has put a secret message in your school locker. He says: 'When you get to school tomorrow morning, go to your locker as soon as possible and read the message. Then destroy it!' Of course you don't want to tell Batman and Robin about your fears. You go to school the next morning and head straight for your locker. Picture yourself going to school. As you ride to school in the bus, you are wondering what the message will say. The bus drives into the schoolyard. The bus stops, you get out and walk slowly to your locker. You don't want to rush there because you don't want to make anyone suspicious."
At this juncture, the boy was asked to describe what was happening—how he was feeling and where he was heading. He described the school building, the hallway along which he was walking, the other children, open ing his locker. When asked how he was feeling, he made no mention of fear or anxiety. In place of the fear was the curiosity, the fun, the excitement, and the drama—what would the message say? The emotive imagery was continued.
"You open your locker and there you see a slip of green paper. It has the emblem of a bat on it and you know who the sender is. You slip it into your pocket, and some of your friends come up to talk to you. As soon as you manage to do so without being seen, you read the message from Batman and Robin. It says: 'We will signal you on your wrist radio during your first recess. Over and out!' You go to class. The teacher gives you some work to do. You are sitting at your desk. You wonder what Batman and Robin will want you to do next. You continue with your work. The nasty teacher who left the school walks into the classroom. You look at him, but you can't let that bother you. Bigger things are at stake. What will Batman and Robin ask you to do?"
The nasty teacher was then made the focus of attention with the aim of changing the boy's fear to feelings of indifference. The image of the particular teacher who had supposedly engendered the boy's phobic reactions was now being revamped and revised. The fact that he had no need to be afraid of this teacher was explicitly woven into the tapestry of the narrative. Of course, when Batman and Robin finally contacted him on the wrist radio they stressed that the "nasty teacher" was in fact the person they were after. The boy was asked to keep the nasty teacher under surveillance. Robin said: "That man may get to be very nasty, but just ignore him."
At this point, the boy, verbalizing his own pent-up aggressions, insisted on finishing the story himself. He described how he would help Batman and Robin lure the nasty teacher into a trap so that they could capture him and remove him to the nearest jail. At the end of the session, the boy was asked if he would try out his own Batman and Robin fantasy in school the next day. Observe that he was not asked whether he would go to school the next day. The "demand characteristics" of the situation placed the emphasis on how the boy would carry out his own fantasy projection in school. This boy was highly motivated, very responsive, and most receptive to emotive imagery. Thus, it took only a single emotive imagery session for him to return to school and to experience no further problems in that regard.
Some people may be concerned that the emotive imagery procedure plays tricks with a child's mind and encourages him or her to daydream and to dwell on fantasy rather than reality. No negative side effects have ever been observed in a wide range of children treated by this method.
Although emotive imagery was first conceived as a rapid way of overcoming many children's phobias, its use with adults is also worth emphasizing. For example, a 22-year-old man who feared rejection was extremely reluctant to ask a woman out on a date. Yet he complained how lonely he felt and how much he wished to establish a good male-female relationship. Consequently, he was asked to form an image in which he approaches an attractive woman, asks her out, and is flatly turned down. The therapist said, "Try to picture this scene without feeling upset." After trying this out for a few days the client reported: "The only way I can visualize this without becoming upset is by firmly believing that the only reason she said 'no' to me was because she had a jealous boyfriend whom, she feared." He was told to take the risk of actually approaching women and asking them for dates while keeping the image and thought of the jealous boyfriend firmly in mind.
He followed this suggestion and took the emotional risk of approaching a woman he had long admired. "As I looked at her I went into my mind game, my mental act. I convinced myself that due to her jealous boyfriend she would have to turn down anyone who asked her out. Once I had established this in my own mind, I simply asked her if she would like to have dinner with me and perhaps go to a movie. I was ready for her 'no thanks' and almost fell over when she said, 'Thank you, I'd like to.' I did similar things with four other women and only struck out once—and it really didn't bother me because I 'knew' about the 'jealous boyfriend.'" As this young man discovered, people who acquire proficiency in the use of imagery have a remarkable built-in tool.
Was this article helpful?