Simple phobia as a symptom of posttraumatic stress disorder in a former prisoner of war.

The team worked with one former prisoner of war. He had PTSD and a 40-year fear of closed spaces.

They blended three tools: systematic desensitization, picture-based exposure, and real-life practice. Sessions moved from imagining safe small rooms to actually sitting in one.

After the package, the man entered small rooms without panic for the first time in four decades. The phobia was gone.

Ricciardi et al. (2006) later used shaping instead of imagery to erase a child’s needle fear. Both studies got rid of strong phobias, showing you can swap imagery for reinforcement and still win.

Shabani et al. (2006) added stimulus fading to help an adult with autism ride a van. Like the POW case, they broke the scary event into tiny steps and chained them forward.

Kawahito et al. (2026) paired stimulus control with in-vivo practice and cut skin-picking by 94%. The same one-person, multi-tool logic repeats across topographies and years.

You can copy the three-step recipe: graded imaginal scenes, then photos or video, then real contact. It still works when PTSD tags along. Start with one brave step the client will tolerate tonight.