Research

The information contained below is not a claim of the efficacy of Aversion therapy, as there have already been multiple studies that indicate Aversion Treatment is the most effective intervention tool to reduce deviant arousal.

 

Below is an introduction to aversion therapy and a comparison of aversion therapy tools in the Aversion Treatment Process.

  

Aversion Therapy

 

For over 40 years, aversive techniques to alter unwanted behavior have been widely reported.  Among the most common techniques to have been used are Olfactory and Gustatory.  Olfaction is the ability to perceive and distinguish odors, where Gustation is the ability to perceive and relate to the sense of taste (Scientific Medical Dictionary 2010). 

 

Both Olfactory and Gustatory aversion involves the temporary pairing of foul smells or tastes with either the fantasized or actual performance of the behavior, which typically results in the reduction, or even elimination, of that behavior.

 

Since the beginning of behavioral therapy there have been attempts to use aversion therapy to suppress over eating, nail biting, pulling of hair, and unhealthy sexual behaviors (to name a few).  The earliest known application to sexual behavior was by Colson (1972) who had a homosexual client who would inhale aversive odors when he was experiencing unwanted sexual fantasies.  Maletzky (1973) believed that there was more to human behavior than just the conditioning of the physical and believed the cognitive motivators of behavior also needed to be present; thus “assisted” covert sensitization was introduced. 

 

Throughout the 1970’s and 1980’s Maletzky continued his research of Olfactory and Gustatory aversion on individuals who experienced the desire to participate in exhibitionism, sadomasochism, and violent rape fantasies.  In 1977 Levion, Barry, Gambaro, Wolfinsohn, and Smith used Maletzky’s procedure with individuals who met the criteria of pedophilia.  Unfortunately, these studies did not measure treatment progress with penile erection measures, but did conclude longer term improvements in societal involvement and recorded self-report data from the client.

 

 

Aversion Procedure

 

Starting in 1978, Laws, Meyer, and Holman created the first standardized procedure technique that is continued to be used today (Laws 2000).  It is when an aversive taste, smell, or electric shock is repeatedly paired with the deviant (or unwanted) sexual stimuli.  The procedure reliably suppresses sexual arousal elicited by those stimuli within a few weeks (some clients took longer).

 

There are some variations of how the procedure should be conducted.  Ideally, a clinic should be relying on empirical data through every step; using the bio-physiological feedback assessment tools that are available to the practicing clinician – the best assessment tool has been the penile plethysmograph (PPG).  Many clinics are now using a Visual Response Time assessment (VRT) such as the Abel Assessment of Sexual Interests®.  During the initial assessment a baseline of how strong an attraction or reaction is toward deviant and non-deviant arousal is taken.  Treatment has been seen to take place up to 3 times a week with the client being monitored on the PPG; however, it is typically seen that the client will perform the technique as “homework” between weekly sessions (this was necessary for a number of reasons, i.e. clinicians time, cost, lab scheduling, etc). In situations where a PPG is not available, the client works with the clinician to identify the proper time of application of the aversion.

 

Clinicians have used a wide variety of aversive tools, including: rancid meat, smelling salts, foul tasting fruit, ammonia, and some have even allowed the client to make their own “mixture”.  At the designated time, the client will apply the aversion (smell or taste) to begin to pair the unpleasant with something they have believed to be pleasant.  In 2012 there were a reported 45 lawsuits filed against practitioners for causing damage to a client by not monitoring the “mixture” which the client was using (Meyers 2013).

 

 

Effects of the Procedure

 

Due to the lack of standardization of aversion tools being used in the process, research has been unable to reliably produce consistent data on the individual steps and what tools have been proven to be most effective. However, there has been great success at reducing sexual recidivism in sexually deviant offenders even without the recording of the standardization of aversion tools.

 

For this report, a combination of 20 clinics and correctional facilities provided data without our knowledge of what groups used what aversion tools.  Each facility performed their individual research on their clients and made the data available to AversX.  AversX supplied the intervention tools at a discounted rate for compensation of allowing the data to be provided from the participants.  Any IRB issues and procedures were the responsibility of the practicing clinician and/or facility.

 

There were a total of 348 individuals who met the criteria for aversion treatment (those who reached over 20% reaction on the PPG toward deviant stimulus).  Of those, it was discovered that 36 participants refused to participate in any aversion therapy and 14 were unable to finish the study due to incarceration sentences which allowed the client to be released early from their lock down facility and were unable to begin treatment in a clinic which provided a structured aversion program to address their deviant sexual interests in a timely manner.

 

With a total of 298 participants, each facility randomly assigned clients to use one of three different aversion tools.  It was found to be each group was very closely paired up with a certain tool, with only a plus or minus of a few participants in each group. 

 

Group A had a total of 109 adult males who used a “homemade” mixture where the client was instructed to go and find something that smelled very unpleasant to them.  Some examples of these mixtures included a rancid piece of pork in a jar, a pig fetus preserved with formaldehyde in a jar; most commonly, standard cleaning agents were mixed into a jar or container of some varying design and would open the container and inhale the aversion tool they created at the designated time. 

 

Group B had 88 adult males who were required to use a standard (and common) tool currently used in the field of aversion therapy: Ryzomus Coptis (imported directly to the US from China in solid form, not powder or shavings), this is also known as “bitterroot”.  Each client was provided a 6” length of root of similar diameter along with a sealable bag to transport.  The client would bite a small portion of the root at the designated time.

 

Group C had 101 adult males and were each given AversX Mouth Spray in the standard 1.0 oz spray bottle.  The client would spray the product into the mouth at the designated time.

 

All three groups were instructed at the same time in the same manner (using a script) on how and when to use the aversion.  All clinicians were trained by AversX clinical staff prior to the data being collected.  All participants were provided the AversX STAMP® manual to work with their clinician over the next 6 weeks, along with an AversX Mobile Pack® and AversX STAMP Progress Log. 

 

Over the course of the next 6 weeks, clients participated in both individual therapy sessions and group therapy sessions.  Individual sessions included the reporting of deviant fantasies, situations and/or triggers they encountered during the week and their progress log was reviewed on how and what intervention tool was used.  Minor adjustments were made accordingly to gain maximal benefit of the client created deviant fantasy (instructed to apply the aversion at a more appropriate point).  Group sessions included discussion of client’s reports of how successful they felt during their week of overall interactions with others and any insights to what they learned about themselves.

 

Each client was again administered a PPG two weeks into the overall 6 week gathering of data.  It was reported:

 

 Group A showed an overall decrease of deviant arousal of 8% from the baseline.

 Group B showed an overall decrease of deviant arousal of 25% from the baseline.

 Group C showed an overall decrease of deviant arousal of 57% from the baseline.

 

At four weeks into the overall six week gathering of data, another PPG was administered and it was reported:

 

Group A showed an overall decrease of deviant arousal of 12% from the baseline.

Group B showed an overall decrease of deviant arousal of 29% from the baseline.

Group C showed an overall decrease of deviant arousal of 72% from the baseline.

 

At the end of 6 weeks a final PPG was administered where data showed:

 

Group A showed an overall decrease of deviant arousal of 14% from the baseline.

Group B showed an overall decrease of deviant arousal of 30% from the baseline.

Group C showed an overall decrease of deviant arousal of 84% from the baseline.

 

 

What was also measured during these sessions was the clients increase to what is considered appropriate arousal, overall, it was reported to us by the clinics and correctional facilities that:

 

Group A showed an increase of appropriate arousal from the baseline of 22%. 

Group B showed an increase of appropriate arousal from their baseline of 31%. 

Group C showed an increase of appropriate arousal from their baseline of 67%.

 

 

Arousal Program Completion is allowed after the client showed no clinically significant arousal to deviant stimuli (less than 19.99% arousal) and showed an increase of appropriate arousal (higher than 20%)

 

Group A completed 2 clients

Group B completed 27 clients

Group C completed 68 clients

 

 

Why does Aversion treatment work?

 

Maletzky (1980, 1991, 1997) has provided some of the most important data as to why this procedure works.

               

“With direct neural connections between the olfactory epithelium, the first – or olfactory – cranial nerve, the olfactory bulbs, and the limbic system of the brain, there is possibly a directly unlinking of sexual arousal previously bonded to a deviant (or theoretically non-deviant) stimulus.  In contrast, the physical irritant, such as ammonia, produces a burning sensation transmitted from submucosal elements via the fifth, or trigeminal, cranial nerve to the thalamus.  This may be a factor limiting its efficacy in deconditioning work.”

 

  

Conclusions:

 

There is no program that every individual client will relate to and embrace.  There are many different reasons why an individual engages in unhealthy sexual behaviors, typically, it is due to power and control; however, when a client is exposed to certain behaviors time and time again, the human brain “learns” how to get maximal benefit from the least amount of effort.  What a human learns, a human can unlearn.

 

From the data that was received from the three different groups who were already required to participate in their court mandated treatment, we can see clearly that there is efficacy in how and what the tools that are used.

 

It was found that Clients in Group A did not always comply with what they were instructed to do.  Some found their “mixture” to be what is considered “invasive” to those around them.  Clients reported during their first week that many strangers asked them what they were doing, which caused social discomfort and increase of shame – Progress notes indicated the struggle, most clients admitted to falsifying their progress logs each week to their clinician.  It was found that less than 14% were in compliance with recording their progress and only 8% were found to be administering their aversion tool on a consistent basis.

 

In Group B it was found that 92% of those participating were using their aversion and 82% were recording their compliance.  Upon further review, it was shown in Group B that the Ryzomus Coptis had a very short ½ life.  When the Ryzomus was tested at the beginning of the 6 weeks, it was already almost at its half-life potency.  So when a client would administer their aversion, the potency of the aversive tool was continually decreasing in strength and impact.  It was seen as convenient to carry with them and compliance was observed.

 

Group C showed that 95% of those participating were using their aversion and 88% were recording their compliance and progress in their logs.  All but 13 clients used no more than one 1 oz bottle of mouth spray, 7 clients were provided another bottle before they ran out so there was no interruption of applying the aversive tool.  6 clients allowed their bottles to run out and averaged 4 days of interruption in their treatment.  There were no signs of the AversX Mouth Spray being tampered with or diluted at the end of the 6 week process.

 

 

It is concluded that with the vast research that has been available that Aversion Therapy works; however, there is a lack of standardization in procedure and tools being used.  The method that AversX employs is a mixture of both cognitive and behavioral interventions to eliminate deviant sexual interests, and as the interests are removed, healthy interests are introduced and rewarded.

 

The procedure has already been identified by Malesky (1997) that it is the “least cumbersome” and falls in to the idea that the client can now take control over their own progress and are active participants instead of what some have called “lab rats” (Laws, 1987).  AversX hopes to make this procedure even less cumbersome and readily available at the exact time the client requires it.

 

As with any therapeutic technique, the involvement of the client and the relationship a client has with their practitioner is the greatest indicator of positive outcome. It is believed that AversX allows the relationship between the client and the practitioner to be more positive and quantifiable with direct feedback being given in the most effective manner.  The client can participate in their individual session with a sense of purpose and reports the data accordingly.

 

AversX attempts to provide the client the opportunity, as Laws (1980) has suggested, to develop their own strategy of self control by teaching and observing the client as the implement the STAMP protocols.  By so doing, the client has greater potential for a more productive and healthy life.

 

AversX also wants to help the practicing clinician avoid potential legal issues that can present themselves by not using a safe and fully tested aversion tool.

 

Acknowledgements

 

Thanks to all the clinics and correctional facilities that participated.  After this 6 week period, AversX was offered to all clients wishing to continue their treatment.  All remaining clients who did not complete their program opted to use the AversX tool. 

 

Due to the sensitive nature of this procedure, and due to clinics potentially being promoted, it was decided that no facilities which participated will be identified in this writing.

 

We appreciate all the hard working clinicians who take on this very noble task of helping clients overcome their struggles.  It is often a thankless job that if they do their job right and help empower the client to do what they need to in order to own their own insights and progress.

 

  

Please click HERE to order the STAMP treatment program or contact stephen@aversx.com to schedule a training seminar.