Mental health articles

Aversion therapy, on the other hand, is used to increase the level of fear associated with carrying out unwanted behaviours, such as those occurring in substance abuse (which includes alcoholism, tobacco smoking and the use of psychoactive drugs) and sexual deviance. Alcoholism, for example, may be treated by administering an emetic (a drug that induces nausea and vomiting) as the unconditioned stimulus (UCS), just prior to alcohol consumption, the conditioned stimulus (CS). The nausea produced by the drug as a unconditioned response (UCR) eventually becomes a conditioned response (CR) to the CS of alcohol. The result is that alcohol will be avoided. In order to prolong the association, the emetic (such as ‘Antabuse’) can be inserted under the skin in a slow-release capsule. The effectiveness of this procedure is generally found to be low. For example, Wallerstein (1957) found that only 24 per cent of a sample of alcoholics showed improvement one year after being given aversion therapy. However, it is important to remember that such disorders are notoriously difficult to treat by any method and the relapse rate is generally high.

Aversion therapy is less popular now because of ethical objections to the use of such unpleasant procedures. However, as Lang and Melamed (1969) have pointed out (see Case study 4.1), both costs and benefits need to be considered when taking ethics into account. A recent development in the treatment of alcoholism using aversion therapy takes account of the ethical objections raised. The system, called ‘Smell, Swish and Spit’ (SSS), requires patients to simply smell the alcohol, take a mouthful (swish) and spit it out again. This means that they feel ill, but as they do not swallow the alcohol, they do not vomit (Cannon et al. 1981).

Another variation of aversion therapy is called covert sensitisation. where thoughts of the unwanted behaviour (such as sexual deviance) are paired in the imagination with unpleasant consequences such as arrest (Cautela 1967). Whether this is as effective as the original procedure is uncertain, but it carries fewer ethical implications.

Tags: aversion therapy, therapy