Covert awareness: what it is and how it is used in therapy
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 learn about covert awareness , a technique specific to this type of conditioning, where the aim is to develop an aversion response to a stimulus that was previously a source of attraction.
Covert awareness: characteristics
Covert sensitization is a type of technique used in covert conditioning. It is an intervention strategy belonging to the behavioural and cognitive models, and consists of imagined repetitions of the problem-behaviour paired with aversive symbolic events .
The goal 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 kind of sexual deviance such as pedophilia, or compulsive eating.
Thus, covert awareness is analogous to positive punishment, since aims to reduce the probability of occurrence of the behaviour , by presenting an imagined aversive stimulus, immediately after the occurrence (also imagined) of that behaviour 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 the opposite way, since what it tries precisely is that the person experiences a certain degree of anxiety or discomfort (vs. relaxation of SD) in the face of undesirable or pathological behaviors, so that the occurrence of these is inhibited.
But how does the technique work concretely? Covert awareness is focused on altering the symbolic or mediating representations of the undesired activity or behaviour , so its effectiveness depends on the fact that this behaviour has such symbolic representations; that is, it is important that we are not facing an automatic behaviour.
Thus, the individual imagines himself performing the behavior whose frequency he intends to reduce, and then imagines, in a contingent and abrupt way, some aversive event that this behavior could produce, or an event that, although unlikely, turns out to be very aversive for the subject.
Components
If we break down the term, we find that sensitization, as its name indicates, implies 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 scenes or situations “X” linked to an unpleasant sensation, of disgust, shame, aversion, etc.
Aversion Stimulus
It is important to choose correctly the aversive stimuli, and that they are really so for the subject. You can even ask the subject directly about situations or images that he finds unpleasant .
Maciá and Méndez described three particularly repulsive scenes:
- The mouth of an old man expectorating.
- A dead animal in an advanced state of decomposition.
- An infected wound.
On the other hand, another author, Costa, in a change of sexual tendency, used a homosexual person who was discovered with another by the girl he was attracted to. On the other hand, Leitenberg, thinks that for problems of paedophilia one should choose the image that is more effective in front of the client .
Caution uses as an aversive stimulus the sensation of vomit adorned with all sensory modalities, and McKay proposes a list of repulsive and terrifying thoughts.
Applications
Covert sensitization is used especially in the area of addictions , specifically towards the last phase of treatment, when the patient is attempting to acquire a good degree of self-control in the face of environments, conditions or people that may lead him/her to relapse.
For example, a patient who suffers from alcoholism and who follows a procedure of covert sensitization, is induced to imagine situations where there are people drinking followed by others that he experiences as aversive, which disgust him, degrade him a lot or make him feel ashamed.
If you apply this consistently and systematically (along with other psychological techniques if required for treatment), you may succeed in weakening your craving for alcohol in contexts similar to those you have imagined.
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 . In other words, some kind of real stimulation is applied.
2. Vicarious covert awareness
Here the subject imagines another person performing the behavior and receiving the punishment or aversive stimulus for it .
Disadvantages
The problem of covert sensitization (as well as other aversive techniques) is the hostility, rejection, aggressiveness or lack of cooperation that the patient may manifest .
Therefore, it will always be necessary to reinforce the adaptive aspects of the behaviour that we want to increase.
Bibliographic references:
- Dahab, J., Rivadeneira, C. and Minici, A. (2005). The techniques of covert conditioning. Journal of cognitive behavioural therapy CETECIC.
- Vallejo, B.A. (2012). Manual of Behavioral Therapy. Volume I. Madrid: Dykinson (Issues 6-12).