Starting with the least anxiety-inducing situation, the individual is exposed to each item while employing relaxation techniques.
They move up the hierarchy only when they can remain relaxed at the current level.
Over time, this exposure in a relaxed state diminishes the anxiety response to the feared stimulus.
The client repeatedly imagines (or is confronted by) this situation until it fails to evoke any anxiety, until they reach the top of their hierarchy (most feared situation).