Aversion Therapy is based on Classical Conditioning principles. It is controversial but has been used effectively to treat addictions - eg: to alcohol.

The therapy substitutes an aversion response (eg: pain or something unpleasant) for the pleasure response. For example, in treating alcoholism, an emetic drug (unconditioned stimulus) that makes the client vomit or feel nauseous (unconditioned response) is administered and then paired with drinking alcohol (neutral stimulus). After a few trials, alcohol (conditioned stimulus) will make the client feel sick (conditioned response).

It is important to give the client other non-alcoholic drinks without the emetic drug during treatment or stimulus generalisation may take place, making it difficult for the client to drink at all!

Aversion Therapy & Homosexuality

The therapy has been used to try to convert homosexuals to heterosexuality. In 1994 the American Psychological Association declared that Aversion Therapy was dangerous and did not work. From 2006 the use of Aversion Therapy in treating homosexuals was said to violate APA codes of practice. Its use with homosexuals is illegal in some countries - though it is still used that way in others.

Its application to homosexual men is to give electric shocks while the men are looking at homosexual pornography. The men are then shown heterosexual pornography without being shocked.

One British gay man, Billy Clegg-Hill, was alleged to have died from coma and convulsions caused by injections of apomorphine designed to make him sick during Aversion Therapy. (This happened during the 1960s - though it was 1996 before the incident, apparently covered up, was published as evidence against Aversion Therapy.) Clegg-Hill, a soldier in the Royal Tank Regiment, had been arrested in a police swoop on gay men in Southampton and sentenced to 6 months compulsory aversion treatment at Netley military psychiatric hospital. The man died 3 days after the treatment began.

Martin Seligman (1966) claimed that 50% of gay men who received the treatment did not continue homosexual practices. However, in 1998 Seligman acknowledged that most of the men he studied where the treatment was successful were, in fact, bisexual. Where true homosexual males were concerned, the treatment rate was much less successful. Some studies have suggested a 99.5% failure rate at trying to convert homosexuals to heterosexuality. The UK National Health Service largely abandoned Aversion Therapy as a treatment for homosexuality after it was decriminalised in 1967.

Other so-called ‘sexually-deviant’ behaviour - eg: fetishism - has also been treated this way.

There have been some claims that interest in sex - homosexual or heterosexual - was destroyed completely by Aversion Therapy.

Aversion Therapy & the Media

The dramatic nature of Aversion Therapy - electric shocks and emetic drugs - and some of the appalling tales of its misuse has enable the media to paint the therapy in lurid tones. It is featured in several major movies, including ‘One Flew Over the Cuckoo’s Nest’ and ‘A Clockwork Orange’.

Evaluation of Aversion Therapy

For some purposes, such as dealing with alcohol addiction, Aversion Therapy has been shown to be successful. Follow-up studies have shown it to be better than other therapies for eliminating the undesirable behaviour(s). David Barlow & Mark Durand (1995) have expressed doubts about its sustained effectiveness in the ‘real world’ where no nausea-inducing drug has been taken and it is obvious no electric shocks will be given.

Matthew Howard (2001) put 82 alcoholics through a 10-day treatment programme with an emetic drug. The alcoholics were tested before and after the programme as to how confident they felt they resist drinking in difficult situations where they would normally be tempted to drink. They were also assessed to ensure that any conditioning effect was specific to alcoholic drinks – pulse-rate was used as the indicator for this. After treatment, the patients expressed confidence that they would be able to resist drinking even in high-risk situations. However, the effect was less strong in patients with a longer history of alcohol-associated nausea and more anti-social behaviour.

Research generally shows it does work well with alcoholics, especially when it is one treatment alongside others. Relapse rates can be very high as continued success depends on the client not being exposed to alcohol without also taking the emetic drug. If the client takes alcohol without being sick, they will eventually lose the association.

Aversion Therapy has been used with some success in other areas.

P C Duker & D M Seys (2000) reported that they had reduced self-injury in 41 children with learning difficulties. Non-aversive therapies and milder aversive stimuli – eg: unpleasant tastes and water sprays – had failed to deter the children from refusing food, vomiting, head banging and hair pulling. Following extensive physical health evaluations and ethical approval, small electric shocks were administered via remote control when children started to self-injure. (The shock was delivered through an electrode attached to the individual’s hand or foot.) However, long-term follow-up 108 months later found that in some of the group the self-injuring behaviour had returned, suggesting the self-injure/electric shock connection had become extinct.

Mark Weinrott, Michael Riggan & Stuart Frothingham (1997) had juvenile sex offenders listen to an audiotaped crime scenario that evoked defiant sexual arousal. The offenders were then immediately exposed to a videotaped aversive stimulus – the negative social, emotional, physical and legal consequences of sex offences. The researchers found that the offenders’ physiological arousal and self-reported measures of arousal were reduced following treatment.

Aversion Therapy has a clearly-understandable theoretical explanation of how the behaviour being treated came about and the rationale of its treatment is easily understood by anyone understanding Classical Conditioning.

The fact that no more people on average discharge themselves from aversion programmes than other treatment programmes suggests that, in spite of the many accusations to the contrary - eg: Charles Silverstein (1972) deeming it unethical and open to abuse - there are no more ethical problems with this concept than other kinds of treatment.

There are ongoing ethical issue with Aversion Therapy due to the power of those administering the therapy over their clients. Although clients are usually asked for their permission for the therapy to go ahead, as it is wider society which determines what behaviours are/are not acceptable, the client may feel unduly pressured to accept.

It is often seen as a treatment of last resort as the client has to be fairly desperate to want to undertake this kind of distressing treatment.

Aversion Therapy is also limited conceptually in that it can only be used to eradicate undesirable behaviour – rather than introduce desirable behaviour – and for those behaviours for which there is a suitable aversive stimulus.

Recently new drugs (trytophan metabolites) have been introduced into the use of Aversion Therapy for alcoholism. According to Abdulla Ab Badawy (1999), as well as making users sick when paired with alcohol, they also induce feelings of tranquillity and well-being - thereby providing an element of positive reward for clients sticking with the treatment programme.