Electrical Aversion

Description of the Strategy

Electrical aversion uses electric shocks to modify urges or behaviors considered unacceptable by the subject treated or others. With one strategy, contingent aversive conditioning, highly painful electric shocks are administered following the carrying out of the behavior. It is used to treat subjects whose behaviors are markedly injurious to others or more commonly to themselves, such as eye gouging or finger biting. When the treatment was introduced, the shocks were commonly administered by a cattle prod directly to the subject's limb, but subsequently they were delivered by remote-control devices. The aim of the shock was to produce immediate cessation of the behavior and prevent its future occurrence.

Other strategies that employed much lower levels of shock at a level determined by the subject to be painful but not unbearable were reintroduced in the 1950s by Wolpe. In one, anxiety relief therapy, subjects were instructed that the shock would be repeated in the treatment sessions and they were to endure it until their desire to have it stop became very strong, when they were to say aloud the word “calm.” The shock would then be immediately terminated. After 30 to 60 seconds, the procedure was repeated, 20 to 30 times at a session. The subjects were warned every time a shock was about to be administered, as otherwise some subjects became very anxious between shocks. It was reported that during the treatment, most subjects reported a feeling of relief at the cessation of the shock. This strength of the feeling was sometimes greatly out of proportion to the discomfort that went before. The aim was that when subjects experienced high levels of anxiety in the course of day-to-day experience, they could reduce this by saying to themselves the word “calm.”

Wolpe also reported studies using electric aversion to produce avoidance reactions to stimuli that he labeled obsessional. He administered an electric shock to the subject in the presence of the obsessional object, citing the successful use of the procedure in the 1930s for the treatment of both alcoholic addiction and fetishism. As used by Wolpe, the stimulus was presented not directly, but as a mental image, by asking subjects to imagine it. They were instructed to signal when the image was clear, when a severe shock was administered to their forearms. This was repeated 5 to 20 times in a session. Its successful use was reported with a woman with what was termed a food obsession. She found foods with a high salt content or that were fattening irresistibly attractive. Following treatment, she reported that on imagining any such food, she immediately had a feeling of fear and revulsion, accompanied by an image of the shock situation. She no longer experienced the previous misery of hours debating, “Should I eat; should I not?”

In the 1960s, electrical aversion was used mainly with the aim of converting homosexual to heterosexual preference in subjects, mostly men, who sought this. Initially, pictures of nude, same-sex people were associated with electric shocks. In an early study, a classical conditioning format was followed. The shocks were administered to the treated man's feet on about a quarter of the occasions immediately after the picture was shown. If the procedure acted by conditioning, the intermittent rather than invariable reinforcement would make the resultant response more resistant to extinction. Subsequently, it was argued that as photographs symbolized the behaviors to be reduced, words would be equally effective symbols and their use would avoid the necessity of obtaining suitable photographs. Presumably, the adherence to behaviorism then current made the use of mental images unacceptable. It was noted by some therapists that with the aversive classical procedure, as with anxiety relief, when subjects became aware that administration of the electric shocks had finished, they experienced great relief. This relief was added to the aversive procedure in a treatment termed aversion relief. With this therapy, subjects were shown a series of words or phrases every 10 seconds. All but the last word or phrase related to the behavior being treated, for example, “homosexual” or “looking at an attractive man.” The last phrase related to the behavior to be encouraged, such as “seeing an attractive woman.” Each time the subject saw a word or phrase, he read it aloud. In the original form, the subject received a [Page 276]painful shock to the feet, except when the last word was shown. It was reported that subjects quickly learned they received no shock with the last word and experienced marked relief. It was expected this relief would increase the attractiveness of the approved behavior. The series of words were shown five times in a session, which was carried out daily. Electrical aversion in either the classical conditioning or aversion relief format was subsequently used to reduce the likelihood of the treated persons carrying out behaviors they wished to cease, but could not. These included paraphilic behaviors, gambling, obsessive ruminations, and alcohol and other substance abuse.

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