Chapter Six
Aversive
In the last chapter
on desensitization it was seen how counterconditioning can be used
to reduce aversive-avoidance reactions to situations. In this chapter is the
opposite, use of counterconditioning to reduce unwanted positive-approach
reactions. This is the procedure of aversive counterconditioning, the countercond itioning of positive reactions using the response to an
aversive (unpleasant) situation as the incompatible response (Feldman, 1 966;
HaIlam & Rachman, 1976; Rachman & Teasdale, 1969). For example, a
person addicted to some drug (e.g., heroin, alcohol, tobacco) has positive
associations to many aspects of taking the drug, including such things as
pleasant associations to a particular bar and drinking friends, a calming
effect associated with lighting up a cigarette, a reduction of withdrawal
symptoms after taking more heroin, or socially approved relaxing of inhibitions
associated with drinking alcohol. These types of positive associations
continually make it more probable the person will again use the drug, thus
strengthening the addiction even though the long range effects of Using the
drug are undesirable and even aversive. The logic of aversive
counterconditioning is to pair situations that elicit the undesired positive
response (e.g., the handling and taste of a cigarette) with stimuli that elicit
a dominant, incompatible, aversive response
(e.g., the reaction to electric Shock) as a way of reducing the positive
reaction.
Aversive counterconditioning
follows the general approach of counter- conditioning described in Chapter
3: First, we identify those stimuli that elicit the undesired response, in
this case a pleasant-approach response. Next, we determine or establish ways
to produce an incompatible response, in this case an aversion response. Then
we gradually apply our counterconditioning, using a hierarchy to control response
dominance. In aversive counterconditioning, a hierarchy is often unnecessary
because the aversion response may always be dominant to the undesired response.
However, this is not always the case and practitioners sometimes overlook
the importance of a hierarchy in some aversive counterconditioning. Finally,
remember that in counterconditioning we can stop at any point along the way
between the two incompatible responses. Thus in aversive counterconditioning
we can stop while the client still has a positive reaction to the stimuli,
continue on and stop when the client feels neutral to the stimuli, or continue
further until the client feels aversion to the stimuli.
Aversive counterconditioning
is primarily used with self-rewarding behaviors. The person smoking an undesired
amount of marijuana is reinforced (rewarded) for smoking by the results of
smoking. The person who is sexually aroused by specific stimuli (e.g., people
of the same sex, young children, certain types of clothes) is reinforced by
the sexual arousal and resulting sexual fantasies and behaviors. This self-reinforcing
aspect of the behaviors makes them difficult to treat by most counseling-therapeutic
approaches. Behavioral treatment involves aversive counterconditioning to
reduce some of the positive associations resulting from the natural source
of reinforcement, as well as helping the client develop alternative reinforcing
behaviors. For example, aversive counterconditioning may involve electric
shock paired with photos of young children that elicit undesired sexual arousal.
This is a good place
to see the importance of temporal contingencies on behavior. Consider an alcoholic
who often gets drunk, feels happy, has a good time with his drinking friends,
and withdraws from his daily problems. As a result of this, he later wakes
up with hangovers, is slowly losing his job, and is involved in marriage problems,
all related to his drinking. Now why do these bad effects from drinking not
have a greater influence on his drinking? Part of the reason is that they
are too distant in time to the actual drinking. The positive associations,
which occur close in time to the drinking, have a stronger effect on the drinking
behavior than the more distant negative associations In fact the negative
associations may act as stimuli for more drinking. Thus a purpose of aversive
counterconditioning is to bring to bear immediate aversive associations to
stimuli associated with the undesired behavior.
Behavior modifiers
frequently use a combination of procedures to increase treatment effectiveness.
This is particularly true for the
types of behaviors treated
with aversive counterconditioning. It would be unusual if aversive counterconditioning
were all that was necessary. Usually treatment would involve other components
such as desensitization, training in social skills, or vocational training.
For example, it would be a disservice to a homosexual to merely help him reduce
his sexual arousal to people of the same sex. In addition, it may be desirable
to help him develop his heterosexual arousal and social skills, as well as
deal with many problems associated with the change in life-style.
Because aversive
counterconditioning is often unpleasant, it is generally restricted to behaviors
that are difficult to treat by other means and to situations in which the
advantage of cure more than offsets any disadvantages of procedure. In reality,
many clients have reported they found aversive counterconditioning less unpleasant
than interpersonal probings, interpretations, and evaluations they experienced
in some other forms of therapy. However, the use of aversive events certainly
raises ethical questions and creates p roblems such as some clients disliking
treatment, some clients becoming more aggressive or more anxious, and the
fact that some procedures cannot be used with some clients (such as electric
shock treatments with some cardiac patients).
COMPARED
WITH OPERANT PUNISHMENT
In most of the
current literature, the material covered in this chapter is subsumed under the
term aversion therapy, which includes two distinct, and often confused,
models: aversive counterconditioning and operant punishment. Aversive counterconditioning,
discussed in this chapter, is based on respondent conditioning, the systematic
pairing of two sets of stimuli, one which elicits the undesired response and
one which elicits the aversion response. The stimuli are paired independent of
what responses the client makes. The client’s responses are only a measure of
the progress of the conditioning. Operant punishment, discussed in the next
chapter, is based on operant conditioning. Here the aversive stimulus is
presented contingent upon a particular response of the client and usually
occurs if and only if the client makes the response. Consider the use of an
unpleasant odor in the treatment of over-eating. In aversive
counterconditioning, the odor would be paired with cues that tend to elicit or
encourage over-eating, as a way of weakening the support for over-eating. In
operant punishment, the odor Would be paired with the response of over-eating
as a way to suppress the act of over-eating.
Keeping in mind the
distinction between the two approaches is important for a number of reasons:
The aversive stimulus is contingent on stimuli in One case and responses in
the other. This leads to significant differences in the occurrence and timing
of the aversive stimulus. The types of results and changes in behavior that
follow from the two procedures are different. And the literatures on respondent
and operant conditioning suggest different optimal ways of conditioning.
In practice or in
reading many of the reports of aversion therapy, it is often difficult to
separate aversive counterconditioning from operant punishment, with many situations
having components of both. In reality, it is impossible to have one without
the other. For whenever the aversive stimulus occurs the person is doing something
(doing “nothing” is doing something; a live person is always behaving) and
hence is punished for what he is doing. And whenever the aversive stimulus
occurs, it will be associated with whatever stimuli are present at that time.
The key then becomes the contingencies the practitioner emphasizes in his
treatment program.
Examples of aversive
counterconditioning are found in a variety of settings. A common way to break a
dog of killing chickens is to hang a dead chicken around the dog’s neck for a
while. Pliny the Elder suggested part of treatment for alcoholism might involve
putting spiders in the bottom of the person’s glass. And aversive associations
are often established at the verbal level as when a person says “Bob is a
gossip.”
Most of the early
clinical reports and experimental studies of aversive counterconditioning
used drugs or electric shock to produce aversion. Much of the early treatment
of alcoholism used chemically induced nausea (Lemere & Voegtlin, 1950).
Treatment may consist of pairing the taste of the person’s favorite alcohol
with a drug that makes him nauseous. A common practice today is to keep an
alcoholic on the drug antabuse (disulfiram), which, combined with even a small
amount of alcohol, causes nausea and vomiting that may last a couple of hours.
However, the use of antabuse is seldom sufficient by itself and generally
needs to be part of a more comprehensive treatment program.
Raymond (1964) reported
several cases of aversive counterconditioning using apomorphine-induced nausea.
One case was a 63-year-old alcoholic man who was given two treatments a day
for 31 days. This was sufficient to produce abstinence from alcohol for the
three years of follow-up. A second case involved a 14-year-old boy addicted
to cigarettes. After three treatments he stopped smoking and even the smoke
from his father’s cigarette made him feel ill. Thompson and Rathod (1968)
employed drugs that would partially stop respiration for a short time. They
were able to reduce the use of heroin by associating this aversion with the
taking of heroin.
Many practitioners
and researchers came to prefer electric shock to drugs as the aversive stimulus.
One reason is that with electric shock it is easier to control many of the
variables which are important in conditioning, such as onset, offset, duration,
and intensity of the aversive event. Fewer trials per day can generally be
given with drugs than shock. Drugs, such as those that produce vomiting, are
often more unpleasant to the client and staff than electric shock. Greater
individual differences and side effects occur with drugs. And some of the
drugs depress the central nervous system and hence retard learning and treatment
effectiveness.
Lubetkin and Fishman
(1974) used shock in the treatment of a 2 3-year- old heroin addict. The client
imagined and described behavior sequences leading up to and including heroin
intake, while receiving electric shocks along the way. Shifting to imagining
a scene of a drug-free situation was paired with the offset of the shock.
Following treatment the client remained drug free during the eight-month follow-up.
It is also possible
to use portable shock units, which then permit in vivo aversive counterconditioning
(McGuire & Vallance, 1964). This permits counterconditioning to important
environmental stimuli, allows the client to carry-out much of the treatment
himself, and makes it possible to gear part of the treatment to internal cues,
such as a craving for a drug, which may be difficult to reproduce in the clinic.
Aversive counterconditioning
has become broader and more flexible as a wider range of aversive stimuli
have been employed. Other sources of aversion include cigarette smoke, unpleasant
odors, aversive pictures or sounds, social and personal criticism, and aversive
imagined scenes.
Lichtenstein and his
associates (1973) reduced smoking by having a machine blow warm cigarette smoke
in their clients’ faces while they were smoking. This produced a significant
reduction at the six-month follow-up with about 60 percent of the clients
totally abstinent.
Morganstern (1974)
took advantage of the fact that smoking a cigarette is aversive to many non-smokers.
His client was a 24-year-old obese female who ate much in addition to her
regular meals (pizza and ice cream one to three times per day, almost 200
pieces of candy and dozens of cookies and doughnuts per week). Treatment,
in the clinic and self-treatment at home, consisted of pairing eating junk
food (e.g., candy) with taking a drag of a cigarette and then spitting out
the food and exclaiming, “Eating this junk makes me sick.” Through this the
client was able to loose 53 pounds.
Colson (1972) successfully
worked with a 24-year-old male homosexual. Treatment involved the client relaxing
and visualizing a homosexual experience while presented with an unpleasant
odor, primarily smelling salts (aromatic ammonia).
Mandel (1970) has
been working with male homosexuals by having them concentrate on a color slide
of a naked man. Counterconditioning was achieved by transposing on this slide
a color slide of hideous running sores which cause disgust.
Serber (1970) has
described what he calls “shame aversion therapy,” Which he uses to treat sexual
deviants who are ashamed of their acts. Treatment consists in having the subject
perform the act in front of the practitioner and/or others. Thus a male transvestite
who is sexually aroused by wearing Women’s clothes in private would be required
to put on and wear these Clothes in front of the practitioner. To the extent
that the person feels ashamed doing this, it may have a counterconditioning
effect.
OFFSET
OF THE AVERSIVE STIMULUS
The onset of an
aversive stimulus is unpleasant by definition. It is the onset that is paired
with other stimuli in aversive counterconditioning and with a response in punishment.
The offset of the aversive stimulus is pleasant by contrast. This offset can be
associated with stimuli (called relief stimuli) to which we wish to
respondently condition a positive effect. Or the offset can be used to reward a
desirable behavior. For example, in treating male homosexuality, male
homosexual slides may be paired with the onset of shock, while female
heterosexual slides would be paired with offset of shock. Variations of this
procedure were used by Feldman and MacCulloch (1965), and by Thorpe and his
associates (1964). In treating alcoholism, the drinking of alcohol can be
paired with shock followed by drinking of orange juice during the relief time
(McBrearty et al., 1968).
Feldman (Feldman,
1966; Feldman & MacCulloch, 1965) argues that the offset of the aversive
stimulus should be used to reward a desired behavior such as avoidance of
the inappropriate object and/or approach to the appropriate object. The main
reason is that the learning under the operant model (particularly avoidance
responses) generally takes longer to extinguish than learning under the respondent
model.
Although the various
suggestions for use of the offset of the aversive stimulus are reasonable,
to date there is a lack of research systematically evaluating the effect of
this variable. There is also a need to separate respondent from operant variables.
For example, Rachman and Teasdale (1969, p. 137) argue that the effective
process in Feldman’s procedure is not the development of an avoidance response,
but rather the respondent conditioning of anxiety to the homosexual stimuli.
An interesting
question often raised is why should the effects of aversive counterconditioning
generalize to situations in which clients know they will not encounter the aversive
stimulus. If people are undergoing aversive counterconditioning in a clinic for
alcoholism, why should this affect them when they are at the corner pub away
from the clinic and practitioner? The facts are that aversive
counterconditioning does generalize, in varying degrees, to non-clinic
situations. One possibility is that the conditioning takes place at a level
outside of cognitive control (see Chapter 9). That is, as a result of
conditioning, alcohol-related cues elicit specific responses in or out of the
clinic. Although people are aware they are not in the clinic, this awareness
has a minimal effect on their conditioned reactions. In this sense, it is like
a phobia in which specific situations trigger anxiety even though the person
knows the anxiety is unreasonable and undesired. Bandura (1969, chap. 8), on
the other hand, accounts for the generalization in terms of self-control. He
suggests that as a result of aversive counterconditioning clients can stop the
unwanted behavior in vivo by reinstating in imagination the aversive reactions
they experienced in treatment.
But whatever the
explanation, several things can be done to facilitate generalization: The
clinic can be arranged to match the real world as much as possible. Many behavioral
treatments of alcoholism use simulated bars set up in the clinic. Any possible
in vivo conditioning should be emphasized. Part of the treatment should help
establish self-control skills, such as mentioned above relative to Bandura
and discussed below relative to covert sensitization. Finally, it is often
desirable to have the client return periodically to the clinic for booster
sessions, additional conditioning sessions to minimize loss of treatment effects.
Several problems
exist in developing a theoretical account of the effects of aversive
counterconditioning (Hallam & Rachman, 1972, 1976). One problem, discussed
earlier, is that aversive counterconditioning and operant punishment are often
confused and confounded in practice and in explanations. A second problem is
that most of the literature consists of case studies and treatment programs in
which aversive counterconditioning is just one component. This is useful for
developing effective treatment approaches, but more research is necessary for
factoring out the relative importance of different components. There has also
been little parametric research, systematically varying different variables
such as the onset and intensity of the aversive stimulus. Of the many applied
counterconditioning approaches, aversive counterconditioning lends itself
better than most for such parametric studies, which would help factor out such
things as the operant and respondent components. There is also a need for
research related to many other variables, including the client’s motivation to
change and the expectancies the client has for the effects of the treatment.
Given these qualifications let us consider four basic theories,
counterconditioning, extinction, state theory, and cognitive theory.
Counterconditioning
According to the
counterconditioning explanation (Chapter 3), aversion reactions gradually
become respondently conditioned to stimuli that previously elicited the
positive or approach responses. Thus through aversive counterconditioning the
taste and smell of a cigarette, which were pleasing and reinforcing, are
gradually neutralized or made aversive. There are currently two problems with
this theory. First is that laboratory studies on conditioning emotional
reactions in humans suggest that these conditioned reactions extinguish
quickly. This could mean that the counterconditioning in aversive
counterconditioning also extinguishes quickly and thus long-term treatment
effectiveness may depend on other treatment components. Or it may be that, for
reasons yet to be determined, the aversive counterconditioning in clinical
situations is longer lasting than the quite different laboratory studies.
The second problem
with the counterconditioning explanation is to account for the generality
of results that often follows fairly specific conditioning. For example, treatment
of alcoholism may involve aversive counterconditioning in the clinic to a
specific set of stimuli related to specific drinks and the cues of the simulated
bar. It would not be unusual if the treatment effects carried over to a wide
range of different drinks and situations. The question is how to account for
such a generality of results. A simple counter- conditioning explanation would
account for these results in terms of generalization, the carry-over of the
conditioning from specific stimuli to similar stimuli. However, what constitutes
“similar” probably depends on cognitive processes of the client, rather than
simple physical properties of the stimuli. Critics of the counterconditioning
theory say the theory cannot adequately account for the generality of the
results.
Extinction
As discussed earlier
(Chapter 3), anything that can be interpreted as counter- conditioning can also
be interpreted as extinction, although I am not familiar with anyone yet
advocating an extinction theory for what is covered in this chapter. According
to an extinction theory, stimuli are presented during treatment without letting
them be paired with the pleasant result, thus producing extinction. For
example, a person might taste a martini, but spit it out before getting effects from the alcohol. Such a hypothesis would
need to account for the effect of the aversive event. One possibility is that
the aversive event prevents the usual pleasant reaction from occurring and
hence facilitates extinction.
Hallam and Rachman
(1976) have proposed a tentative “state theory,” which is based on a change in
general responsiveness (sensitization), rather than changes in specific
stimulus-response associations. According to this theory, aversive
counterconditioning has two effects: (1) a general sensitization, a tendency
simply to be more reactive to the types of stimuli encountered in treatment;
and (2) a suppression of the undesired behavior, with the suppression diminishing
over time. The success of the treatment depends on how long the suppression
lasts, what alternative reinforcing behaviors are developed during suppression,
and the amount of reinforcement from the success in suppressing the undesired
behavior.
Cognitive theory
According to
cognitive theories of aversive counterconditioning (e.g., Bandura, 1969), the
effects of treatment are based on such elements as expectancy of treatment
results and the learning of self-control. Cognitive theorists essentially suggest
learning is more cognitive or central than is their conceptualization of
conditioning theories such as counterconditioning. The generality of results
following specific treatment is often offered as support of this position.
Another possible cognitive aspect of aversive counterconditioning is based on
cognitive dissonance. The argument is that because the treatment is aversive
clients will change their behavior following treatment to “justify” (avoid
dissonance) going through such aversion (Carlin & Armstrong, 1968). A
critical test for many cognitive theories would be to see if aversive
counterconditioning generalizes to situations where the client knows he won’t
encounter the aversive stimulus and is motivated away from such generalization.
Because of the many
confounding variables discussed at the beginning of this section, it is not
possible to currently separate the various effects. Probably different treatment
programs are based on and emphasize different combinations of the various
factors suggested by the different theories.
A variation of aversive counterconditioning is covert sensitization (also called verbal aversion and aversive imagery) in which the stimuli to be counterconditioned and the aversive event are imagined scenes (Cautela, 1966b, 1967, 1970c; Cautela & Wisocki, 1971). Here a person imagines a situation in which the undesired behavior would occur, imagines beginning to do the undesired behavior or intending to do it, and then imagines a scene that is aversive, such as vomiting, falling into a cesspool, or social criticism. For example, Polakow (1 975) used covert sensitization as part of a program in
treating a 24-year-old, female barbituate addict. Imagined scenes of thinking
about barbituates, making contact with a dealer, and ingesting pills were
associated with images of being attacked by hordes of large sewer rats (Which
she had indicated on the Fear Survey Schedule as being a strong Source of
fear).
Although little research
has been done on optimizing covert sensitization, Cautela, who has done much
of the work in this area, suggests several guidelines for effective treatment:
The emphasis of the treatment should be on the intent to do the behavior, rather than the behavior itself. This catches
the problem earlier in the behavior chain, and Cautela believes it minimizes
overgeneralization. That is, the covert sensitization may involve conditioning
related to the client’s intent on drinking alcohol, rather than anyone drinking
alcohol or alcohol in general. Cautela also suggests alternating the aversive
scenes with scenes in which the client performs an alternative desired behavior
and experiences relief. The imagery may be enhanced through the various senses,
as by having the client smell or hear something related to what he is imagining.
Finally, as is true of most aversive counterconditioning, covert sensitization
is often most effective when combined with other procedures such as relaxation
training. The following is part of Cautela’s (1970c) treatment of smoking
for a client:
You are sitting at your desk in the office preparing your lectures for class. There is a pack of cigarettes to your right. While you are writing, you put down your pencil and start to reach for a cigarette. As soon as you start reaching for the
cigarette, you get a nauseous feeling in your stomach. You begin to feel sick to your stomach, like you are about to vomit.
You touch the package and bitter spit comes into your mouth. When you take the
cigarette out of the pack, some pieces of food come into your throat. Now you
feel sick and have stomach cramps. As you are about to put the cigarette in
your mouth, you puke all over the cigarette, all over your hand, and all over
the package of cigarettes. The cigarette in your hand is very soggy and full of
green vomit. There is a stink coming
from the vomit. Snots are coming
from your nose. Your hands feel all slimy and full of vomit. The whole desk is
a mess. Your clothes are full of puke. You get up from the desk and turn away
from the vomit and cigarettes. You immediately begin to feel better being away
from the cigarettes. You go to the bathroom and wash up and feel great being
away from the cigarettes.
There are many
advantages to covert sensitization, in general and in comparison to other forms
of aversive counterconditioning. One advantage is that it requires no apparatus
or drugs. A second advantage is that it can be made very specific, such as
gearing it toward eating the second piece of pie or drinking the second
manhattan when the treatment is geared toward reducing
over-eating or excessive drinking. Perhaps most important is that the client
can utilize the procedure on himself, permitting in vivo counter- conditioning
and the development of a powerful self-control skill.
Consider a female
college student who has trouble with over-eating. The cafeteria, snack bar,
vending machines, and food in her room all provide cues that cause her to
eat excessively and unwisely. Part of her treatment may involve covert sensitization,
perhaps with aversive scenes such as seeing her boyfriend with his arm around
another girl, laughing at how fat the client is. Now after a few treatment
sessions, the client may use these scenes in a self-control fashion. When
a candy bar in a vending machine calls out to her, she can switch to an imagined
scene to stop her desire for, or intent to get, the candy bar. With practice,
she may find that eventually she does not need to call up the whole aversive
scene, but can do it indirectly through a subjective feeling of “willing”
not to buy or eat something. With more time, she may find that her willing
becomes automatic and the whole process slides out of consciousness.
There are many problems,
primarily lack of research, in experimentally evaluating covert sensitization
and deciding among various theoretical explanations (see Mahoney, 1974a, p.
93—103). Most of the literature is case studies reporting varying degrees
of success. There are few systematic controlled studies; and covert sensitization
is often used with, and hence confounded with, other procedures. The fact
that the whole treatment takes place in the client’s imagination makes evaluation
of exactly what is going on very difficult. All the problems and theories
related to aversive counter- conditioning, discussed earlier, apply here.
In this context, I have described covert sensitization as an example of aversive
counterconditioning, while Cautela sees it as an example of operant punishment.
In practice it is usually possible to find elements of both of these. The
issue is which you emphasize.
The following is
a sample of some of the mixed reports on covert sensitization: In cases of
overeating covert sensitization is often part of a successful treatment program
(e.g., Cautela, 1966b). But some controlled studies have questioned its usefulness
(e.g., Diament & Wilson, 1975). Foreyt and Hagen (1973) compared covert
sensitization and a placebo control (imagining a pleasant scene rather than
an aversive one) for weight reduction. Both groups showed a significant decrease
in their perceived palatability of the foods imagined during treatment, but
no significant weight loss. The results were explained in terms of factors
such as suggestion and attention. Janda and Rimm (1972) found covert sensitization
effective in reducing eating and weight, but the results at the end of treatment
were only significant for those subjects reporting the highest degree of arousal
when presented with the aversive scenes. At a six-week follow-up the changes
for the entire group of covert sensitization subjects were significantly greater
than for the controls. Barrett and Sachs (1974) studied the effects on smoking
of covert sensitization. They compared four groups, a forward group (smoking
scene, then aversive scene), a backward group (aversive scene, then smoking
scene), a backward interval group (backward plus 60 seconds between scenes),
and a non-associative group (aversive scene only). They found all treatments
to be equally effective. They suggested their results were best explained
in terms of such variables as motivation or cognitive changes. In evaluating
all such research studies, it is important to keep in mind that covert sensitization
is Probably most effective when coupled with other treatment procedures, particularly
when dealing with complex self-reinforcing behaviors such as Over-eating,
smoking, and excessive drinking.
Overall, aversive
counterconditioning appears to be a potentially useful Component in the treatment
programs for some difficult behaviors. Evaluation, explanation, and improvement of aversive counterconditioning awaits further
research.
Procedurally,
aversive counterconditioning is
the counterconditioning of situations that elicit positive-approach behavior using an aversive event, such as
unpleasant reactions to certain
drugs, electric shock, pictures, odors, sounds, and responses of other people. Covert sensitization is aversive
counterconditioning in which the stimuli to be conditioned and the aversive
event are imagined scenes. In aversive counterconditioning, the aversive event is primarily respondently
associated with stimuli that tend
to elicit aspects of the undesired behaviors; while in operant punishment, the
aversive event is primarily associated with the occurrence of the undesired
behaviors and is usually used to suppress these behaviors. The offset of the
aversive event may be used to respondently condition positive effect to some
stimuli and/or operantly
reinforce some desired behavior. Theories of aversive counterconditioning include counterconditioning,
extinction, state theory, and cognitive theory. Although considerable more
research is needed, aversive counterconditioning appears to be an effective
component of many change programs, particularly when coupled with other approaches. This is especially true in dealing with
self-reinforcing behaviors that are difficult to reduce by other means.
|
1.
|
Give
three examples of aversive counterconditioning occurring naturally, that
is, without someone specifically setting up the contingencies. |
|
2.
|
Give
two different hypothetical clinical examples of aversive counterconditioning
using aversive events other than those mentioned in the chapter. |
|
3.
|
Outline an aversive counterconditioning program for smokers who come to your clinic. How would you maximize generalization to situations outside the clinic? |
|
4.
|
Outline
an aversive counterconditioning program for a hypothetical case of heroin
addiction, using hierarchies, in vivo conditioning, and respondent use
of the offset of the aversive event. |
|
5.
|
Outline a covert sensitization program for a hypothetical problem drinker. What other approaches (e.g., desensitization) may be part of your overall program? Why? |
|
6.
|
Using
a table or diagram, show the relationships among respondent conditioning,
counterconditioning, desensitization, and aversive counterconditioning. |
|
7.
|
What
are the implications of the fact that whenever you have aversive counterconditioning
you also have operant punishment? Give an example in which this would
be a serious problem. |
|
8.
|
Are
there any problem behaviors that are not self-reinforcing which you would
change by aversive counterconditioning? Explain your answer. |
|
9.
|
How important in aversive counterconditioning is the client’s motivation to change? How would a counterconditioning theorist answer this question differently from a cognitive theorist? |
|
10
|
There
have been several times in which a sex offender is offered the choice
of going to jail or going through aversive counterconditioning. Discuss
the ethical and practical issues involved. |
|
11.
|
Describe
an experiment that would distinguish, at least for one situation, between
a counterconditioning and state theory explanation of aversive counterconditioning. |
|
12.
|
Construct
a theory of aversive counterconditioning that incorporates counterconditioning,
sensitization, suppression, and self-control. |
Davison II, W. S.
Studies of aversive conditioning for alcoholics: A critical review of theory and research methodology. Psychological Bulletin, 1 974, 8 1, 571—581.
Hallam, R. S. & Rachman, S. Current status of
aversion therapy. In Hersen, M., Eisler, R. M., & Miller, P. M. (eds.), Progress in behavior modification. Vol. 2. New York: Academic Press, 1976.
Rachman, S. & Teasdale, J. Aversion therapy and behaviour disorders: An analysis. Coral Gables, Fla.: Univ. Miami Press, 1969.