Aversion therapy

Domain II · Behavioural & cognitive · 1930

What it is

Definition. Aversion therapy is an umbrella term for procedures that repeatedly paired a behaviour, urge or stimulus the treater wanted removed (drinking, smoking, sexual images, clothing, a fantasy) with something unpleasant: drug-induced nausea and vomiting, a drug-induced inability to move or…

Format

• The courses below are described as patients experienced them, as far as the sources allow. There was no shared protocol; British clinicians working on sexual orientation had no common protocol or ethical guidelines, and systematic follow-up existed only in research settings.
• Setting and staff: a private sanitarium or hospital ward; the treatment room was typically fitted out to resemble a bar, with the patient's usual drinks on display, and a nurse or physician present.

Who practises it, and how they are trained or regulated

• Alcohol, commercial and hospital (USA, 1935–2022): chiropractor Charles Shadel licensed an emetic programme in Seattle (1935) and opened the Shadel Sanitarium (1937), with Walter Voegtlin as medical director and psychiatrist Frederick Lemere as collaborator; the model spread to hospital chains such as Raleigh Hills (24 branches by 1983) and survived at Schick Shadel Hospital until it closed on 30 June 2022. Earlier…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

Problems the guide addresses

• Current positions
• Alternatives by former indication
• A client asks for aversion therapy
• Assessing and treating someone who went through it
• Ethical, reporting and legal duties

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.