Systematic Desensitization: When Anxiety is the Obstacle to your Client’s Goal
Certain tasks or situations can create a lot of anxiety for clients, which can then become an obstacle to achieving their desired outcome. Anxiety around the scope of the goal, about what others will think, of success, failure, of letting themselves or others down.
The client avoids and/or postpones the task or situation, which often reinforces the avoidant behavior, which then leads to further anxiety, and thus creates a vicious cycle and habit loop of procrastination.
In this article, I explore a technique used in psychotherapy for anxiety disorders called Systematic Desensitization (Exposure and Response Therapy) and illustrate how understanding some of the basic concepts of this therapy can help you work with your client in helping them complete and carry out anxiety-inducing tasks and situations to reach their desired goal.
What is Systematic Desensitization and How can it Help in Coaching Interactions?
As a Coach, you likely already use some aspects of Systematic Desensitization. An example of this might be supporting a client to approach and face a challenge (exposing the client), that might be a part of a larger challenge (end goal), while they use relaxation and self-soothing techniques and your support along the way.
Systematic Desensitization is a common psychological treatment geared toward helping those with anxiety disorders. In this treatment, the client is gradually exposed to the object or situation that makes them anxious or fearful, while supporting them through various relaxation-based techniques. The goal is to help the client overcome the anxiety and/or fear that is preventing them from achieving their goal. (For more information on this type of therapy, refer to the American Psychological Association.
Note: A coaching interaction is not therapy, and the intent of this article is not that you practice this concept as a therapeutic technique. We are simply exploring the concept behind this technique and using its principles and our understanding thereof to help guide the coaching interaction as we facilitate the client’s progress toward a goal.
Components of Systematic Desensitization in coaching can help a client who has clarity around their goal and displays a strong motivation to achieve it. The client should understand and acknowledge the task(s) and what needs to be overcome, all the while being aware that anxiety is the obstacle or interference. Here are some examples of what a client’s goal might be:
- Returning to work (or office)
- Having to give a presentation
- Writing a resume or website
- Addressing a major clean-up/decluttering project
- Learning to feel comfortable being alone
Components of Systematic Desensitization
The actual technique incorporated three processes. Again, we are not using this as a therapeutic technique, but instead as a concept that can be applied to coaching.
1. Create a Hierarchy of Fears
In Coaching, this might be having the client create a list of steps that they have determined to take and rate their level of anxiety toward each step (can use an exposure hierarchy). You can use a 1-10 scaling method (where 10 is the most fear and 0 is the least).
2. Establish relaxation techniques
This is where a client implements relaxation techniques before, during and after exposure. As a Coach you can ask your client about what techniques have worked for them in the past (i.e., deep breathing, listening to music, grounding techniques) and/or what they think may help them relax. Then ask them to select one method to try and see how it works.
3. Gradual Exposure and Support
Have the client pick one step from their list (implementing gradual exposure) that they are ready and willing to take. This is often the step that induces the least amount of anxiety. If possible and desired, the client can do this step during a Coaching session so that you can explore and reflect on their experience in real time. Alternatively, they can do this outside of the coaching session, where you can recommend that the client journal their response, reactions, and experience and then reflect on this with you in the subsequent session.
Important points to Consider
- One step (exposure) at a time as to be determined by client
- A step (exposure) does not have to be a physical action, it can be a visualization, even a conversation
- A step (exposure) can be repeated until the client feels ready to move to the next step (unless there is a pressing deadline!)
- The client holds the agenda and is accountable and responsible for their actions and results.
- Challenge, but don’t push, and ask permission. The degree to which you use this will depend on your rapport and established coaching agreement.
- Ensure a strong ICF-based coaching agreement. You may want to include in your coaching agreement that you may bring in aspects of various tools and techniques into the appointment. Update the coaching agreement as/if necessary.
- Resistance is a natural part of the process in moving forward. Help the client distinguish between resistance and making a methodical decision to postpone or change their goal.
- There is a difference between feeling anxious and having an anxiety disorder. When in doubt, refer the client to appropriate healthcare services.
- What are your thoughts and experiences with Systematic Desensitization?
- Can you think of a time that you yourself may have used components of this technique to help a client or maybe yourself?
- How do you think understanding the mechanisms and concepts of this technique may help your clients, both as a Coach and on a personal level?