Imaginal Desensitisation

Abstract Imaginal desensitization is a simple but effective relaxation-based technique that uses images to assist individuals suffering with specific types of impulse control disorders: pathological gambling, sexual paraphilia, trichotillomania (compulsive hair-pulling), kleptomania (shoplifting), compulsive buying, and some forms of explosive aggression and compulsive eating behaviours. The technique involves teaching a brief progressive muscle relaxation procedure. Clients are then instructed to visualize themselves being exposed to a situation that triggers the drive to carry out their impulsive behaviour, contemplating acting on their urge but then leaving the situation in a state of continued relaxation without having acted upon their urge. Sessions can be recorded on cassette audiotape for home-practice. Several studies have confirmed the effectiveness of imaginal desensitisation in diminishing the strength of a compulsive drive by reducing levels of arousal associated with the urge to carry out a behavior. With problem gamblers, for example, imaginal desensitisation significantly decreased the heightened state of arousal and anxiety typically associated with gambling urges at both twelve-month and five-year follow-up intervals. Clients report improved abilities to control impulses and a sense of enhanced self-efficacy.