Aversion Therapy is a form of behavior modification in which the subject is exposed to an undesirable behavior, like drinking or smoking while simultaneously being subjected to some form of negative stimulus, like nausea inducing drugs or electric shocks. The desired end result of aversion therapy is to encourage the subject to give up undesirable habits in response to association with an unpleasant effect.

Aversion Therapy is a technique derived from the theory of classical conditioning; a type of learning that automatically occurs due to repeated interactions with specific stimuli and learned responses. 

Aversion Therapy uses classical conditioning to associate a negative response with negative consequence, the result is that the subject is conditioned to fear the associated stimuli.

Common practices of Aversion therapy include:

  • Use of electric shocks
  • Inducing nausea/ vomiting with the use of drugs
  • Violent or pornographic images 
  • Unpleasant sounds, tastes or smells
  • Restraint and Seclusion
  • Cruel and unusual punishments 
  • Attack therapy/ shaming
  • Rape reenactments, sexual abuse and “corrective rape” 

Aversion Therapy has been highly controversial within the psychological community for the ethical concern of using abuse as treatment and its potential for harming the subjects. This is because aversion therapy can be psychologically traumatic, which has led to many former “patients” being diagnosed with PTSD and Complex PTSD. Similarly, the reported success of the treatment is questionable, as it has been proven that outside of the influence of the controlled aversive environment, relapse is common.

A Clockwork Orange, the 1962 book by Anthony Burgess adapted as a film by Stanley Kubrick, contained aversion therapy techniques. Set in a dystopian future of violent crime, the story examines the treatment of young Alex de Large, who is offered freedom from a long jail sentence if he agrees to undergo aversion therapy. In order to force De Large to associate violence with personal suffering, he is shown violent images, subjected to electric shocks and given drugs that would make him feel ill.

History 

Classical Conditioning had a major influence on the school of thought in psychology known as behaviorism. Classical conditioning was discovered by Russian physiologist Ivan Pavlov and involves learning by associating an environment with a naturally occurring stimulus.

While Ivan Pavlov showed that classical conditioning applied to animals, further experiments proved that it could also apply to humans. In a famous (though ethically dubious) experiment, Watson and Rayner’s study of a 9 month old infant named Little Albert; it was concluded after the continuous association of a white rat and a loud noise, Little Albert was classically conditioned to experience fear at the sight of the rat.

In BF Skinner’s theory of Operant Conditioning, rewards and punishments are used to motivate behavior. Operant conditioning involves associating a behavior with a consequence (positive or negative) by enforcing punishment for undesired behavior. 

However, Skinner severely underestimated the role of biology in shaping, regulating, and explaining human behavior, dismissing the fields of behavior genetics, evolution psychology, and cognitive science. Though operant conditioning may be considered beneficial for basic learning, the use of aversive behavior conditioning has proven extremely problematic for the “treatment” of neurodivergent disorders.

Aversion Therapy, which has its roots in this research, still continues to be practiced today, despite the fact that such experiments would now be viewed as highly unethical. All things considered, it’s clear that these ideas, if implemented without care for ethical boundaries, would certainly cause more problems than they would solve.

How Aversion Therapy is used in Behavior Modification programs

The use of Aversion Therapy in residential behavior modification programs, has long been touted as “tough love” for wayward youth or alternative therapeutic treatment for any range of behavioral disorders. Punishment based treatment in uncontrolled environments certainly has ethical concerns, but is even more likely to lead to physical, mental and emotional harm.

Conversion Therapy

Before 1973, homosexuality was classified as a mental illness in the Diagnostic and Statistical Manual of Mental Disorders (DSM). It was believed to be curable by some medical professionals. Many LGBTQ+ youth have been forced into conversion therapy programs for revealing their orientation.

Conversion therapy can involve the use of involuntary reparative psychotherapy, hypnosis, emetic drugs and receiving electric shocks while viewing pornographic images or addressing gender conforming issues. Even though the use of these methods are clearly unethical, they are especially cruel if they are being used to change a person’s sexual orientation.  

Attack Therapy

Attack therapy is a controversial form of psychotherapy where patients are verbally abused or humiliated by their therapist, or by their fellow patients during group therapy sessions. Ridicule and shame are often used to pinpoint and punish undesirable behavior patterns. These sessions could include rape enactments and physical altercations sanctioned by the staff. This methodology is especially problematic when the group members are captive and not allowed to leave during the sessions.

Attack Therapy was first developed in Synanon, widely known to be the cult that spawned the troubled teen industry. It was referred to within the group by members simply as “The Game” and has been described as “brutal and bordering upon sadism” by survivors of Synanon.

Cruel and Unusual Punishment

Children in behavior modification programs are often subjected to punishments that can only be described as cruel and unusual. Punishments may include physical abuse, sexual abuse, denial of basic necessities, humiliation, social isolation, forced labor, exhaustive calisthenics. As well, corrective or preventive protocols are often misused, such as the cruel, unusual and unnecessary use of restraints, seclusion, strip searches and cavity searches.

The Judge Rotenberg Center​​

The most egregious example of use of Aversion Therapy with electric shock devices is at the Judge Rotenberg Center (JRC) in Massachusetts, a center for the treatment of youth with moderate to severe mental disabilities. JRC is understood to be the only facility in the US still using electric shock devices as treatment for disabled children. Children are subject to electric shocks to their legs, arms, feet, hands and torsos. The shocks, which last 2 seconds each, are strong enough to leave burns and blisters on the skin. Some patients receive dozens of shocks per day – some even hundreds.  

It has been reported that although aversive punishments were supposed to only be used in response to behavior, the staff would often provoke reactions that would result in the administration of more shocks.

Despite the overwhelming evidence of abuse at JRC, it remains in operation today, and aversive shocks are still used.

In 2010, Mental Disability Rights International presented an urgent appeal to the UN Special Rapporteur on Torture – Torture Not Treatment: Electric Shock and Long Term Restraint in the United States on Children and Adults with Disabilities at the Judge Rotenberg Center. 

This urgent appeal documents human rights abuses – the intentional infliction of pain to punish students for certain behaviors – called “treatment” for children and adults with disabilities as well as the resulting physical and psychological abuse. 

“At JRC pain is the treatment.”

Read the full report here:

https://icapanetwork.org/wp-content/uploads/2021/11/USReportandUrgentAppeal.pdf

Electrical Stimulation Devices

Electrical stimulation devices (ESDs) are designed to deliver electric shocks to a patient via electrodes attached to their skin. They have been deployed in some settings to prevent self-injury or aggressive behavior; conditioning them to refrain from engaging in that behavior in the future. 

Those with conditions such as autism may have difficulty processing and expressing distressing emotions like fear or pain, which can lead them to act out and harm themselves or others. To prevent injury, this kind of behavior needs to be effectively managed. But the efficacy of ESD-centric aversive therapy is questionable from both an ethical and an efficacy perspective. 

The US Food and Drug Administration issued a final rule on March 20, 2020, prohibiting the use of electrical stimulation devices to treat self-injurious or aggressive behavior in neurotypical patients claiming the devices provide an “unreasonable and substantial risk of illness or injury.”

However, the Washington D.C. Circuit Court of Appeals ruled in July 2021 that the FDA’s ban conflicted with the authority of healthcare professionals to practice medicine, allowing the Judge Rotenberg Educational Center to continue its use of electric shock devices.

Conclusion

Aversion therapy is NOT therapy. Neither is it a safe or ethical practice of behavior modification. Simply put, Aversion Therapy is torture; particularly when it is used on children and persons with disabilities and for purposes of conversion of sexual or gender identities. It is time to ban the use of aversion therapy. It is far beyond time to protect our children from cruel and inhumane treatment. 

Torture ≠ Treatment

Chelsea Filer 
Executive Director 
ICAPA Network 
www.icapanetwork.org