Counterconditioning is an aspect of behavior therapy that involves weakening or extinguishing an undesired response by introducing and strengthening a second response that is incompatible with it.

The type of counterconditioning most widely used for therapeutic purposes is systematic desensitization, which is employed to reduce or eliminate fear of a particular object, situation, or activity. An early example of systematic desensitization was an experiment that is also the first recorded use of behavior therapy with a child. In a paper published in 1924, Mary Cover Jones, a student of the American behaviorist John Watson (1878–1958), described her treatment of a three-year-old with a morbid fear of rabbits. Jones countered the child's negative response to rabbits with a positive one by exposing him to a caged rabbit while he sat some distance away, eating one of his favorite foods. The boy slowly became more comfortable with the rabbit and the cage was gradually moved closer, until he was eventually able to pet it and play with it without experiencing any fear or anxiety.

In the 1950s, South African psychiatrist Joseph Wolpe (1915–97) pioneered a prototype for systematic desensitization that continued to be used into the early twenty-first century. Like Cover's experiment, Wolpe's technique involved gradually increasing the intensity of exposure to a feared experience. However, instead of countering the fear with a pleasurable stimulus such as food, Wolpe countered it with deliberately induced feelings of progressive relaxation. He had the client imagine a variety of frightening experiences and then rank them in order of intensity. The client was then trained in progressive deep muscle relaxation and instructed to practice it as he systematically and hierarchically imagined the experiences he had described, moving gradually from the least to the most frightening. Systematic desensitization of the type pioneered by Wolpe is used with both adults and children. In adults, uses range from overcoming phobias, such as fear of snakes or flying, to increasing tolerance of pain from chronic illnesses, ongoing painful or frightening medical procedures, or natural childbirth. In children, it is used to overcome a wide variety of fears, such as fear of certain animals, fear of various types of medical procedures, or fear of the dark.

Another type of counterconditioning is aversive conditioning, which renders a particular behavior unappealing or even aversive by pairing it with a highly unpleasant stimulus. Aversive conditioning has been effectively used in adults to combat addictions to substances such as tobacco, illicit or prescription drugs, and alcohol. Individuals with substance dependence are sometimes given a drug that induces nausea contiguous in time or immediately subsequent to substance use, to eliminate the positive feelings associated with addictive behavior.

See also Cognitive behavior therapy; Conditioning ; Desensitization .



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