Counterconditioning was one of the most significant techniques in the development of psychotherapy, especially because of its pioneering use in the treatment of phobic 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 the therapeutic uses of counter-conditioning in phobias and addictions ; in relation to these we will talk respectively about systematic desensitization and aversive counter-conditioning. To begin with, we will briefly consider the definition of this concept and its historical development.

What is counter-conditioning?

Counterconditioning is a psychological technique developed from behavioural orientation that consists of eliminating an undesired response and replacing it with another more appropriate by using pleasant stimuli. It is applied with certain frequency to treat irrational fears in both human beings and animals, as well as addictions.

In this procedure the person is exposed to the stimulus to be counter-conditioned, which provokes an inappropriate response, while another stimulus of opposite sign is also present. Thus, to make a phobic object less scary 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 cause nausea, tachycardia and other unpleasant sensations. This makes the alcohol less palatable, so that the drinking behaviour is counter-conditioned when associated with such physiological alterations.

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

Historical development of this technique

In 1924 Mary Cover Jones first used counter-conditioning 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 effectiveness of the technique in reliable experimental conditions.

Cover Jones used a nice meal for Peter as a replacement incentive. First the boy ate in the same room as a rabbit, although the rabbit was a significant distance away. Gradually the animal came closer to little Peter; eventually the child was able to pet it without showing any anxiety response.

The case of little Peter was a key milestone in the emergence of behavior therapy. Later Joseph Wolpe, who developed the technique of systematic desensitization in the 1950s using counter-conditioning as a basis, would refer to Mary Cover Jones as “the mother of behavior therapy.

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 behaviours incompatible with anxiety in order to substitute it since, in Wolpe’s own words, 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, this 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 the counter-conditioning of responses opposed 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 operative reinforcement of the approach responses.

In any case, systematic desensitization has lost popularity in recent decades due to the refinement of live exposure techniques, which have greater empirical support and are more efficient at addressing irrational fears, as they are based primarily on the contributions of scientific research.

Aversive counter-conditioning

The goal of aversive conditioning is to make the subject associate an unwanted behavior with an unpleasant stimulus so that it loses its value as a reinforcer. In the case of aversive counter-conditioning, this is achieved by matching the behaviour to be eliminated with stimuli that provoke responses opposite to those of pleasure.

The most common application of this technique is in the context of aversion therapy for substance addiction such as alcohol, tobacco, cannabis or cocaine. The use of the drug in question is identified with the undesired behaviour, while the stimuli are usually other substances which react negatively to the first one.

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

The aversive electrical stimulation therapy has also been successfully used to treat the use of tobacco, marijuana and cocaine. On the other hand, compulsive habits such as onychophagia (nail biting) or trichotillomania (hair pulling) can also be eliminated with aversive counter-conditioning, although there are more tolerable procedures.

Bibliographic references:

  • Cover Jones, M. (1924). A Laboratory Study of Fear: The Case of Peter. Pedagogical Seminary, 31: 308-315.
  • Rutherford, A. (2010). Profile of Mary Cover Jones. In A. Rutherford (Ed.), Psychology’s Feminist Voices Multimedia Internet Archive. Retrieved from http://www.feministvoices.com/mary-cover-jones/
  • Wolpe, J. (1969), The Practice of Behavioral Therapy. New York: Pergamon Press.