Aversion Therapy Uses and Effectiveness

Key Takeaways

• Aversion therapy pairs an unwanted behavior with discomfort to make people less likely to do it.
• Aversion therapy can be used to treat problems like alcoholism and smoking, but it doesn’t always work and can sometimes be harmful.
• It’s important to work with a trained professional if you’re considering aversion therapy.

Aversion therapy is a behavioral therapy where an unwanted behavior is repeatedly paired with discomfort. For instance, someone trying to quit smoking might receive an electric shock whenever they see a picture of a cigarette. The aim is to make the person associate the stimulus with unpleasant sensations.

People naturally tend to avoid pain and seek pleasure. When a behavior activates the reward center in the brain, people experience feelings of pleasure and are more likely to repeat the behavior again in the future, even if it is something that isn’t healthy or adaptive. 

Aversion therapy works by interrupting this reward-pleasure system. Instead of experiencing positive feelings, aversion therapy adds a negative experience to the situation. The goal is to make people less likely to engage in the problematic behavior.

How Does Aversion Therapy Work?

During aversion therapy, the client might be asked to think about or engage in the behavior they enjoy while experiencing something unpleasant like a bad taste, a foul smell, or mild electric shocks.

Once the unpleasant feelings become associated with the behavior, the hope is that unwanted behaviors or actions will begin to decrease in frequency or stop entirely.

How long it takes for aversion therapy to be effective can vary depending on the behavior and the situation. Research suggests that you may begin seeing some results after around four treatments.

Types of Aversion Therapy

Different types of aversion therapy include:

• Medication-based aversion therapy: Certain medications are sometimes used as aversive stimuli in the treatment of addictions. Antabuse (disulfiram), for example, is a medication that causes nausea and vomiting if a person drinks alcohol after taking it.
• Sensory aversion therapy: This relies on uncomfortable sensations, such as a disgusting taste or smell, as an aversive experience.
• Electrical aversion therapy: This approach involves applying painful electrical shocks as an aversive stimulus. This type of aversion therapy is considered controversial and is rarely used.

Uses for Aversion Therapy

Aversion therapy can be used to treat a number of problematic behaviors including the following:

• Bad habits
• Addictions
• Alcoholism
• Smoking
• Gambling
• Violence or anger issues

Aversion therapy is most commonly used to treat drug and alcohol addictions. A subtle form of this technique is often used as a self-help strategy for minor behavior issues.

In such cases, people may wear an elastic band around the wrist. Whenever the unwanted behavior or urge to engage in the behavior presents itself, the individual will snap the elastic to create a slightly painful deterrent.

How Effective Is Aversion Therapy? 

The overall effectiveness of aversion therapy depends upon a number of factors, including:

• The treatment methods and aversive conditions that are used.
• Whether or not the client continues to practice relapse prevention after treatment is concluded.
• In some instances, the client may return to previous patterns of behavior once they are out of treatment and no longer exposed to the deterrent.

Aversion therapy is generally effective only while directed by a therapist, as relapse rates tend to be high.

Once the individual is out in the real world and exposed to the stimulus without the presence of the aversive sensation, it is highly likely that they will return to the previous behavior patterns.

Aversion therapy has shown some success in the treatment of alcohol use problems. In one study, around 60% of participants were still sober a year after treatment.

The results for other health concerns, including obesity and smoking, have been less promising. Attempts to create negative associations among smokers have been unsuccessful, so professionals in the smoking cessation field have largely abandoned this approach. It has also been ineffective in treating obesity and other lifestyle behaviors.

Pitfalls and Criticisms of Aversion Therapy

One of the major criticisms of aversion therapy is that it lacks rigorous scientific evidence demonstrating its effectiveness. It can be helpful in some cases, but appears to be largely ineffective in others.

Ethical issues over the use of punishments in therapy are also a significant concern.

Practitioners have found that in some cases, aversion therapy can increase the anxiety that actually interferes with the treatment process. In other instances, some patients have also experienced anger and hostility during treatment.

The Harms Association With Aversion Therapy

In some instances, serious injuries and even fatalities have occurred during the course of aversion therapy. Aversion therapy has also been misused to create tremendous harm to LGBTQIA+ people.

Conversion therapy is a form of aversion therapy that seeks to alter people’s sexual orientation and behaviors through punishments and aversive stimuli. This practice is traumatic and unethical. It has been directly linked to lasting harm to people subjected to it, including increased risks for anxiety, depression, post-traumatic stress disorder, and suicide. 

The American Psychological Association opposes these sexual orientation change and gender identity change efforts. The practice is banned for minors in 20 U.S. states, and research has shown that there is no scientific evidence to suggest that efforts to change a person’s sexual orientation are effective.

The use of aversion therapy to “treat” homosexuality was declared dangerous by the American Psychological Association (APA) in 1994. In 2006, ethical codes were established by both the APA and the American Psychiatric Association. Today, using aversion therapy in an attempt to alter sexual orientation is considered a violation of professional conduct.

Things to Consider Before Trying Aversion Therapy

If you are considering aversion therapy to treat a problematic behavior such as alcohol use or other issue, there are some important things to consider beforehand.

First and foremost, it’s important to find a therapist who is trained and experienced with this practice. If you are treating an alcohol use problem, for example, you should work with a mental health professional with training and expertise in treating addictions.

It is also essential to be aware of other behavior change alternatives that can be helpful. Some options you might consider include:

• Cognitive-behavioral therapy (CBT): Helps people identify and change negative thought patterns that contribute to problem behaviors
• Exposure therapy: Gradually exposes people to situations or stimuli that trigger symptoms and lead to avoidance, which can help reduce avoidant behaviors
• Medications: Some medications can help treat behaviors related to mental health conditions such as anxiety, depression, and substance misuse
• Support groups: People who struggle with addictions or other problem behaviors can also benefit from joining support groups where they can find encouragement and resources

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5. Elkins RL, Richards TL, Nielsen R, Repass R, Stahlbrandt H, Hoffman HG. The neurobiological mechanism of chemical aversion (emetic) therapy for alcohol use disorder: An fMRI study. Front Behav Neurosci. 2017;11:182. doi:10.3389/fnbeh.2017.00182

6. ScienceDirect. Aversion therapy.

7. Arlinghaus KR, Foreyt JP, Johnston CA. The issue of aversion in lifestyle treatments. Am J Lifestyle Med. 2016;11(2):119-121. doi:10.1177/1559827616680554

8. American Psychological Association. APA resolution on sexual orientation change efforts.

9. American Psychological Association. Banning sexual orientation and gender identity change efforts.

10. Ethical Principles of Psychologists and Code of Conduct. American Psychological Association.

11. Practice Guidelines. American Psychiatric Association.

By Kendra Cherry, MSEd

Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the “Everything Psychology Book.”

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