This is the 2007 version. Click here for the 2017 chapter 13 table of contents.

Covert Sensitization

Covert sensitization is a form of sensitization in which the conditioning process occurs in imagination, out of sight (therefore covert rather than overt). Suppose an alcoholic wishes to give up drinking. One approach is to attempt to establish a negative emotional response to thoughts of drinking. This can be done, in theory, by following thoughts of drinking with anxiety-arousing or disgusting thoughts. Here is an excerpt from covert sensitization treatment by Cautela (1967, pp. 461-462):

What is the goal of covert sensitization? What was Cautela's procedure?

You are walking into a bar. You decide to have a glass of beer. You are now walking toward the bar. As you are approaching the bar you have a funny feeling in the pit of your stomach. Your stomach feels all queasy and nauseous. Some liquid comes up your throat and it is very sour. You try to swallow it back down, but as you do this, food particles start coming up your throat to your mouth... [The description continues and becomes more vivid and awful.]

...You turn away from the beer and immediately you start to feel better. As you run out of the barroom, you start to feel better and better. When you get out into the clean, fresh air you feel wonderful. You go home and clean yourself up.

What procedure resembling Cautela's technique was tried in the Soviet Union of the 1930s?

Alcoholics in the Soviet Union take a nausea-inducing drug mixed with liquor

Overt sensitization treatments using nausea-inducing drugs, not just imagination, were tried in the Soviet Union as early as the 1930s. A Soviet psychology text from the 1930s shows a line of men sitting on little stools, each with a metal bucket between his knees, each drinking something out of a shot glass. What they were drinking was liquor mixed with a drug that would quickly make them vomit. This was supposed to condition them against drinking.

What "treatment" was used in the movie A Clockwork Orange ?

The movie A Clockwork Orange featured a treatment very much like the Soviet anti-alcoholism treatment just described. The protagonist, a young man, was arrested for murder. To turn him against violence, he received a nausea-inducing drug while being forced to watch films of violence with his eyelids taped open. While this was going on, the music of Beethoven was playing in his ears. After being released, the young man became very ill whenever he initiated a violent act or heard Beethoven's music.

Why would the procedure used in A Clockwork Orange probably not work?

The caricature of sensitization therapy in A Clockwork Orange alarmed the public and added to public distrust of conditioning techniques. In reality, it is unlikely such a technique would work. An individual forced to watch violent movies while becoming nauseated from a drug would blame the sickness on the drug, not the content of the movie. In general, animals do not associate sickness with sights or sounds, they associate sickness with taste. Taste aversion, the development of an avoidance reaction or feeling of sickness associated with a taste, is one of the most powerful forms of conditioning known. However, the procedure in A Clockwork Orange involved visual stimuli, which are not so easily associated with illness.

How do the commercial preparations Antabuse and Bantron work?

Several commercial products attempt to harness the power of taste aversion in order to eliminate addictions. Antabuse is a pill for people who wish to weaken their desire for alcohol. It causes nausea if the person drinks. In theory, this should help the person develop an aversion to drinking. Bantron is a similar product for people who smoke cigarettes. It makes cigarettes taste sickeningly awful, which (in theory) helps a person stop desiring cigarettes.

Unfortunately, theory does not always translate successfully into practice. Cravings are some of the strongest motivational forces that exist. Opposing them with conditioned aversion is not a magic solution. In fact, it does not work as well as more traditional approaches such as group therapy with fellow addicts. Conditional aversion techniques have another disadvantage: they are unpleasant! So, except for Antabuse—which plays a useful role in alcoholism treatment programs—behavior therapists do not usually use covert sensitization or similar aversion-creating techniques.

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