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Covert Sensitization

pedophilia treatment therapy consequence client aversion

An aversion therapy that reduces unwanted behaviors by repeated, imagined associations with an unpleasant consequence.

Covert sensitization was first described in the mid-1960s by psychologist Joseph Cautela as a new treatment for people who engage in undesirable behaviors. In the past 30 years it has been researched as a treatment for alcoholism, smoking, obesity, and various sexual deviations including pedophilia and exhibitionism.

Covert sensitization discourages people from engaging in unwanted behaviors by creating an association between those behaviors and an unpleasant consequence. Because of this, it is classified as a type of aversion therapy. What is unique about covert sensitization, however, is that the unwanted consequence is never actually present in therapy. This is best illustrated with an example. If a person was undergoing covert sensitization to stop using alcohol, for instance, a typical therapy session would involve the therapist instructing the client to imagine himself drinking and becoming very nauseous. Then the client would be encouraged to imagine himself becoming so nauseous that he starts vomiting all over himself, the room he is in, and in the beer mug from which he was drinking. By imagining this disgusting scene over and over again, the client starts associating alcohol with vomit, and drinking becomes much less appealing. Finally, the therapist would instruct the client to imagine accepting a drink, becoming nauseous again, and then deciding to refuse the drink. In the imagined scene, the nausea (which is an unpleasant stimulus for almost everyone) goes away as a consequence of the client's choice not to drink.

The major advantage covert sensitization has over other methods of aversion therapy is that it works without the presence of the unwanted behavior and the unpleasant consequence. This has practical and ethical advantages. For example, when treating exhibitionists, it would be difficult to justify encouraging people to expose themselves to others while a therapist administered a shock or some other unpleasant stimulus. It is important to note that aversion therapy is not the only way to break bad habits. Large-scale studies comparing several methods have found that other techniques, such as behavioral family counseling and self-management techniques, are also effective.

Timothy Moore

Further Reading

Rimmele, C., Howard, M., & Hilfrink, M. "Aversion Therapies." In Hester, R., Miller, W., et al., eds. Handbook of Alcoholism Treatment Approaches: Effective Alternatives. Boston: Allyn & Bacon, 134-147,1995Plaud, J. & Gaither, G. "A clinical investigation of the possible effects of long-term habituation of sexual arousal in assisted covert sensitization." Journal of Behavior Therapy and Experimental Psychiatry, 28 no. 4 (1997): 281-290.

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