Treatment Method: Aversion Therapy - Definition, Applications, and Debate
Aversion therapy (AT) is a behavior modification technique that aims to eliminate unwanted behaviors by linking them with painful or unpleasant experiences. It's popularly known as "deterrent therapy" or "aversive conditioning."
AT is commonly employed to tackle issues related to addictive behaviors such as smoking, alcohol use disorder (AUD), and even gambling addiction. However, it's less often used compared to other substance use disorder treatments.
The practice has stirred debate, and some mental health experts regard it as unethical due to the use of punishment as a treatment method.
What's the deal with Aversion Therapy?
AT functions by repeatedly pairing an undesirable behavior or habit with an unpleasant experience to create an aversion. The goal is to discourage or extinct the behavior or habit entirely.
Which habits can Aversion Therapy treat?
A few examples of behaviors that AT may assist in managing include:
- Nail-biting
- Tobacco smoking
- AUD, encompassing alcohol misuse and alcohol dependence
- Gambling addiction
Illustrative Examples of Aversion Therapy
Here are some real-world applications of AT.
Emetic Counter-Conditioning
Emetic counter-conditioning (ECC) is a type of AT that could potentially reduce alcohol cravings in individuals with AUD. During multiple ECC sessions, a person takes a medication to induce nausea and vomiting. Following this, they consume various alcoholic beverages. As a result, the person develops an aversion to drinking alcohol due to the unpleasant sensation of nausea.
Graphic Warning Labels
Graphic warning labels on cigarette packages, present in 118 countries, display images illustrating the potential health hazards of smoking. These images act as a form of AT, as they associate smoking with the unpleasant experience of viewing disturbing or upsetting images.
Rapid Smoking
Rapid smoking involves inhaling and exhaling a cigarette every few seconds to create an unpalatable sensation, thereby reducing nicotine dependence. A 2016 review states that rapid smoking offers limited long-term efficacy as a smoking cessation treatment.
Rubber Band Aversion Therapy
Rubber band aversion therapy (RBAT) is a method used to treat obsessive compulsive disorder (OCD). People undergoing RBAT wear a rubber band around their wrist and snap it whenever they have an obsessive thought. The rationale is that over time, the person learns to associate obsessive thoughts with pain, leading to fewer obsessive thoughts. However, a 2010 review suggests that RBAT is not an effective OCD treatment.
Does Aversion Therapy really work?
The evidence indicates that AT can temporarily decrease addictive behavior.
In a small 2017 study, researchers discovered that ECC might be an effective treatment for AUD. The participants reported reduced alcohol cravings at 30 and 90 days after treatment, and 69% of the participants remained sober 12 months later. Brain scans before and after treatment showed a decrease in craving-related brain activity, suggesting that ECC may be a promising approach to treating AUD, albeit more research is needed to confirm its long-term impact.
Research into the efficacy of AT for other addictive behaviors is still lacking. A review of many studies found that while rapid smoking seemed effective in the short-term for smoking cessation, it did not provide sustained relief over an extended period. Furthermore, the same review noted that, as a treatment for obesity, AT can reduce the desire for specific foods in the short term, but the effects are not long-lasting.
Why is Aversion Therapy contentious?
Some mental health professionals reject AT based on ethical concerns, as it employs punishment as a form of treatment.
AT has a history of controversy, with "conversion therapy" being a form of AT previously utilized to address homosexuality before it was delisted as a mental health disorder in 1973. Some doctors argued that conversion therapy could alter a person's sexual orientation. Many people were coerced into conversion therapy, while others sought it out due to feelings of shame, guilt, or social stigma.
A recent review highlights that some mental health practitioners still follow the practice of so-called conversion therapy today. The authors advocate a ban on this practice in all U.S. states.
The use of AT for addiction-related behaviors also faces criticism. Some mental health experts consider the treatment unethical due to its application of a negative stimulus that could potentially cause psychological or physical distress or discomfort.
- Aversion therapy (AT) is a behavior modification technique that aims to eliminate unwanted behaviors by linking them with unpleasant experiences, often known as "deterrent therapy" or "aversive conditioning."
- AT is commonly used to tackle issues related to addictive behaviors such as alcohol use disorder (AUD), tobacco smoking, and gambling addiction, but it is less frequently employed compared to other substance use disorder treatments.
- The practice of aversion therapy has sparked debate among mental health experts, with some viewing it as unethical due to the use of punishment as a treatment method.
- Aversion therapy functions by repeatedly pairing an undesirable behavior or habit with an unpleasant experience to create an aversion, with the goal of discouraging or extincting the behavior or habit entirely.
- In 2017, a study discovered that emetic counter-conditioning (ECC), a type of AT, might be an effective treatment for AUD, resulting in reduced alcohol cravings for some participants and 69% of participants remaining sober 12 months later.
- However, research into the efficacy of AT for other addictive behaviors, such as smoking cessation and obesity, has shown mixed results and suggests that it may not provide sustained relief over an extended period.
- The application of aversion therapy has faced criticism for its use of punishment, potential to cause psychological or physical distress, and historical connection to controversial practices like conversion therapy.
