[DA0048] Aversion Therapy

Aversion therapy is used to help people to overcome undesirable habits or behavior. It does this by associating the habit which is to be changed with an unpleasant sensation so that the person does not want to continue doing it.  

Aversion Therapy: What is it?

Aversion therapy is a kind of behavioral therapy based on the classical conditioning theory. It is used to modify different types of undesirable behavior. According to the Behaviorists, all behavior is learned, usually due to imitation, and it is possible, that under the right circumstances, an unwanted behavior can also be unlearned. During Aversion Therapy, an unpleasant stimulus, called an aversive stimulus, is received by the person while they are performing or thinking about the behavior which needs to be modified. After a while, the person begins to associate the unpleasant sensation with the behavior and so decreases or eliminates the unwanted behavior. Gradually a behavior that the person originally perceived as pleasant and desirable becomes regarded as unpleasant and something to be avoided. The treatment focuses on one specific behavior trait that is to be changed. The unpleasant stimulus can be applied by another person, or in some cases it is auto-inflicted, that is the person themselves applies it.

Aversion Therapy Theory

Behaviorism is the name of the theories behind Aversion therapy.

                How Does Aversion Therapy Suggest the Mind Works?

According to the theories of Behaviorism, everything we do is learned, and hence, everything we do can be unlearned. Behaviorists believe that people are born with a completely empty mind and that everything they learn is the result of outside stimulus. They do not consider that people are born with certain characteristics or have predispositions for certain behaviors. Faulty learning, or conditioning, is considered to be the cause of abnormal behavior. Conditioning is an effective form of learning which can be reinforced with either positive or negative stimuli.

Followers of the Behaviorism theories believe that people develop certain habits by copying others around them and that they receive some kind of positive reward from following them. For example, someone may start drinking alcohol because they see their friends doing it. The positive reward they receive is being accepted by the group, as well as the initial enjoyable effects of the alcohol.

How Does Aversion Therapy Cause Change?

Aversion Therapy causes changes in behavior because during therapy the person learns that a certain behavior will cause them an unpleasant sensation. This could be a physical pain or a sensation of feeling unwell. Gradually the person learns to associate the unpleasant sensation with that behavior, and so they will decrease or stop the undesirable behavior to avoid receiving the unpleasant stimulus. Eventually, the person will avoid the undesired behavior even when there is no unpleasant stimulus to be applied. The person develops an aversion, an intense dislike, or even disgust for the behavior which formerly brought them pleasure, as they have been conditioned to associate the noxious stimulus with discomfort and pain.

What Happens in an Aversion Therapy Session?

The therapist will assess the problem by measuring the severity, frequency, and the environment of the undesirable behavior. This will allow them to formulate a treatment program. Depending on the behavior to be modified, the therapist will decide on which is the appropriate aversive stimulus to use. The patient may need to receive a general medical check-up before therapy to ensure that they do not have any condition which could be negatively affected by the application of the aversive stimulus. For example, electric shocks would not be given to a person with a heart condition, nor certain chemicals to someone with a gastrointestinal condition

Some types of therapy which use more intrusive stimulus may be applied in an inpatient situation where the person can be closely monitored. Others can be given in outpatient therapy sessions. It is important that the therapist explains to the client what will happen during the session, and also explains to them how the therapy works. The person will be asked to sign a consent form stating that they understand the process and that they are willing to participate in it. Sometimes, the therapist will ask the person to keep a diary documenting the changes in the behavior to be modified.

                Techniques Used in Aversion Therapy

Different aversive techniques can be used, depending on the nature of the behavior which is targeted to be modified.

Physical stimuli used in Aversion therapy can include pinches or smacks, and sometimes the patient can administer his own aversive stimulus, for example by snapping an elastic band which is on his wrist.

The use of electric shocks as the aversive stimulus is perhaps the most controversial in Aversive Therapy. These shocks, which are sometimes called Faradic shocks, are unpleasantly painful but they are not dangerous. The patient can choose the level of shock that they will receive, and they are usually applied to the arm or the leg. Electric shocks are frequently used in cases of sexual deviations and can be applied directly to the genital area. A pedophile may be shown photos of children or asked to think about touching a child in an improper way. At the same time, the electric shock is applied. This is repeated many times so that the person becomes conditioned to relate his desire to abuse a child with a painful consequence. While the use of electrical stimuli may be controversial, they do have the advantage that it is a relatively cheap stimulus, which is easy to administer, with few adverse side effects, and which gives the therapist complete control over the application. As therapy progresses the patient may be given a portable shocking unit which he can use at home.

Sometimes, chemical or pharmacological aversants are used. The drug disulfiram (Antabuse) is frequently used for treating alcohol abuse. It causes a desire to vomit and a very unpleasant overall sensation when alcohol is ingested after administering it. The effects may include headaches, heart palpitation, nausea and vomiting, dizziness, flushing, and shortness of breath. Symptoms appear about 10-minutes after ingesting alcohol and are so unpleasant that some alcoholics do restrain from drinking. Acamprosate and Naltrexone are also used to control alcohol consumption. Chemical stimuli can be quite effective, but they are quite expensive, and as they often need to be administered in a hospital setting this can further elevate the cost. Additionally, they can sometimes have unpredictable or excessive effects, and the therapist does not have such control over the stimulus. Also, the very unpleasantness of the aversive substance can cause a high drop-out rate and patients becoming aggressive and unwilling to continue the entire course of treatment. Aversion therapy for alcoholism is usually carried out in an inpatient setting and is reinforced with other therapies and support groups. Sometimes, the person who is addicted to alcohol will need to pass through a period of detoxification before treatment can begin. Often family counseling sessions, stress management, and social skills training are also incorporated into the recovery program.

Occasionally, gustatory or olfactory stimuli are used. Here, the aversive stimulus is something which has a repulsive taste or smell, like Ammonia.  Sometimes, a bitter-tasting substance is painted on the nails of a habitual nail-biter. Loud noises can also be used as aversive stimuli.

Nowadays, visual imagery is often used, in a technique known as verbal aversion therapy or covert sensitization. In this treatment method, the person is asked to think about the target behavior and to imagine an undesirable consequence. For example, someone who cannot control their eating of ice-cream may envisage a mound of ice-cream covered in maggots or excrement.  As no actual painful consequence is administered, it is only imagined, this is considered to be a more acceptable form of aversion therapy. It does require the assistance of a skilled therapist to guide the person to think of a sufficiently impacting image.


Flooding is also known as implosion therapy. It is another form of behavioral therapy which exposes the person to the most extreme expression of their deepest fears or phobia. The person is forced to confront their phobia or fear repeatedly in a controlled setting. At first, their panic is intense, but with repeated exposure, their fear lessens until finally, they create a new association between the feared object or situation and the pleasant experience of lack of fear. Phobias persist because the person avoids facing the situation or object and learning that it is in fact harmless. This form of treatment for phobias is rarely used as the result is difficult to control and can actually worsen the situation.

Does Aversion Therapy Work?

There has not been a lot of research done as to whether Aversion Therapy is effective, and those studies which have been completed reveal mostly mixed results. Aversion therapy has limited success when used on its own, and patients frequently revert back to the undesirable behavior or habit once the unpleasant stimulus is not there or they are out of the controlled situation. This is because the underlying problems motivating the behavior have not be solved, and often the addiction to one substance may simply be replaced with that of another.  Using Aversion Therapy along with other psychological techniques and instigating a relapse prevention program can achieve better results. Generally, chemical aversive stimuli are more effective than electric shocks, but much depends on the patient’s attitude and to the behavior which is being modified. Additionally, some people have a hostile response to the stimuli, especially with electric shocks. This anger and resentment can impede the effectiveness of treatment and, in some cases, actually make the problem worse. It can appear that the painful stimuli are a form of punishment and this can have a damaging psychological impact on some people.

                What Kinds of Concerns is Aversion Therapy Best For?

Aversion Therapy is used to eliminate bad habits and to modify self-destructive or undesirable behaviors. It can be used effectively for conditions such as drug and alcohol abuse, eating disorders, smoking, nail-biting, uncontrolled gambling, and sexual deviations such as pedophilia. It can also be useful for anger management and for controlling violent behavior.  

How Are Aversion Therapy Specialists Trained?

Aversion Therapy specialists are licensed therapists who hold a degree in a psychological field and who have received special training and practice in the Behavioral therapies.  Ask your doctor to recommend a suitably qualified person who has experience and good results using Aversion therapy if you feel that this treatment may be of help to you.

Concerns/Limitations of Aversion Therapy

Aversion therapy is used to modify just one specific behavior. It does not consider the possibly extensive reasons as to why that behavior developed. It treats the symptom, that is the undesirable behavior, without finding the cause. The nature of Behaviorism means that unconscious motives and presuppositions are not investigated or considered relevant.

The ethics of applying painful stimuli to people have been questioned, and nowadays, most unpleasant stimuli are self -administered and controlled by the patient.

The secondary effects of the chemicals used can be quite severe.

Aversion therapy has been used to modify behavior in people with mental retardation, but this is not common nowadays.

The use of Aversion Therapy in children and adolescents has been banned in most states.

Aversion therapy has become less popular in recent times.

Important Practitioners in Aversion Therapy       

Behaviorism was developed by the famous Russian psychologist and physiologist Ivan Pavlov, who received a Nobel prize for his work. His experiments with dogs demonstrated his classical conditioning theory about learning. Dogs naturally salivate when they are going to be fed. So, every time the dogs in the experiment were fed, Pavlov sounded a bell. Eventually, the dogs salivated just on hearing the bell.

Albert Bandura further developed Behaviorism with his Social Cognitive Theory, where he suggested that people observe the behaviors of others and model their own behavior by imitation.

The American psychologist BF Skinner used Behavioral or Operant Conditioning to teach pigeons to dance when they received a visual stimulation by using a reward method.

Controversies with Aversion Therapy

The use of Aversion therapy has been the subject of much criticism and controversy. Many people consider it to be unethical to use a treatment method which inflicts pain on a person. Many professionals feel that Aversion Therapy can only be used when the person is administering the negative stimulus to themselves. Also, many people have expressed concern about the kinds of behaviors which Aversion therapy should be used to treat.

                Conversion Therapy

 Aversion Therapy has been used to modify behaviors such as homosexuality. This is now considered incorrect, and that the Behaviorist theory that homosexual behavior has been learned and so can be unlearned, is untrue. Nowadays, homosexuality is not considered to be something which can be ‘cured’ and ‘conversion therapy’ is rarely used as ‘treatment’. ‘Conversion camps’ where parents sent their children who had homosexual tendencies to be ‘cured’, used to be common, but his practice is now banned in most states.  Conversion therapy served only to make gay people feel guilty or shameful of their behavior. In some cases, this caused them to suppress their homosexual urges but not to develop heterosexual ones. Attempts to actually change sexual orientation using Aversion Therapy were unsuccessful and it is now considered by most to be unethical and to promote discrimination. In some cases, homosexuals, transgenders, and cross-dressers who received conversion therapy became severely depressed or suicidal.

Aversion Therapy remains a useful tool in the treatment of certain types of undesired behavior, particularly addictions, and if it is supported with other therapies and a follow-up program the results are quite good. It has offered a real alternative for some people to cure their addictions or undesirable behavior and should not be discarded, despite the controversies surrounding it.


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author avatar
Angel Rivera
I am a Bilingual (Spanish) Psychiatrist with a mixture of strong clinical skills including Emergency Psychiatry, Consultation Liaison, Forensic Psychiatry, Telepsychiatry and Geriatric Psychiatry training in treatment of the elderly. I have training in EMR records thus very comfortable in working with computers. I served the difficult to treat patients in challenging environments in outpatient and inpatient settings
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