Aversion therapy, sometimes called aversive therapy or aversive conditioning, is used to help a person give up a behavior or habit by having them associate it with something unpleasant.
Aversion therapy is most known for treating people with addictive behaviors, like those found in alcohol use disorder. Most research has been focused on its benefits relating to substance use.
This type of therapy is controversial and research is mixed. Aversion therapy isn't often a first-line treatment and other therapies are preferred.
How long the therapy lasts for has also been criticized, as outside of the therapy, relapse may occur.
Aversion therapy is based off the theory of classical conditioning. Classical conditioning is when you unconsciously or automatically learn a behavior due to a specific stimuli. In other words, you learn to respond to something based on repeated interactions with it.
Aversion therapy uses conditioning but focuses on creating a negative response to an undesirable stimulus, such as drinking alcohol or using drugs.
Many times, in people with substance use disorders, the body is conditioned to get pleasure from the substance — for instance, it tastes good and makes you feel good. In aversion therapy, the idea is to change that.
The exact way aversion therapy is performed depends on the undesirable behavior or habit that’s being treated. One commonly used aversive therapy is chemical aversion for alcohol use disorder. The goal is to reduce a person’s craving for alcohol with chemically-induced nausea.
In chemical aversion, a doctor administers a drug that causes nausea or vomiting if the person being treated drinks alcohol. They then give them alcohol so that the person gets sick. This is repeated until the person begins to associate drinking alcohol with feeling ill and thus no longer craves alcohol.
Other methods that have been used for aversion therapy include:
- electrical shock
- another type of physical shock, like from a rubber band snapping
- an unpleasant smell or taste
- negative imagery (sometimes through visualization)
Can you do aversion therapy at home?
Traditional aversion therapy is done under the supervision of a psychologist or other therapist. You can, however, use aversion conditioning at-home for simple bad habits, such as biting your nails.
To do this, you can place a clear coat of nail polish on your nails, which will taste bad when you go to bite them.
Aversion therapy is believed to be helpful for people wanting to quit a behavior or habit, typically one that's interfering with their life negatively.
While a lot of research has been done on aversion therapy and alcohol use disorder, other uses for this type of therapy have included:
- other substance use disorders
- eating disorders
- oral habits, such as nail biting
- self-injurious and aggressive behaviors
- certain inappropriate sexual behaviors, such as voyeuristic disorder
Research on these applications is mixed. Some, like lifestyle behaviors, have been generally shown as ineffective. More promise has been found for addiction when using chemical aversion.
Some research has shown that aversion therapy is effective for treating alcohol use disorder.
Recent research found that participants who craved alcohol prior to the therapy reported avoiding alcohol 30 and 90 days after treatment.
Yet, research is still mixed on the effectiveness of aversion therapy. While many studies have shown promising short-term results, the long-term effectiveness is questionable.
While the previously mentioned study found that 69 percent of participants reported sobriety 1 year after treatment, a longer-term study would help to see if it lasted past that first year.
In some of the most comprehensive research on aversion therapy in the 1950s, researchers noted a decline in abstinence over time. After 1 year, 60 percent remained alcohol-free, but it was only 51 percent after 2 years, 38 percent after 5 years, and 23 percent after 10 years or more.
It’s believed that the lack of long-term benefit occurs because most aversion therapy happens in-office. When you’re away from the office, the aversion is harder to maintain.
While aversion therapy may be effective in the short-term for alcohol, there have been mixed results for other uses.
Most research has found aversion therapy to be unhelpful for smoking cessation, especially when the therapy involves rapid smoking. For example, a person would be asked to smoke an entire pack of cigarettes in a very short amount of time until they feel ill.
Aversion therapy has also been considered for treating obesity, but it was
Aversion therapy has had backlash in the past for several reasons.
Some experts believe that using negative stimulus in aversion therapy is equal to using punishment as a form of therapy, which is unethical.
Before the American Psychiatric Association (APA) deemed it an ethical violation, some researchers used aversion therapy to “treat” homosexuality.
Some people did voluntarily seek this or other types of psychiatric therapy for homosexuality. This was often due to shame and guilt, as well as societal stigma and discrimination. However, evidence showed that this “treatment” was both ineffective and harmful.
After the APA removed homosexuality as a disorder due no scientific evidence, most research on aversion therapy for homosexuality stopped. Yet, this harmful and unethical use of aversion therapy left it with a bad reputation.
Aversion therapy may be helpful for stopping specific types of unwanted behaviors or habits. Yet, experts believe that even if used, it shouldn’t be used alone.
Aversion therapy is a type of counterconditioning treatment. A second one is called exposure therapy, which works by exposing a person to something they fear. Sometimes these two types of therapies can be combined for a better outcome.
Therapists may also recommend other types of behavioral therapy, along with in or outpatient rehabilitation programs for substance use disorders. For many people who experience addiction, support networks can also help to keep them on track with recovery.
Medication may be prescribed in some cases, including for smoking cessation, mental health conditions, and obesity.
Aversion therapy aims to help people stop undesirable behaviors or habits. Research is mixed on its uses, and many doctors may not recommend it due to criticism and controversy.
You and your healthcare provider can discuss the right treatment plan for you, whether that includes aversion therapy or not. Often, a combination of treatments including talk therapy and medication can help you cope with your concern.
If you have a substance use disorder or believe you may be experiencing addiction, reach out to a healthcare provider. If you’re not sure where to start, you can call SAMHSA’s National Helpline at 800-662-4357.