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Covert sensitization is a type of aversion therapy. It has been used to treat maladaptive behaviors such as alcoholism, smoking, and overeating. It is part of a group of approaches known as covert conditioning. It relies on the ability of the individual to associate unwanted behaviors with negative stimuli using their imagination rather than actually experiencing these negative consequences. Covert sensitization is sometimes referred to as verbal aversion therapy.
The aim of covert sensitization is to help clients cease undesirable behavior that may be causing them harm. It is a type of behavior modification therapy. This treatment is based on the assumption that all negative behavior is learned and therefore can also be unlearned.
Problems occur when the individual develops an association between the undesirable behavior and positive consequences. An example would be the alcoholic who has learned to associate drinking booze with feelings or relaxation and pleasure. If this same individual can be trained to associate the undesirable activity with negative consequences, then they will be less likely to indulge in it in the future.
Aversion therapy can involve overt sensitization and covert sensitization. Overt sensitization involves ingesting something like a drug to create negative consequences when mixed with an unwanted behavior. The most famous example of this would be the pharmacological agent antabuse. This drug is given to alcoholics and it works by making them feel ill when they ingest alcohol. Critics of this approach argue that it is unethical to deliberately cause people to suffer symptoms such as nausea.
Covert sensitization does not rely on any drug to create the negative stimuli. Instead the individual is asked to just imagine aversive consequences and associate this with the negative behavior. Covert sensitization differs from overt sensitization because the unwanted consequence never actually happens and is only imagined. Therefore, it eliminates the ethical concerns that are associated with overt sensitization.
Covert sensitization begins with a therapy session. The therapist asks the individual to imagine that they are performing the undesirable behavior. The client will then be instructed to associate this with a negative consequence. If the client is an alcoholic, they may be asked to imagine feeling nauseous. The therapist will help they client create a more powerful and vivid image by asking them to add details such as vomiting all over their clothes.
The aim of covert sensitization is for the imagined scene to be so disturbing that it will greatly impact the client. If the image isn’t disturbing enough, then it is unlikely to work. Each individual will have their own tolerance to this type of imagery, so the therapist is required to delve into the client’s psyche to find the most suitable image.
At the end of this therapy session, the client will be asked to imagine a scene where they refuse to indulge in the negative behavior. They will then be instructed to consider how this refusal meant that they avoided the negative consequence.
The main advantage of covert sensitization over other forms of aversion therapy is that it avoids introducing actual negative consequences. A drug like antabuse will actually induce symptoms such as vomiting, and this has ethical implications. There is also concern that such treatments could lead to physical harm to the client. The fact that the negative consequences in covert sensitization are purely imagined means that they do not cause any actual harm. The individual is in complete control with this approach.
Covert sensitization can be an effective treatment for some types of behavior modification. More research is need in order to fully judge the effectiveness of this approach, but the results so far are encouraging. One study found that alcoholics who received covert sensitization therapy experienced significantly longer periods of abstinence.
Covert sensitization is unlikely to be a treatment that will work for everyone. It seems to work best with highly motivated people dealing with particular undesirable behaviors such as nail biting or overeating. It may also be a possible option for treating alcoholism and other addictions. One concern is that this approach only tackles the actual behavior and not the reasons behind it. The worry is that if the motivation behind the addiction is not dealt with, the individual will continue to have problems in the future.
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