Counterconditioning: therapeutic uses of this technique

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

In this article we will describe 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 briefly dwell on the definition of this concept and its historical journey.

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What is counterconditioning?

Counterconditioning is a psychological technique developed from the behavioral orientation that consists of delete an unwanted response and replace it with another more appropriate through the use of pleasant stimuli. It is applied with some frequency to treat irrational fears in both humans and animals, as well as addictions.

In this procedure, the person is exposed to the stimulus that is to be counterconditioned, and that causes an inappropriate response, while another stimulus of the opposite sign is also present. Thus, to make a phobic object less fearful, 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 this drink causes nausea, tachycardia and other unpleasant sensations. This makes alcohol less appetizing, so that the drinking behavior is counterconditioned by being associated with said physiological alterations.

A similar concept is extinction, which is part of the paradigm of operant conditioning. The difference is that the procedure extinction is the removal of a response by withdrawal of reinforcement that was previously contingent on its execution, and not on substituting said behavior for another, as happens in counterconditioning.

Historical development of this technique

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

Cover Jones used a nice meal for Peter as a substitution stimulus. First, the boy ate in the same room as a rabbit, even though the rabbit was a significant distance away. Gradually the animal came closer to little Peter; in the end the child was able to stroke it without showing any anxiety response.

The case of little Peter was a key milestone in the emergence of behavior therapy. Subsequently Joseph Wolpe, who developed the technique of systematic desensitization in the 1950s, using counterconditioning as a basis, he 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 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 the words of Wolpe himself, 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, it is not a necessary component, but could be replaced 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 counterconditioning. 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, expectation, or operant reinforcement of approach responses.

In any case, systematic desensitization has lost popularity in recent decades due to improvements in in vivo exposure techniques, which They have greater empirical support and are more efficient for treating irrational fears, as they are fundamentally based on the contributions of research. scientific.

aversive counterconditioning

The goal of aversive conditioning is the subject begins to associate an unwanted behavior with an unpleasant 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 elicit responses opposite to those of pleasure.

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

In the case of alcohol, as we have said previously, aversive therapies are used consisting of the consumption of drugs that, when interact with alcohol in the body, cause unpleasant physiological responses, mainly related to the system digestive. The two most used drugs in this regard are naltrexone and disulfiram.

It has also been used successfully aversive electrical stimulation therapy to treat consumption of tobacco, of dope and cocaine. On the other hand, compulsive habits such as onychophagia (nail biting) or trichotillomania (tearing the hair) can also be removed with aversive counterconditioning, although there are more tolerable.