Covert Sensitization: What It Is And How It Is Used In Therapy

Covert awareness

Covert conditioning consists of a type of conditioning in imagination, developed by Cautela. 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 the covert awareness 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.

Covert sensitization is a psychological technique used primarily in behavior therapy to help individuals overcome unwanted behaviors or addictions. By pairing undesirable behaviors with negative imagery or thoughts, this method aims to create an aversion to those behaviors. This article will explore the concept of covert sensitization, how it works, its applications, and its effectiveness in treating various issues.

Understanding Covert Sensitization

Definition of Covert Sensitization

Covert sensitization is a type of aversive conditioning that involves the use of mental imagery to create negative associations with specific behaviors. Unlike traditional sensitization, which relies on external stimuli to elicit responses, covert sensitization focuses on internal thoughts and imagery.

  • Internal Visualization: Patients are guided to visualize distressing or negative scenarios related to their undesirable behavior.
  • Goal of Conditioning: The objective is to weaken the behavior by associating it with unpleasant emotions or images.

How Covert Sensitization Works

Covert sensitization typically involves the following steps:

  1. Identification of Target Behavior: The individual identifies the behavior they wish to change, such as smoking, overeating, or engaging in risky behaviors.
  2. Imagery Training: The therapist guides the individual in creating vivid mental images associated with the negative consequences of the behavior. For instance, a smoker might visualize themselves developing severe health issues due to their habit.
  3. Reinforcement of Negative Associations: As the individual practices these mental images, the negative associations strengthen, making the undesirable behavior less appealing.

Covert sensitization: characteristics

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

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

Thus, covert sensitization is analogous to positive punishment, since aims to reduce 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 Systematic Desensitization (SD), that is, it would act in reverse, since what it attempts precisely is for the person to experience a certain degree of anxiety or discomfort (vs. relaxation of DS) against unwanted or pathological behaviors, so that their occurrence is inhibited.

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

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

Components

If we break down the term, we find that awareness, as its name indicates, involves becoming sensitive to certain stimuli or situations (that is, they end up generating aversion), and covert means that the technique is developed in the patient’s imagination, which implies that the patient will have to imagine “X” scenes or situations linked to an unpleasant sensation of disgust, shame, aversive, etc.

aversive stimulus

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

Maciá and Méndez described 3 especially repulsive scenes:

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

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

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Applications of Covert Sensitization

Covert awareness It is especially used in the field of addictions specifically towards the last phase of treatment, a time when the patient is intended to acquire a good degree of self-control in the face of environments, conditions or people that could lead to a relapse.

For example, a patient who suffers from alcoholism and who follows a covert sensitization procedure is induced to imagine situations where there are people drinking followed by others that he experiences as aversive, that produce disgust, degrade him greatly or make him feel embarrassed. .

If you apply this consistently and systematically (along with other psychological techniques if required for treatment), you can weaken your desire to consume alcohol in contexts similar to those you have imagined.

Treatment of Addictions

Covert sensitization is particularly effective in treating various addictions, including:

  • Substance Abuse: Individuals struggling with alcohol or drug addiction can benefit from visualizing the negative consequences of their substance use, such as health problems or social isolation.
  • Food Addiction: Those with compulsive eating behaviors may visualize the distressing physical effects of overeating, helping to reduce cravings and promote healthier choices.

Overcoming Phobias

Covert sensitization can also be applied to phobia treatment. By visualizing frightening scenarios and their potential negative outcomes, individuals can learn to associate their fears with discomfort rather than avoidance.

  • Fear of Heights: A person afraid of heights might visualize falling or experiencing panic in high places, which can help desensitize their fear response.
  • Social Anxiety: Individuals with social anxiety may visualize negative social outcomes, prompting them to confront their fears in real-life situations.

Behavioral Issues in Children

Covert sensitization can be used with children to address various behavioral problems, such as bedwetting or nail-biting.

  • Visualizing Consequences: By guiding children to visualize the embarrassment or discomfort associated with these behaviors, therapists can help them develop a desire to change.

Effectiveness of Covert Sensitization

Research and Evidence

Research on covert sensitization has shown promising results in treating a variety of behavioral issues. Studies indicate that this technique can effectively reduce unwanted behaviors and improve psychological well-being.

  • Success Rates: Many individuals report significant improvements in their behaviors following covert sensitization therapy, particularly in addiction treatment.
  • Long-Term Effects: The negative associations created through mental imagery can lead to lasting changes, helping individuals maintain their progress over time.

Limitations of Covert Sensitization

While covert sensitization can be effective, it is not without limitations.

  • Not Suitable for Everyone: Some individuals may struggle with visualization techniques, making it challenging to engage fully in the process.
  • Potential for Increased Anxiety: For certain individuals, focusing on negative imagery can exacerbate anxiety or distress rather than alleviate it.
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Covert Sensitization vs. Other Therapies

Comparison with Aversion Therapy

Covert sensitization is often compared to aversion therapy, which involves using unpleasant stimuli (such as electric shocks or nausea-inducing medications) to deter unwanted behaviors. However, covert sensitization relies on mental imagery rather than external aversive stimuli, making it less invasive and potentially more acceptable to patients.

Integration with Cognitive Behavioral Therapy (CBT)

Covert sensitization can be integrated with cognitive behavioral therapy (CBT) to enhance treatment outcomes. By addressing cognitive distortions and incorporating visualization techniques, therapists can provide a more comprehensive approach to behavior change.

  • Cognitive Restructuring: Combining CBT with covert sensitization can help individuals identify and challenge negative thought patterns while developing healthier associations with their behaviors.

Variants

Covert sensitization has two variants:

1. Assisted covert awareness

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

2. Vicarious covert sensitization

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

Disadvantages

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

Covert sensitization is a powerful therapeutic technique that leverages mental imagery to help individuals overcome unwanted behaviors and addictions. By creating negative associations with specific actions, this method aims to reduce their appeal and promote healthier choices. While it has shown effectiveness in various applications, including addiction treatment and phobia management, it is essential to consider individual differences and potential limitations. Ultimately, covert sensitization can be a valuable tool in the arsenal of behavior change strategies, especially when combined with other therapeutic approaches.

FAQs

What is covert sensitization?

Covert sensitization is a psychological technique that uses mental imagery to create negative associations with undesirable behaviors, aiming to reduce their appeal.

How does covert sensitization work?

It works by guiding individuals to visualize negative consequences associated with their target behavior, reinforcing aversive feelings toward that behavior.

What are some applications of covert sensitization?

Covert sensitization is commonly used in treating addictions, phobias, and behavioral issues in children.

Is covert sensitization effective?

Research has shown promising results, with many individuals reporting significant improvements in unwanted behaviors following covert sensitization therapy.

Can covert sensitization be combined with other therapies?

Yes, covert sensitization can be integrated with cognitive behavioral therapy (CBT) to enhance treatment outcomes and address cognitive distortions alongside behavior change.