Counterconditioning: therapeutic uses of this technique

This behavior modification technique is very effective in therapies against phobias and addictions.

Counterconditioning was one of the most significant techniques in the development of psychotherapy, especially for its pioneering use in the treatment of phobic anxiety. Although Mary Cover Jones was the first to use counterconditioning for this purpose, it was Joseph Wolpe for this purpose, it was Joseph Wolpe who popularized it within the framework of systematic desensitization.

In this article we will describe the therapeutic uses of counterconditioning in phobias and addictions.In relation to these, we will talk respectively about systematic desensitization and aversive counterconditioning. To begin with, we will stop briefly at the definition of this concept and its historical path.

What is counterconditioning?

Counterconditioning is a psychological technique developed from the behavioral orientation that consists of eliminating an undesired response and substituting it for another more more appropriate by means of the use of pleasant stimuli. It is frequently applied to treat irrational fears in humans and animals, as well as addictions.

In this procedure, the person is exposed to the stimulus to be counter-conditioned, which provokes an inappropriate response, while another stimulus of opposite sign is also present. Thus, to make a phobic object less frightening it could be associated with a relaxation response, such as Jacobson's progressive Muscle relaxation.

Similarly, in many cases of alcoholism, drugs such as disulfiram are prescribed, which when combined with alcohol causes nausea, tachycardia and other unpleasant sensations. This makes alcohol less palatable, so that drinking behavior is counterconditioned by being associated with such physiological alterations.

A similar concept is extinction, which is framed in the paradigm of operant conditioning. The difference is that the procedure of extinction consists of eliminating a response by withdrawing the reinforcement that was previously that was previously contingent to its execution, and not in substituting said behavior for another, as occurs in counterconditioning.

Historical development of this technique

In 1924 Mary Cover Jones used for the first time counterconditioning in the treatment of phobia in the famous case of little Peter, a child with a fear of rabbits. This researcher was the first to demonstrate the efficacy of the technique under reliable experimental conditions.

Cover Jones used a pleasant food for Peter as a replacement stimulus. At first the child ate in the same room as a rabbit, although the rabbit was at a significant distance. Gradually the animal was brought closer to little Peter; eventually the child was able to pet it without showing any anxiety response.

Little Peter's case was a key milestone in the emergence of behavioral therapy. Subsequently Joseph Wolpe, who developed the technique of systematic desensitization in the 1950's using the in the 1950s using counterconditioning as a basis, would refer to Mary Cover Jones as "the mother of behavior therapy".

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Role in systematic desensitization

Systematic desensitization is a technique that aims to reduce or eliminate anxiety and avoidance responses that are produced in the presence of an that occur in the presence of a phobic stimulus. It is based on the execution of behaviors incompatible with anxiety in order to replace it since, in Wolpe's own words, it is not possible to be relaxed and nervous at the same time.

In particular, Wolpe used the progressive muscle relaxation technique developed by Edmund Jacobson as an incompatible response. However, this is not a necessary component, but could be substituted by another relaxation method, such as slow, deep breathing, or any response that is not compatible with anxiety.

Although Wolpe attributed the usefulness of systematic desensitization to the counter-conditioning of responses opposite to those of anxiety, later authors have questioned this hypothesis. Thus, it has been proposed that the basis of this technique may be habituation, extinction, expectancy or operant reinforcement of approach responses.

In any case, systematic desensitization has lost popularity in recent decades due to the improvement of live exposure techniques, which have greater empirical support and are more efficient in treating irrational fears, being based mainly on scientific research contributions.

Aversive counterconditioning

The goal of aversive conditioning is the subject to associate an undesired behavior with an aversive stimulus, so that it loses its value as an aversive stimulus. stimulus so that it loses its value as a reinforcer. In the case of aversive counterconditioning this is achieved by pairing the behavior to be eliminated with stimuli that provoke responses opposite to those of pleasure.

The most common application of this technique is in the context of aversion therapy for aversive behavior. aversion therapy for addiction to substances such as alcohol, tobacco, tobacco addiction, alcohol, tobacco addiction, alcohol, tobacco addiction, alcohol and tobacco addiction. such as alcohol, tobacco, cannabis or cocaine. The consumption of the drug in question is identified with the undesired behavior, while the stimuli are usually other substances that react negatively to the former.

In the case of alcohol, as previously mentioned, aversive therapies are used, consisting of the consumption of drugs that, when interacting with alcohol in the organism, provoke unpleasant physiological responses, mainly related to the digestive system. The two most commonly used drugs in this regard are naltrexone and disulfiram.

Aversive electrical stimulation aversive therapy aversive electrical stimulation therapy has also been used successfully to treat tobacco, marijuana and cocaine use. tobacco, marijuana and cocaine use. On the other hand, compulsive habits such as onychophagia (nail biting) or trichotillomania (hair pulling) can also be eliminated with aversive counterconditioning, although there are more tolerable procedures.