Experimental Studies ofFear Reduction
PETER J. LANG
University of Wisconsin, Madison, Wisconsin
The reduction of fear and anxiety in human
beings is a primary goal of most psycho-
therapeutic procedures. Nevertheless, ther-
apy has been studied rarely in the experi-
mental laboratory. The reasons for this
lacuna lie in the difficulties in adapting tra-
ditional forms of treatment to the labora-
tory context, problems in the measurement
of the fear response, and ethical considera-
tions raised by the experimental study of
patients seeking help.
The research described here was designed
to evaluate the effectiveness of systematic
desensitization therapy in reducing fear. A
number of special conditions allowed us to
overcome the problems mentioned. First
of all, the desensitization technic differs
from most other psychotherapies in that
it can be defined as a series of repeatable
operations that can be carried out under
laboratory conditions. The treatment does
not involve an exploration of unconscious
motives or the historical antecedents of the
fear; rather, it is designed to directly treat
most reported anxieties. A partial list of
problems to which desensitization has been
successfully applied includes social fears of
various kinds, classical phobias,' nervous
anorexia,2 and fears of injections or other
medical treatments.'
The first step in this procedure is the con-
struction of an anxiety hierarchy-a gradi-
ent of fear stimuli extending in equal inter-
vals from a point of maximum intensity to
stimuli that are similar but that evoke only
minimal fear. The subject is then instructed
in deep muscle relaxation, according to an
abbreviated version of Jacobson's proce-
dure.4 The desensitization process itself is a
systematic effort at substituting relaxation
for anxiety or fear.
In desensitization, fear is considered to be
a response of the organism, having strongly
aversive, autonomic components.' The goal
This research was supported by U.S. Public Health Service
Grant MH 10993 from the National Institute of Mental Health,
National Institutes of Health, Bethesda, Md.
1618
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permission.
of treatment is to countercondition the fear
responses, so that the stimuli that pre-
viously elicited anxiety instead call up
muscle relaxation and the associated dim-
inution of autonomic arousal. This is ac-
complished by first instructing the subject
to relax and then presenting the least
frightening item on the anxiety hierarchy.
This is repeated until the subject reports
that the item is no longer distressing. The
next item is then taken up, and so on, during
subsequent therapy sessions until the sub-
ject has been exposed to the maximum
stimulus in the series and reports no distress.
When practical, this procedure may be em-
ployed with the actual stimuli.5 In our re-
search and in most clinical applications,
however, the subjects are instructed to
imagine the appropriate stimulus situations
(sometimes with the aid of hypnosis).
The present series of experiments with
this method was begun in 1959 at the Uni-
versity of Pittsburgh and is now being con-
tinued at the University of Wisconsin.
Rather than using patients as subjects, in-
dividuals with intense fears were selected
from the student population by question-
naire and invited to participate. in the re-
search. One of the fears reported with the
highest frequency under these circumstances
is fear of nonpoisonous snakes, and this has
been the subject of most of our laboratory
experiments.
Fear is a complex response, evident in
verbal, overt motor, and somatic systems of
behavior. It is necessary in assessing fear
change to sample each of these systems.6 In
the present studies, subjects were given a
questionnaire to evaluate their verbal ex-
pression of generalized anxiety. They were
carefully interviewed concerning degree of
fear, and these interviews were recorded on
magnetic tape. Overt fear behavior was
measured by confronting the subjects with a
tame, live snake. Extent of approach and
judged anxiety during this test were re-
Vol. 45, 1966
corded, and radio telemetry was used to
measure heart rate activity.
The laboratory form of desensitization
consists of two sequential parts: training and
desensitization. During the five training
sessions,the anxiety hierarchy is constructed
and the subjects are instructed in muscle
relaxation and hypnosis. This is followed by
11 desensitization sessions of approximately
45 minutes each. Fear is assessed by inde-
pendent evaluators as indicated previously.
Subjects are tested before training, after
training, after desensitization, and retested
approximately 6 months and 18 months
after the end of the main experiment.
Initial investigations with this proce-
dure7' 8 showed that subjects who experi-
enced desensitization yielded greater reduc-
tions in phobic behavior (as measured by
avoidance behavior and self-ratings of fear)
than did untreated control subjects. Fur-
thermore, the desensitization subjects tend-
ed to hold or increase these gains after 6
months. In addition, it was shown that the
more hierarchy items a subject completed
during 11 sessions, the more likely he was
to show fear reduction.
These findings were confirmed and ex-
tended in a subsequent study.9 In this ex-
periment, a group of phobic subjects were
given placebo treatment, in which a rela-
tionship with a therapist was maintained
over a period equivalent to that of the de-
sensitization subjects. Desensitization sub-
jects changed significantly more than con-
trols, and the placebo treatment group was
no different than untreated phobic subjects.
The Stanford Hypnotic Susceptibility Scale10
was administered to all subjects in the ex-
periment. Although a relationship between
this scale and fear change was apparent for
control subjects, no significant correlation
between hypnotic susceptibility and fear
reduction was found for the desensitization
group. Furthermore, subjects who experi-
enced desensitization without hypnotic in-
duction showed as much fear reduction as
those for whom trance induction was a part
of the procedure. These data argue strongly
that the improvement observed for desensi-
tization subjects was attributable to the
treatment method, and not an artifact of
suggestibility, transference, or relationship
factors.
In addition to showing change in their
snake fear, subjects who experienced de-
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EXPERIMENTAL STUDIES OF FEAR REDUCTION 1619
sensitization tended to show a general re-
duction in self-ratings of other fears. Recent
studies suggest that the extent of change is
related to the initial correlation of the fear
with the treated snake phobia. These results
indicate that desensitization leads to posi-
tive generalization of fear reduction rather
than to the symptom substitution that
would be predicted by most dynamic theo-
ries.
Experiments currently under way are
designed to explore physiologic changes dur-
ing desensitization. Initial data suggest
that heart rate is momentarily faster during
presentation of hierarchy items for which
the subject signals anxiety than of items for
which anxiety is not reported. Progress has
also been made in automating this proce-
dure. By placing the therapist's instructions
and comments on magnetic tape and allow-
ing the subject to control presentation of
items through a switching arrangement,
considerably more experimental control over
the procedure may be achieved.11
In summary, these investigations indi-
cate that desensitization is an effective
method for reducing maladaptive fears, and
suggest that the laboratory analogue used
here is a powerful tool for the investigation
of fear and anxiety.
References
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