Therapeutic Approach Triggering Dislike: Aim, Instances, and Disputes
Aversion therapy, likewise known as "deterrent therapy" or "aversive conditioning," is a behavioral approach that aims to discourage unwanted behaviors by pairing them with unpleasant experiences. This method is often employed to tackle behaviors linked to addiction, such as smoking or alcohol use disorder (AUD).
However, aversion therapy is less common than other treatment methods for substance use disorders, and some mental health experts consider it unethical. Questions persist about its long-term effectiveness as a treatment for substance use disorders.
The principle behind aversion therapy is simple - by repeatedly linking an undesirable behavior with an unpleasant experience, the individual will develop a negative association and hopefully avoid the behavior in the future.
Aversion therapy can potentially address a range of behaviors, including:
- Nail biting
- Tobacco smoking
- Alcohol misuse and alcohol dependence
- Gambling addiction
Here are some examples of aversion therapy methods:
Emetic counter conditioning
Emetic counter conditioning (ECC) is a form of aversion therapy that could aid in reducing alcohol cravings for those battling AUD. During multiple ECC sessions, a person is given a medication to induce nausea and vomiting. Subsequently, they taste and swallow different alcoholic beverages. Over time, the person associates drinking alcohol with the unpleasant sensations of nausea or vomiting.
Graphic warning labels
Graphic warning labels on cigarette packages, mandatory in 118 countries, show images depicting the potential health consequences of smoking, such as diseased lungs and cancerous tumors. These labels operate as a form of aversion therapy, as they connect the act of smoking with disturbing or upsetting images.
Rapid smoking
Rapid smoking involves inhaling a cigarette every few seconds to trigger unpleasant sensations and reduce nicotine dependence. However, research suggests that rapid smoking is not an effective long-term treatment for individuals looking to quit smoking.
Rubber band aversion therapy
Rubber band aversion therapy (RBAT) is used to address obsessive compulsive disorder (OCD). In RBAT, a person wears a rubber band around their wrist and snaps it every time they have an obsessive thought. The objective is to create a connection between the pain of the rubber band and the obsessive thought, thereby reducing the frequency of these thoughts. However, research also indicates that RBAT is not an effective therapy for OCD.
Research suggests that aversion therapy can temporarily reduce addictive behaviors, as demonstrated in a small 2017 study investigating the effects of ECC on alcohol-related brain activity in 13 individuals with AUD. During five sessions, participants took an emetic medication and consumed alcoholic beverages. The participants reported alcohol aversion or avoidance at 30 and 90 days after treatment, and 69% of participants remained sober 12 months later.
Brain scans before and after the treatment revealed significant reductions in craving-related brain activity, suggesting that ECC could be an effective treatment for AUD. However, it's unclear whether these effects are temporary or long lasting. Research into the effectiveness of aversion therapy for other addiction-related behaviors is limited.
Aversion therapy is controversial due to concerns about its ethics, as it involves using punishment as a form of therapy. "Conversion therapy," a form of aversion therapy used to treat homosexuality, was listed as a mental health disorder until 1973. Many individuals were forced into this treatment against their will, while others sought it out due to feelings of shame or societal discrimination.
Some mental health professionals believe that aversion therapy is unnecessary and unethical because it subjects individuals to psychological or physical pain or discomfort without providing lasting results. A 2022 review calls for the practice of conversion therapy to be banned in all U.S. states. The use of aversion therapy for addiction-related behaviors is also contentious, as it is considered unethical by some mental health experts.
So, while aversion therapy may help individuals reduce addictive behaviors in the short term, it is not always considered an effective or ethical long-term treatment. Other evidence-based treatments, such as behavioral therapies and pharmacotherapies including naltrexone and acamprosate, are generally more successful in achieving sustained abstinence.
- Psychotherapy, alongside behavioral treatments like aversion therapy, plays a significant role in addressing various addictive behaviors, such as alcohol misuse and gambling addiction.
- Alternative medicine practices, like emetic counter conditioning (ECC), are employed in aversion therapy to aid individuals who struggle with alcohol use disorder (AUD) by creating a negative association with drinking alcohol through inducing nausea and vomiting.
- In the realm of health-and-wellness and mental-health, the effectiveness of aversion therapies and treatments is often debated due to concerns about long-term efficacy, ethics, and potential psychological or physical discomfort.
- The science of psychology and psychiatry has identified other evidence-based treatments, such as naltrexone and acamprosate, as more viable options for achieving long-term abstinence and maintaining overall well-being.
