Covert sensitization: what it is and how it is used in therapy

Covert conditioning is a type of conditioning in imagination, developed by Caution. It is based on the fact that cognitive activity follows the same laws as observable responses, the only difference being the degree of accessibility.

In this article we will know covert sensitization, a technique typical of this type of conditioning, where the objective is to develop an aversion response towards a stimulus that was previously a source of attraction.

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Covert Sensitization: Characteristics

Covert sensitization is a type of covert conditioning technique. It is an intervention strategy belonging to behavioral and cognitive models, and consists of imagined repetitions of the problem behavior paired with symbolic aversive events.

The goal of covert sensitization is to cause the patient some degree of inhibition in potentially harmful behaviors and that the patient does not want, such as smoking, drinking alcohol, some type of sexual deviation such as pedophilia or eating compulsive.

Thus, covert sensitization is analogous to positive punishment, since it intended to decrease the probability of occurrence of the behavior, through the presentation of an imagined aversive stimulus, immediately after the occurrence (also imagined) of that behavior that we want to eliminate. That is, it is indicated to modify maladaptive or dysfunctional behaviors.

How does it work?

It is a procedure that would consist of the “opposite” of the Systematic Desensitization (DS), that is, it would act the other way around, since what it intends is precisely for the person to experience a certain degree of anxiety or discomfort (vs. the relaxation of the DS) against unwanted or pathological behaviors, so that their occurrence is inhibited.

But how does the technique actually work? Covert sensitization is focused on alter symbolic representations or mediators of unwanted activity or behavior, so its effectiveness depends on that behavior having such symbolic representations; that is, it is important that we are not dealing with automatic behavior.

Thus, the individual imagines himself carrying out the behavior whose frequency he intends to reduce, starting to imagine, contingently and abruptly, some aversive event that this behavior could produce, or an event that, although unlikely, is highly aversive for the subject.

Components

If we break down the term, we find that sensitization, as its name suggests, involves becoming sensitive to certain stimuli or situations (that is, they end up generating aversion), and covert means that the technique takes place in the patient's imagination, which implies that the patient will have to imagine scenes or situations "X" together with an unpleasant feeling, disgust, shame, aversive, etc

aversive stimulus

It is important to correctly choose the aversive stimuli, and that they really are for the subject. You can even ask the subject directly about unpleasant situations or images.

Maciá and Méndez described 3 especially repulsive scenes:

• The mouth of an old man expectorating.
• A dead animal in an advanced state of decomposition.
• An infected wound.

On the other hand, another author, Costa, in a change of sexual tendency, used a homosexual person who was discovered with another by the girl he was attracted to. For his part, Leitenberg believes that for pedophile problems, one should choose the image that is most effective for the customer.

Caution uses the sensation of vomiting embellished with all sensory modalities as an aversive stimulus, and Mckay proposes a list of repulsive and terrifying thoughts.

Applications

covert sensitization It is used especially in the field of addictions, specifically towards the last phase of the treatment, moment in which the patient is tried to acquire a good degree of self-control before the environments, conditions or people that can lead to a relapse.

For example, a patient suffering from alcoholism and who follows a covert sensitization procedure, is led to imagine situations where there are people drinking followed by others that he experiences as aversive, disgusting, demeaning, or putting him off shame.

If this is applied consistently and systematically (together with other psychological techniques if required to treatment), it may be possible to weaken their desire to consume alcohol in contexts similar to those they have experienced. imagined.

variants

Covert sensitization has two variants:

1. Assisted Covert Sensitization

In this case, the aversion to the stimulus is strengthened by the use of an electric shock or unpleasant smelling substance. That is, some kind of real stimulation is applied.

2. Vicarious covert sensitization

Here the subject imagines another person executing the behavior and receiving the aversive punishment or stimulus for it.

Drawbacks

The problem with covert sensitization (as well as other aversive techniques) is the hostility, rejection, aggressiveness or lack of cooperation that the patient may manifest. For this reason, it will always be necessary to reinforce the adaptive aspects of the behavior that we want to increase.