Last Updated on February 21, 2023 by Mike Robinson
Covert sensitization is a therapy for changing behavior. It is based on learning theory, which says we learn all our behaviors. Therefore, we can unlearn behaviors under the right conditions.
Covert sensitization is one of a group of behavior therapy procedures classified as “covert conditioning,” in which we combine an aversive stimulus in the form of nausea- or anxiety-producing image along with an undesirable behavior to change that behavior.
Types of Behaviors to Change
It’s best to consider it a combination of classical and operant conditioning. The Covert Conditioning Handbook, written in 1986 by psychologists Joseph Cautela and Albert Kearney, is still the best book. It is based on research that began in the 1960s.
The goal of covert sensitization is to eliminate bad behavior directly. This differs from insight-oriented psychotherapies, which try to get people to change by revealing their unconscious reasons.
Examples of maladaptive approach behaviors that need to change:
- Drinking too much
- Using drugs
- Smoking
- Pathological gambling
- Overeating
- Sexual deviations
- Sexually based nuisance behaviors, like making obscene phone calls.
How Does Covert Sensitization Work?
Covert sensitization uses aversive imagery to reduce the occurrence of an undesired response. Here’s how it’s done: obtain six index cards. Write a brief description of a scene related to the habit you wish to control on each card. The scene should be so disturbing or disgusting that thinking about it would temporarily make you uncomfortable about indulging in the habit.
Real Life Examples
If you are trying to quit smoking, you might write these statements on your cards. They will provide vivid and powerful messages.
- “I am in a doctor’s office. The doctor looked at some reports and told me I had lung cancer. She says a lung must be removed and sets a date for the operation.”
- “I am in a bed under an oxygen tent. My chest feels caved in. There is a tube in my throat. I can barely breathe.”
- “I wake up in the morning and smoke a cigarette. I began coughing up blood.”
- “My lover won’t even kiss me because my breath smells bad.”
Other behaviors you wish to change would continue along the same path.
For overeating, the cards might read like this:
- “I am at the beach. I get up for a swim and overhear people whispering to each other. Isn’t that fat and disgusting?”
- “I am at a store buying clothes. I try on several things that are too small. The only thing that fit looks like a tent. Salespeople are staring at me.”
- “I can’t fit into my seat at the movies.”
How to Use the Visualization Cards
Next, make a rule: before you can get a cup of coffee or get up from your chair, or whatever you have selected as a cue, you must take your cards.
You then must vividly picture yourself engaging in the action you wish to curb (eating or smoking, for example). Then vividly visualize the scene described on the top of the card. Imagine the scene for 30 seconds.
After visualizing the top card, move it to the bottom to rotate the cards. Make up new cards each week. It would be best if you made the scenes as upsetting as possible. The more disturbing the visual is, the more effective it will be.
Covert Sensitization Improves Self-Control
Covert sensitization can also be used directly in situations that test your self-control. If you are trying to lose weight, you can turn down attempting dessert in this way: as you look at the dessert, visualize maggots crawling all over it.
When you make this image as vivid and disgusting as possible, losing your appetite is almost certain. If you want to apply this technique to other situations, be aware that vomiting scenes are especially effective.
Conclusion
Covert sensitization may sound like you’re playing games with yourself, but it can be a great help to reduce a bad habit.
The treatment depends on the type of behavior that needs changing and the features of the aversive imagery the person will use. You often receive the treatment outside a hospital, either alone or as part of a multimodal program. Homework assignments that the person has to do on their own are almost always part of the treatment plan. Some therapists use covert sensitization along with hypnosis because they think it will improve the results.
