Covert And Overt Sensitization Therapies In Treating Alcoholism

Covert And Overt Sensitization Therapies In Treating Alcoholism

Covert and overt sensitization

Aversion therapy doesn’t constitute a new approach in dealing with various addictions, including alcohol, drugs or cigarettes, but the effectiveness and ethical aspects of these procedures are still up for debate in the medical community. There are two distinct types of aversion treatments, namely overt sensitization and covert sensitization.

The former version is perceived as less ethical than the latter due to the methods employed to create a negative correlation between the maladaptive behavior and its consequences. Before we proceed to discuss the two forms of aversion therapy, let’s first examine the fundamental principles behind them, shall we?

How aversion therapy was developed

Cognitive behavioral adepts have the theory that the persistence of the negative conducts – alcohol or drug abuse, for instance – are in direct correlation with the positive effects of consumption. To put it simply, the addict consumes alcohol or drugs because the substance confers him a way to numb the negative emotions and, in short term, it brings along a state of relaxation. Over time, the brain creates an association between the behavior and the effect, which makes the person appeal to the drugs or alcohol every time his life becomes unbearable.

The aim of aversion therapy consists of replacing the association between alcohol and/or drugs and a positive outcome with negative consequences. In other words, aversion treatments attempt to change an addict’s perception on the effect of substance abuse, which eventually should modify the maladaptive coping behavior. However, the methods employed by the two previously mentioned types of aversion therapy are fundamentally different.

Covert sensitization  

The therapist performing covert sensitization therapy requires the patient to conjure various disturbing and downright nauseating mental images while concentrating on the negative behavior. For example, an alcoholic could be required to picture himself at the local bar surrounded by all his drinking buddies. At this point, he should instantly imagine he’s feeling nauseous and begins to vomit all over the bar and himself.

The therapist helps the patient confer more authenticity to the mental image through various techniques. Repeating the exercise several times is said to create a powerful correlation between the alcohol and the effect in the mind of the addict. In time, substance consumption will be perceived as an incredibly disgusting habit, which should repel any future cravings. To boost the effectiveness of the covert sensitization, patients are also required to imagine scenarios where they resisted the temptation of alcohol and therefore avoided the unpleasant situation, in order to create positive reinforcements as well.

Overt sensitization

The same concept in theory – but not in practice – overt sensitization relies on more brutal methods to get the point across. In essence, its unethical nature stems from the substances that are mixed with the addict’s drug of choice – often that substance consists of the agent “Antabuse”- which triggers physical reactions of nausea.

The addict is unaware that his alcoholic beverages or drugs have been “spiked” with a foreign agent and should begin associating the maladaptive behavior with physical illness. Needless to say, there are many critics of this form of aversion therapy, which is perceived as inhumane and unethical by most of the medical community. If you want to find out more thoughts on overt sensitization, I invite you to check out our forum.