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Aversion therapy is a form of psychiatric or psychological treatment in which the patient is exposed to a stimulus while simultaneously being subjected to some form of discomfort. This aversive conditioning is intended to cause the patient to associate the stimulus with unpleasant sensations in order to stop the specific behaviour.
Aversion therapies can take many forms such as placing unpleasant-tasting substances on the fingernails to discourage nail-chewing), to pairing the use of emetine (a medication that causes nausea through stomach irritation) with the sight smell and taste of alcohol or pairing behavior with electric shocks of various intensities. Of note, disulfiram (Ant-abuse) is not an aversion technique since there is no pairing of nausea with drinking, just the threat of nausea.
Aversion Therapy for Addiction
Today, the major use of aversion therapy is for the treatment of addiction to alcohol and other drugs. This form of treatment has been in continuous operation since 1932. The treatment is discussed in the Principles of Addiction Medicine, Chapter 8, published by the American Society of Addiction Medicine in 2003. Their website is www.asam.org.
Aversion therapy works on changing positive emotional associations with the sight smell and taste of alcohol or other drug. Follow up studies done at 6 and 12 months on populations matched on 17 baseline variables shows that aversion therapy resulted in significantly better abstinence rates. There was no increase in leaving the hospital against medical advice in patients seeking aversion therapy compared to patients in non-aversion programs.
Aversion therapy and homosexuality
Aversion therapy has been used in attempts to convert homosexual individuals to heterosexuality. While more common in past decades, it is still utilized in some situations.
Since as early as 1994, the American Psychological Association has declared aversion therapy as a dangerous practice that doesn't work. As of 2006, aversion therapy, when used to treat homosexuality, is in violation of the codes of conduct and professional guidelines of the American Psychological Association and American Psychiatric Association. The use of aversion therapy for treatment of homosexuality is illegal in some countries.
In 1966, psychologist Martin E.P. Seligman reported that while using aversion therapy to try to change gay men's sexual orientation to heterosexual was controversial, in some instances, the process "worked surprisingly well," with up to 50% of men subjected to
such therapy not acting on their homosexual urges. (Seligman, p. 156) [How to reference and link to summary or text ] These results produced what Seligman described as "a great burst of enthusiasm about changing homosexuality [that] swept over the therapeutic community" after the results were reported in 1966. (Seligman, p. 156) [How to reference and link to summary or text ] However, Seligman notes that the findings were later demonstrated to be flawed: most of the men treated with aversion therapy who did in fact stop homosexual behaviour were actually bisexual. Among men with an exclusive or near-exclusive homosexual orientation, aversion therapy was far less successful. (Seligman, p157) [How to reference and link to summary or text ]
Injections of apomorphine were also reportedly used as part of aversion therapy for homosexuality, resulting in violent illness. At least one person has reportedly died from this treatment. [How to reference and link to summary or text ]
There is currently little published data available on "conversion" rates. However, four studies have reported "success" rates during conversion therapy of 0.4%, 0.0%, 0.5% and 0.04%. That is, conversion therapy has a failure rate in excess of 99.5% in each study. Furthermore, anecdotal data indicates a high percentage of extremely depressed and suicidal clients emerging from conversion therapy. [How to reference and link to summary or text ]
Aversion therapy and "sexually deviant" youth
Forced aversion therapy is still sometimes used on children and teenagers who violate sex laws, and especially used on individuals believed to have deviant sexual feelings. These youth have been forced to smell ammonia, describe humiliating scenarios, or engage in other uncomfortable situations, while looking at nude pictures, listening to audio tapes describing sexual situations, or describing their own fantasies. In order to measure sexual response, devices like penile plethysmographs and vaginal photoplethysmographs are sometimes used, despite the controversies surrounding these devices.
In 1992, the Arizona Civil Liberties Union challenged the Phoenix Memorial Hospital for its use of these methods on children as young as 10. They were defended by the Association for the Treatment of Sexual Abusers. Since then, policies have usually discouraged the use of forced aversion therapy on children under 14.