Implosive therapy: characteristics and applications

There are several psychological techniques to treat phobias, Although it is known that the most effective are the techniques which expose the subject to a phobic stimulus (exposure techniques).

Today we will meet one of them, implosive therapy, A mass exhibition technique proposed by Thomas Stampfl in 1961.

    Exposure techniques

    Exposure techniques are used to deal mainly with fears and phobias. They consist in exposing the subject to the phobic object or situation, so that he gets used to the anguish (that he learns to tolerate) that he feels when exposed to it.

    The goal is that he learns that there is no harm and that therefore the stimulus is not dangerous.

    For example, that would be exposing a person to the dark and making them understand that it is not dangerous, or exposing a person with a phobia of dogs to one and seeing that they don’t bite them.

    However, in most phobias the person knows that this fear is irrational and that the phobic stimulus (or the situation) is not really dangerous; however, the person is unable to resolve the phobia spontaneously unless exposed to it and understands this “non-association”.

    Article hierarchy

    Let’s take a look at the first step in exposure techniques.

    To apply an exposure technique, a hierarchy of stimuli must first be designed according to the level of anxiety they produce.

    The patient will then have to expose himself first to the items which cause him the least anxiety, and to move up the scale of the items (at least to the most anxiety). The hierarchy will be developed by the patient alongside the therapist.

    Difference from systematic desensitization

    Unlike systematic desensitization techniques (where the patient applies an incompatible response to anxiety, such as relaxation, to exposure to the phobic stimulus), during exposure, exposure to stimuli is less progressive (The hierarchy is more abrupt).

    Mass exposure techniques

    Within the exhibition techniques, there are different types depending on the type of exhibition (live exhibition, symbolic, through virtual reality, etc.).

    On the other hand, implosive therapy is part of the mode of mass exposure, where therapy sessions last 1 or 2 hours per day for 7 consecutive days. In this sense, mass exposure techniques are more effective techniques than spaced exposure techniques (for example with sessions 1 or 2 days per week).

    In turn, we find two types of mass exposure techniques: implosive therapy and flood therapy.

    Implosive therapy

    Implosive therapy was created by Thomas Stampfl in 1961. Its theoretical basis is based on psychoanalysis and experimental psychology (Unlike the flood, which we will see later, and which is based solely on experimental psychology).

    Exposure to aversive stimuli is only by the imagination and the escape response is not allowed. In the event of a flood, on the other hand, the exposure can be live or imagined, and the evacuation response is possible. The content of stimuli is dynamic content.

    On the other hand, the hierarchy of the presentation of the stimulus is less gradual than in flood, that is to say it switches more easily from a less aversive stimulus to a more aversive stimulus, The change is more abrupt.

      Flood therapy

      Similar to the above, but with the differences discussed, is flood therapy, created by Baum in 1968. As we have seen, here the theoretical foundations focus on experimental psychology and exposure to stimuli. it can be both alive and imaginative. There may or may not be an escape response during exposure, and the content of the stimuli is realistic.

      Implosive therapy and flood therapy can use hierarchical presentation of stimuli, but this is less demanding and graduated than in more abrupt systematic desensitization (SD).

      Exhibition guidelines

      When a subject is exposed to a phobic situation through implosive therapy and continues to exhibit anxiety at the time of its application, the phobic stimulus must continue to be maintained. In the event that the phobia is excessive, the escape to a calm situation will be allowed (only in the event of a flood).

      In the event of an implosion, the presentation of the stimulus will continue until the anxiety is reduced, and in the next session, it will begin with a previous item in the hierarchy, as the last one will not be considered overcome.

      Variants and their level of effectiveness

      Depending on the characteristics of the exposure technique we are going to use, differences appear in terms of the degree of efficiency. Let’s see them:

      Living and symbolic exhibition

      As we have seen, in implosive therapy, phobic stimuli will always be presented in the imagination. However, it should be noted that the most effective exposure techniques are those that present the stimulus live (in real form).

      Exposure gradient

      We know that maximum efficiency is given when the gradient or intensity of exposure to stimuli is as sharp as the patient can tolerate; in this case, implosive therapy would be a good therapeutic option to eliminate phobias, especially if they need to be eliminated quickly.

      However, a gradual intensity will also be effective, although if it is abrupt it will offer faster results (but it does not need to be more effective; it will depend on the type of patient).

      Interval between sessions

      By defining the mass exposure techniques, we have also seen that implosive therapy is applied daily (the interval between sessions is short). therefore it will be more efficient than if the interval between sessions is long (Frequency of weekly sessions, for example).

      Duration of sessions

      In implosive therapy, the sessions last between 1 and 2 hours. We know that the effectiveness is maximum when the duration is as long as necessary to facilitate the part (between 30 and 120 minutes). Therefore, in this sense, this technique will be one of the most effective.

      However, it should be noted that applying overexposure as long as the fear does not go away does not improve results.

      Bibliographical references:

      • Cavall, V. (1991). Handbook of Behavioral Therapy and Modification Techniques. S. XXI: Madrid
      • Farmers, FJ et al. (1993). Handbook of Behavior Modification Techniques and Therapy. Pyramid: Madrid

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