Alcoholism Drug TherapyIn aversion therapy you 'unlearn' that alcohol equals pleasure
Aversion therapy is a behavioral therapy, one of a group of therapies that attempt to change undesirable and/or destructive behaviors.
Each of these go about it in their own way, however, the aversion method is perhaps the most controversial.
How Does It Work?
This particular behavioral therapy works on the principle that all behavior is learned. It follows, then, that if all behavior is learned then it can be unlearned.
Why would we want to unlearn behavior? Simple really; if it is destructive or undesirable. Such behavior could include gambling, alcohol/drug abuse, deviant sexual acts, smoking and so on.
These undesirable behaviors come about because we associate them with pleasure, the brain learns that, let's say, drinking makes us feel relaxed and lowers our stress levels.
This is fine in itself, however if we come to rely on alcohol and it starts to take control of us, then it has become an undesirable behavior. We need to unlearn that alcohol equals pleasure.
Aversion therapy goes about stopping this behavior by attempting to break the association between alcohol and pleasure. The therapy, in the case of alcoholism, involves the 'patient' drinking while at the same time having a negative stimulus administered. This negative stimulus could be an emetic drug (i.e. one that makes the patient vomit when drinking alcohol) such as an emetic drug (one that induces vomiting when alcohol is taken) like disulfiram, or an electric shock administered whenever the subject drinks.
In short then the patient is 'punished for drinking' and, for the same reason a parent punishes a child, a successful outcome is to reduce or completely eliminate their undesirable behavior.
If you or someone close to you wants help and advice on quitting drinking then take a look at the following pages:
Do not attempt aversion therapy unless you are in the care of a behavioral therapist who has been trained in aversion therapy.
There are those who attempt to utilize aversion therapy by themselves, using the negative disulfiram (Antabuse) reaction to help them stop drinking. It is highly unlikely that you will be successful going it alone and it is dangerous.
So, once you have found a behavioral therapist, he or she will begin by asking you any number of questions. From these questions the therapist will be able to:
Determine how severe your drinking problem is (very important, alcohol withdrawals can be fatal, so the therapist needs to discover the extent of your drinking and consult a medical professional if he/she believes alcoholism detox will cause problems)
Determine the how often and how much you drink. The frequency.
Determine the environment in which your drinking takes place
Establish a rapport. Due to the nature of aversion therapy, a positive client/therapist relationship can improve the chances of a positive outcome
Also you will have to undergo a full medical exam to ensure that you no heart problems or other health issues that may make this kind of treatment unsuitable.
With the data above, the therapist will design a treatment plan for you. You will have to give your informed consent, as the treatment is not without its risks.
Which Negative Stimuli Will They Administer
The two most common negative stimuli for drinking problems are an emetic drug (e.g. disulfiram) or electric shocks.
The emetic drug is taken (orally/intravenously) prior to drinking. When you drink if causes a number of negative reactions such as vomiting etc. Thus reinforcing the notion that drinking is unpleasant.
With electric shock treatment, electrodes are placed on a part of the body (usually the thigh or forearm), and an electric shock is given whenever alcohol is consumed
With alcoholism, the drug therapy is preferred because it is easier to administer and can be self-administered (orally) once the therapy sessions have ended.
Inpatient or Outpatient
This usually depends on the severity of the drinking problem.
An outpatient setting is preferable for those who are not alcoholic, but have issues with alcohol that are impacting on their lives in some way. In other words they are NOT physically dependent on alcohol. Usually you will have to undergo the therapy daily for at least 10 days.
Continuing the therapy at home is also essential, as it has been shown that if the aversive stimuli is removed when the subject drinks, the old behavior soon returns.
An inpatient setting is best for those whose drinking problem is more severe. In other words those who ARE physically dependent on alcohol. They are more likely to suffer from alcohol withdrawals, have other health/psychological problems and need a more comprehensive treatment plan than those who 'merely' abuse alcohol but are not physically addicted.
Is It Effective?
Aversion therapy has got a bad reputation, not least because of its portrayal in the media. Anyone remember, "A Clockwork Orange"?
Also many people confuse aversion therapy's use of electric shocks with the controversial treatment for depression and other mental health problems, electro-convulsive therapy.
Due to the nature of aversion therapy i.e. the patient is punished for their behavior, many people never finish their treatment becuase they find it too unpleasant. Also, there have been cases when patients have become verbally and physically aggressive due to the negative stimuli they are receiving.
What about studies on its effectiveness?
Not many have been undertaken, but those that have seem to show some success for the treatment. In 2001, Matthew Howard, an aversion therapist, treated 82 alcohol dependents with an emetic drug for 10 days. After this treatment the subjects stated that they felt that they would be able to resist drinking due to the therapy. Unfortunately, no further studies were done to determine how well they managed in the real-world.
Aversion therapy is not widely used for alcoholism today. Cognitive behavioral therapy is the preferred behavioral therapy for use with alcohol dependents. Those who do choose aversion therapy usually do so within a treatment regimen that includes support groups, counseling etc.
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Deborah Morrow, M.S. Addiction Psychology, is the director of treatment programs for The Alcoholism Guide website. In her practice, Deborah provides on-line coaching and support for those dependent on alcohol or who require other services such as relapse prevention or court mandated services. (Read More)