This method was first used in 1935 in an effort to eliminate homosexuality. It attempts to associate in the patientís mind a previously attractive sexual stimulus or behavior with an unpleasant sensation, such as pain, nausea, or fear. The therapist presents the patient with a deviant stimulus (such as a photograph of a nude child, or an audiotape of a child in a sexual context), while simultaneously presenting him with an unpleasant (aversive) stimulus.27
Aversive stimuli have included the following:28
- vomit-inducing and paralysis-inducing substances - discontinued due to risk of gastric rupture, salt depletion, cardiovascular problems, fever, and delerium
- electric shock - commonly used in the past, now considered unethical by many
- substances producing noxious odors, such as ammonia - commonly used today29 (One treatment specialist has recommended the use of putrifying tissue, such as human placenta inoculated with bacteria, perhaps "doped" with meat, fish, urine, or feces.30)
Covert sensitization is a physically safer variation that has also been used with homosexuals and sexual deviants.31
- Both the deviant stimulus and the aversive stimulus are to be imagined and described aloud by the patient, rather than actually experienced.
- The described aversive situation is required to be an extremely noxious or nauseating scene, feelings of intense shame and guilt, or severe legal consequences.
- The method is sometimes supplemented with actual aversive stimuli such as noxious odors.
Another variation, shame aversion therapy, involves subjecting the patient to public shame or humiliation in conjunction with his deviant behavior.32
Evaluations of the effectiveness of these methods have been uncontrolled case studies, involving very small numbers of subjects, and have found inconsistent results.33
- Some studies have found that homosexual and deviant arousal patterns decreased, but then returned to original levels when treatment was stopped.
- Researchers say aversion therapy seems not to interfere with normal sexual functioning.
- No studies of side-effects have been conducted.
- Some doctors have claimed that in the case of homosexual men, aversion therapy has resulted in serious long-term psychological effects, including feelings of despair and depression.34
- Only a few cases of shame therapy are reported in the literature; one reported that a transvestite attempted suicide after a treatment session.35
28. Council on Scientific Affairs of the American Medical Association, 1987; Crawford, 1981; Hall, 1996; Langevin, 1983; Maletzky, 1991; Matson & DiLorenzo, 1984.
29. American Academy of Child and Adolescent Psychiatry, 1999*.
30. Maletzky, 1991.
31. American Academy of Child and Adolescent Psychiatry, 1999*; Council on Scientific Affairs of the American Medical Association, 1987; Crawford, 1981; Langevin, 1983; Maletzky, 1991; Matson & DiLorenzo, 1984.
32. Maletzky, 1991; Langevin, 1983.
33. Center for Sex Offender Management, 1999*; Council on Scientific Affairs of the American Medical Association, 1987; Crawford, 1981; Hall, 1996; Langevin, 1983; Matson & DiLorenzo, 1984; McConaghy, 1999.
34. Harris, 1987.
35. Langevin, 1983.
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