How Does Aversion Therapy Work?

Medically reviewed by Laura Angers Maddox, NCC, LPC
Updated October 4, 2024by Regain Editorial Team
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Aversion therapy generally refers to pairing a stimulus and a form of discomfort to create an aversion to a particular behavior. It is generally not as common today as it once was, as it frequently receives criticism. However, aversion therapy is sometimes used to treat substance use disorders and obsessive-compulsive disorder, among other mental health challenges. Exposure and response therapy is sometimes used in place of aversion therapy today. If you’d like to learn more about aversion therapy and its alternatives, speaking to a therapist online or in person can be helpful.

Wondering if aversion therapy may be right for you?

Aversion therapy first appeared in 1932, and it has generally been in use (and considered controversial) ever since. This type of conditioning therapy is a treatment where the individual typically experiences a stimulus and discomfort at the same time. The general idea is usually that the mind will grow to associate discomfort with the behavior that is being treated. This discomfort may eventually discourage the individual from engaging in the unwanted behavior. Aversion therapy is typically administered by a therapist, psychologist, psychiatrist, or other licensed mental health professional. There can be many reasons for choosing aversion therapy to be rid of unwanted behavior, but the most common reason for its use is often addiction.

This type of therapy is usually considered behavioral therapy. Behavioral therapies are psychological treatments that can be used to change unwanted behavior. Changing unwanted behavior is generally achieved through conditioning, and conditioning tends to go back to the theories of classical conditioning. The idea that the mind can be conditioned through association, repetition, and exposure to change unwanted behavior is normally at the heart of all types of behavioral therapy.

Aversion therapy was once popular for addiction treatment and has also been used to banish other unwanted behavior with varying degrees of success. For those who gamble, smoke, or engage in behaviors ruining their relationships, this type of therapy may once have been considered effective.

Aversion therapy for addiction

Addiction can drastically affect a person's life, but everyone tends to have different experiences. For some, marriages hit the rocks, friendships deteriorate, and close family ties break down when addiction is present. Others might experience little to no effect on their daily lives, depending on their type of addiction and how severe it is. 

Aversion therapy is a behavioral treatment intervention that has had success in managing addictive behaviors. The main problem that arises once this therapy helps change the behavior is usually relapse. Still, one should keep in mind that relapse can be possible with any treatment, condition, or addiction. 

Other types of aversion therapy for addiction include electrical aversion techniques and imagery aversion techniques. Electrical aversion generally works by administering an electrical shock as the individual engages in the unwanted behavior. Aversion imagery techniques often use pictures to "shock" or “trigger” aversion as the individual engages in the unwanted behavior. Both techniques tend to assume that eventually, the individual will associate negative things with the unwanted behavior and thus change the behavior.

Criticisms 

Criticisms of electrical and imagery techniques usually revolve around the effectiveness of the techniques in general. Although many believe that electrical shock and imagery techniques can work and create an aversion to addiction, clinical research shows that these aversion therapies are usually less effective than drug aversion therapy. The effectiveness of these two techniques often depends largely on the individual and how they respond.

Most psychologists, psychiatrists, counselors, and therapists agree that relapse rates are high after aversion therapy. Aversion therapies may help those who live with addiction while at the therapist's office, but the therapy may be less effective once they leave the office. With relapse rates so high, most, if not all, psychologists and therapists tend to use newer cognitive-behavioral techniques to treat addiction. Of course, whether or not someone relapses usually depends on many different factors. Every individual may respond to treatment differently and have various life circumstances that either propel them forward or hold them back after treatment.

Aversion therapy and compulsive disorders 

Aversion therapy is a behavior modification therapy, and this type of therapy can work well for compulsive disorders. Several aversion therapies can be used to control compulsive disorders, such as nail-biting, skin-picking, hair-pulling, and others. Behavior modification using aversion therapy can be as simple as snapping a rubber band on the wrist or as intense as receiving an electric shock.

Common aversion therapy for nail-biting can be applying a bitter-tasting substance to the nail. Once the substance is applied, when the individual bites the nail, they usually taste the bitter substance, potentially leading them to avoid biting their nails. Research shows that electric shock aversion therapy can work well for nail-biting, with an efficacy rate of up to 80% success.

Other types of obsessive-compulsive and compulsive disorders have been treated with electric shock aversion therapy in the past. The electric shock is usually applied each time the individual engages in compulsive behavior, and this discomfort typically becomes paired with the unwanted behavior. Once the shock and behavior are paired in the mind, the individual may no longer want to engage in the unwanted obsessive-compulsive behavior.

Criticisms 

Many therapists and doctors of psychiatry and psychology do not agree with aversion therapy for obsessive-compulsive disorders (OCD). Most doctors and therapists agree that the most effective type of treatment for OCD is cognitive-behavioral therapy. The use of painful stimuli to create an aversion to OCD behaviors is usually not the first type of therapy used to treat this problem, although it can be listed as a viable treatment for OCD on some websites.

Ethical concerns about the use of painful shocks have generally made aversion therapy outdated. The field of psychology has made many advances in understanding OCD, and modern therapies tend to have a much greater effect on controlling this anxiety disorder. Simple aversion techniques, such as snapping a rubber band on the wrist each time an unwanted behavior surfaces, may help an individual re-focus their attention, but the electric shock is often viewed as a thing of the past.

Modern aversion therapy alternatives

Exposure and response therapy (ERT) can be a modern alternative to outdated aversion therapy techniques. Exposure and response therapy usually works better than aversion therapy because it generally centers on facing the actual problem rather than managing the stress that often occurs when the behavior is not acted upon. Individuals are usually exposed to triggers that precipitate OCD behaviors; then, they are walked through an effective response to the trigger. The individual can learn that the stress and anxiety will lower on their own without engaging in the behavior. 

For example, consider someone who is afraid of going outside. Using Exposure and Response Therapy, the therapist might slowly guide the person to leave their house. Perhaps they'd start by getting them to go on their porch. Next, they could walk down to their mailbox. Over time, they could walk to neighboring houses and eventually visit the grocery store or a shopping mall. 

ERT is generally all about teaching people with compulsive disorders that nothing bad happens when they face the triggers that make them fearful and anxious. When the person continues to leave their house without anything bad happening, it tends to become easier and easier. Eventually, the fears and anxieties may not have the same grip over the person as they once did.

Although some may still offer aversion therapy, most have abandoned it for more progressive and scientific therapies. As the science of psychology grows and expands, treatments and therapies available to those who need them tend to change as well. 

How online therapy can help

Getty/Vadym Pastukh
Wondering if aversion therapy may be right for you?

If you’re living with substance use disorder, obsessive-compulsive disorder, or any other type of mental health challenge, please know that therapy can be a helpful tool that can benefit your overall mental health. Sometimes, traditional in-office therapy may not be the most accessible or affordable option. If this is the case for you, you may wish to try online therapy, where you can get the professional help you deserve from the comfort of your own home at a time that works for you.

As this study explains, there’s generally no difference between the efficacy rates of in-person therapy and online therapy. Both options can be valid ways to treat mental health issues, and online therapy may have additional benefits such as convenience and affordability.

Takeaway

During aversion therapy, a specific stimulus is often paired with discomfort in an attempt to cause an individual to develop an aversion to an unwanted behavior, such as an addiction or compulsion. Today, aversion therapy is often considered controversial and is frequently criticized. Alternatives like exposure and response therapy are typically used instead. To learn more, you may benefit from speaking with a licensed mental health professional in person or online.

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