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Aversion therapy

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Aversion therapy
ICD-9-CM94.33
MeSHD001348

Aversion therapy is a form of psychological treatment in which the patient is exposed to a stimulus while simultaneously being subjected to some form of discomfort. This conditioning is intended to cause the patient to associate the stimulus with unpleasant sensations in order to stop the specific behavior.

Aversion therapies can take many forms, for example: placing unpleasant-tasting substances on the fingernails to discourage nail-chewing; pairing the use of an emetic with the experience of alcohol; or pairing behavior with electric shocks of various intensities.

In addictions

The major use of aversion therapy is currently for the treatment of addiction to alcohol and other drugs. This form of treatment has been in continuous operation since 1932. The treatment is discussed in the Principles of Addiction Medicine, Chapter 8, published by the American Society of Addiction Medicine in 2003.

Aversion therapy is also used in the self-help community to treat minor behavioral issues with the aid of an elastic band, the user or patient would snap the elastic band on his/her wrist while an undesirable thought/behavior presents itself.

The results of Antabuse combined with behavioral marital therapy for treating alcoholism was popular and well-regarded in the 80s and 90s, though the results were mainly ascribed to the behavioral therapy provided.[1][2]

Traditional aversion therapy, which employed either chemical aversion[3] or electrical aversion[4] has now, since 1967, typically been replaced by aversion in the imagination, a technique which is known as covert sensitization.[5]

Kraft & Kraft assessed the value of covert sensitization in six case studies—a fingernail biter, a cannabis smoker, an obese lady, a cigarette smoker, an individual with a chocolate addiction, and an alcoholic. The study found that covert sensitization was effective in all six individual cases. All the participants in the study eliminated their undesirable behavior and this effect held in a longitudinal follow-up.[6] In contrast, Okulitch and Marlatt found that a cohort of 30 alcoholics and 30 social drinkers subjected to aversive therapy via electric shock did worse than an untreated control group at the 15 month follow up period.[7][8]

In homosexuality

See also: Conversion therapy

Aversion therapy was previously considered as a treatment for homosexuality, but since 1994, the American Psychological Association (APA) has declared that it is a dangerous practice that does not work. Since 2006, the use of aversion therapy to treat homosexuality has been in violation of the codes of conduct and professional guidelines of the APA and American Psychiatric Association. The use of aversion therapy to treat homosexuality is illegal in some countries. The standard in psychotherapy in America and Europe is currently gay affirmative psychotherapy.[9]

Psychologist Martin E.P. Seligman[10]: 156  reported that using aversion therapy to try to change homosexual men's sexual orientation to heterosexual was controversial. In some instances, notably a series of 1966 experiments, the process was initially judged to have worked surprisingly well, with up to 50% of men subjected to such therapy not acting on their homosexual urges. These results produced what Seligman described[10]: 156  as "a great burst of enthusiasm about changing homosexuality [that] swept over the therapeutic community" after the results were reported in 1966. However, Seligman notes[11]: 157  that the findings were later shown to be flawed: most of the men treated with aversion therapy who stopped homosexual behavior were actually bisexual; among men with an exclusive or near-exclusive homosexual orientation, aversion therapy was far less successful.

Dr. Robert Card conducted shock aversion therapy and published papers advocating therapy to eliminate homosexuality from a patient's personality, including "The Empirical Characteristics and Clinical Utility of the Monarch Adolescent Audio Visual PPG Stimulus Materials"[12] and "What is 'Deviant?' An Examination of Three Distinct Groups' Penile Plethysmograph Responses."[13] In one treatment method, gay volunteers had electrodes attached to their genitals and were then shown homosexual pornography. As the pornography played, the patients were injected with emetic drugs and administered electric shocks.[14] The shocks and emetics would then cease and the homosexual imagery would be replaced by heterosexual pornography, during which time the patient would not be abused.

Aversion therapy took place at a number of research universities during the 1970s.[15] Mental illness and suicide have been attributed to be caused by shock aversion therapy by those who have undergone it and their family members.[16]

Aversion therapy and "sexually deviant" youth

In 1992, the Arizona Civil Liberties Union challenged the Phoenix Memorial Hospital for its use of these methods on children as young as 10. They were defended by the Association for the Treatment of Sexual Abusers. Since then, policies have usually discouraged the use of forced aversion therapy on children under 14.[17][18]

See also

References

  1. ^ O'Farrell, T.J.; Cutter, H.S.G.; Choquette, K.A.; Floyd, F.J. & Bayog, R.D. (1992). Behavior marital therapy for male alcoholics: Marital and drinking adjustment during the two years after treatment. Behavior Therapy, 23, 529–49.
  2. ^ O'Farrell, T.J.; Cutter, H.G. & Floyd, F.J. (1985). Evaluating behavioral marital therapy for male alcoholics. Behavior Therapy, 16, 147–67.
  3. ^ Watson, J.B. & Reyner, R. (1920). Conditioned emotional reactions. Journal of Experimental Psychology, 3: 1–14
  4. ^ Maguire, R.J. & Vallance, M. (1964). Aversion therapy by electric shock: a simple technique. British Medical Journal, 1: 151–153.
  5. ^ Cautela, J.R. (1967). Covert Sensitization. Psychological Reports 20: 259–468.
  6. ^ Kraft T. & Kraft D. (2005). Covert Sensitization Revisited: Six Case Studies' Contemporary Hypnosis, 22(4): 202–209.
  7. ^ Bowen, S.; Chawla, N.; Marlatt, G.A. (2011) Mindfulness-Based Relapse Prevention for Addictive Behaviors: a clinician's guide
  8. ^ Okulitch PV & Marlatt GA. (1972). Effects of varied extinction conditions with alcoholics and social drinkers. Journal of Abnormal Psychology. 79(2):205-11.
  9. ^ http://www.apa.org/pi/lgbc/guidelines.htm APA:l
  10. ^ a b Seligman, Martin E.P. What You Can Change and What You Can't: The Complete Guide to Self Improvement. Knopf, 1993; ISBN 0-679-41024-4
  11. ^ Seligman
  12. ^ "The Empirical Characteristics and Clinical Utility of the Monarch Adolescent Audio Visual PPG Stimulus Materials." A paper by Peter M. Byrne, M.S. & Robert D. Card, PhD, presented at the 18th Annual Research & Treatment Conference of the Association for the Treatment of Sexual Abusers (ATSA), Orlando, Florida, October 1999.
  13. ^ "What is 'Deviant?' An Examination of Three Distinct Groups' Penile Plethysmograph Responses." A paper by Peter M. Byrne, M.S. & Robert D. Card, PhD, presented at the 18th Annual Research & Treatment Conference of the Association for the Treatment of Sexual Abusers (ATSA), Orlando, Florida, October 1999.
  14. ^ YouTube – A gay mormon describes aversion therapy at BYU Part 1 Part 2 Part 3
  15. ^ [1]
  16. ^ Sin and Death in Mormon Country
  17. ^ http://www.ethicaltreatment.org/arizonarepublic.htm
  18. ^ http://www.ethicaltreatment.org/yankowski.htm
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