Aversion therapy is a form of

psychological Psychology is the scientific study of mind and behavior. Psychology includes the study of conscious and unconscious phenomena, including feelings and thoughts. It is an academic discipline of immense scope, crossing the boundaries between t ...

treatment in which the patient is exposed to a stimulus while simultaneously being subjected to some form of discomfort. This

conditioning Conditioning may refer to: Science, computing, and technology * Air conditioning, the removal of heat from indoor air for thermal comfort ** Automobile air conditioning, air conditioning in a vehicle ** Ice storage air conditioning, air condition ...

is intended to cause the patient to associate the stimulus with unpleasant sensations with the intention of quelling the targeted (sometimes compulsive) 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 Alcohol most commonly refers to: * Alcohol (chemistry), an organic compound in which a hydroxyl group is bound to a carbon atom * Alcohol (drug), an intoxicant found in alcoholic drinks Alcohol may also refer to: Chemicals * Ethanol, one of sev ...

; or pairing behavior with

electric shock Electrical injury is a physiological reaction caused by electric current passing through the body. The injury depends on the density of the current, tissue resistance and duration of contact. Very small currents may be imperceptible or produce ...

s of mild to higher intensities. Aversion therapy, when used in a nonconsensual manner, is widely considered to be inhumane. At the Judge Rotenberg Educational Center, aversion therapy is used to perform

behavior modification Behavior modification is an early approach that used respondent and operant conditioning to change behavior. Based on methodological behaviorism, overt behavior was modified with consequences, including positive and negative reinforcement continge ...

in students as part of the center's

applied behavioral analysis Applied behavior analysis (ABA), also called behavioral engineering, is a psychological intervention that applies empirical approaches based upon the principles of respondent and operant conditioning to change behavior of social significance.Se ...

program. The center has been condemned by the

United Nations The United Nations (UN) is an intergovernmental organization whose stated purposes are to maintain international peace and international security, security, develop friendly relations among nations, achieve international cooperation, and be ...

for

torture Torture is the deliberate infliction of severe pain or suffering on a person for reasons such as punishment, extracting a confession, interrogation for information, or intimidating third parties. Some definitions are restricted to acts c ...

In addictions

Various forms of aversion therapy have been used in the treatment of addiction to alcohol and other drugs since 1932 (discussed in ''Principles of Addiction Medicine'', Chapter 8, published by the American Society of Addiction Medicine in 2003).

Alcohol addiction

An approach to the treatment of

alcohol dependence Alcohol dependence is a previous (DSM-IV and ICD-10) psychiatric diagnosis in which an individual is physically or psychologically dependent upon alcohol (also chemically known as ethanol). In 2013, it was reclassified as alcohol use disorde ...

that has been wrongly characterized as aversion therapy involves the use of

disulfiram Disulfiram is a medication used to support the treatment of chronic alcoholism by producing an acute sensitivity to ethanol (drinking alcohol). Disulfiram works by inhibiting the enzyme acetaldehyde dehydrogenase, causing many of the effects of ...

, a drug which is sometimes used as a

second-line treatment A therapy or medical treatment (often abbreviated tx, Tx, or Tx) is the attempted remediation of a health problem, usually following a medical diagnosis. As a rule, each therapy has indications and contraindications. There are many different ...

under appropriate medical supervision. When a person drinks even a small amount of alcohol, disulfiram causes sensitivity involving highly unpleasant reactions, which can be clinically severe. Rather than as an actual aversion therapy, the nastiness of the disulfiram-alcohol reaction is deployed as a drinking deterrent for people receiving other forms of therapy who actively wish to be kept in a state of enforced sobriety (disulfiram is not administered to active drinkers).

Cocaine dependency

Emetic (to induce

vomiting Vomiting (also known as emesis and throwing up) is the involuntary, forceful expulsion of the contents of one's stomach through the mouth and sometimes the Human nose, nose. Vomiting can be the result of ailments like Food-poisoning, foo ...

) therapy and faradic ( administered shock) aversion therapy have been used to induce aversion for cocaine dependency.

Cigarette addiction

It is unknown whether aversion therapy, in the form of rapid smoking (to provide an unpleasant stimulus), can help tobacco smokers overcome the urge to smoke.

In compulsive habits

Aversion therapy has been used in the context of subconscious or compulsive habits, such as chronic nailbiting, hair-pulling (

trichotillomania Trichotillomania (TTM), also known as hair-pulling disorder or compulsive hair pulling, is a mental disorder characterized by a long-term urge that results in the pulling out of one's own hair. A brief positive feeling may occur as hair is remov ...

), or skin-picking (commonly associated with forms of

obsessive compulsive disorder Obsession may refer to: Psychology * Celebrity worship syndrome, obsessive addictive disorder to a celebrity's personal and professional life * Fixation (psychology), a persistent attachment to an object or idea * Idée fixe (psychology), a preo ...

as well as trichotillomania).

In history

Pliny the Elder Gaius Plinius Secundus (AD 23/2479), called Pliny the Elder (), was a Roman author, naturalist and natural philosopher, and naval and army commander of the early Roman Empire, and a friend of the emperor Vespasian. He wrote the encyclopedic '' ...

attempted to heal alcoholism in the first century Rome by putting putrid spiders in alcohol abusers' drinking glasses. In 1935,

Charles Shadel Charles is a masculine given name predominantly found in English and French speaking countries. It is from the French form ''Charles'' of the Proto-Germanic name (in runic alphabet) or ''*karilaz'' (in Latin alphabet), whose meaning was " ...

turned a colonial mansion in Seattle into the Shadel Sanatorium where he began treating alcoholics for their substance use disorder. His enterprise was launched with the help of gastroenterologist Walter Voegtlin and psychiatrist Fred Lemere. Together, they created a medical practice that exclusively treated chronic alcoholism through Pavlovian conditioned reflex aversion therapy. In the 1960s and 1970s aversion therapy was used on a small group of lesbian and bisexual identifying woman in England. Electric shocks and injections to induce vomiting were used to prevent the woman from looking at other woman. This was meant to work as a form of

conversion therapy Conversion therapy is the pseudoscientific practice of attempting to change an individual's sexual orientation, gender identity, or gender expression to align with heterosexual and cisgender norms. In contrast to evidence-based medicine and cli ...

In popular culture

* In Anthony Burgess's novel ''

A Clockwork Orange ''A Clockwork Orange'' may refer to: * ''A Clockwork Orange'' (novel), a 1962 novel by Anthony Burgess ** ''A Clockwork Orange'' (film), a 1971 film directed by Stanley Kubrick based on the novel *** ''A Clockwork Orange'' (soundtrack), the film ...

'' and the film adaptation directed by

Stanley Kubrick Stanley Kubrick (; July 26, 1928 – March 7, 1999) was an American film director, producer, screenwriter, and photographer. Widely considered one of the greatest filmmakers of all time, his films, almost all of which are adaptations of nove ...

, the main character Alex is subjected to a fictional form of aversion therapy, called the " Ludovico technique", with the aim of stopping his violent behavior. * Aversion therapy plays a major role in the '' King of the Hill'' episode ''Keeping up with the Joneses'', where one of the characters is forced to smoke an entire carton of cigarettes to discourage them from smoking, only for this tactic to backfire and worsen addiction.

Judge Rotenberg Center

The Judge Rotenberg Center is a school in Canton, Massachusetts that uses the methods of ABA to perform behavior modification in children with developmental disabilities. Before it was banned in 2020, the center used a device called a

Graduated Electronic Decelerator The graduated electronic decelerator (GED) is an aversive conditioning device that delivers a powerful electric skin shock to punish behaviors considered undesirable. The GED was created by Matthew Israel for use on students at the Judge Roten ...

(GED) to deliver electric skin shocks as aversives. The Judge Rotenberg Center has been condemned by the

for

as a result of this practice. While many human rights and disability rights advocates have campaigned to shut down the center, as of 2020 it remains open. Six students have died of preventable incidents at the school since it opened in 1971.

References

{{Psychotherapy Treatment of mental disorders Behaviorism Sexual orientation change efforts Psychiatry controversies