Habit reversal technique: what it is and how is it used

Tics can be behaviors that, although simple, can involve a significant degree of discomfort in the person exhibiting them.

It is for this reason that in psychotherapy one generally works on them starting from the habit reversal technique, A tool that allows you to introduce a behavior that prevents the appearance of the tick or an unwanted habit. Let’s see what this technique consists of.

    What is the habit reversal technique?

    The habit reversal technique is a type of behavior therapy that it has been shown to be very effective in extinguishing repetitive behaviors, harmful habits and tics.

    This technique was originally developed by NH Azrin and RG Nunn, and is often used in people who perform actions that cause problems both to their physical and mental health, as well as to a high degree of interference in their social life. Among these problematic behaviors, we can find all kinds of tics, torn hair (trichotillomania), nail biting (onychophagia) or pinching the skin. The therapy is suitable for any age group and socioeconomic background.

    It is a procedure composed of five phases which add up to a total of eleven techniques, according to the proposal raised by Azrin and Nunn in 1973.

    1. Awareness

    At this stage it’s done that the person becomes aware of the stimuli and the situations which can favor the appearance of a harmful tic, A habit or pattern of unwanted behavior that causes some kind of harm to himself and others.

    It is here that a detailed description of the behavior to be quenched is made, and training is encouraged that prompts the person to take a voluntary solution to the problem.

    In addition, the person is trained to be aware of when they are performing the tic and to be able to detect the background that encourages their appearance.

    2. Relaxation training

    Habits or tics can be common when the person is under high stress.

    It is for this reason that it can be very useful to learn skills that help you relax, such as deep breathing, imagining pleasant places, mindfulness, or techniques such as yoga and relaxation. meditation.

      3. Training to make an answer incompatible with the habit

      At this stage it causes the person to develop non-harmful behavior that prevents the onset of the habit which must be turned off.

      To do this, the new behavior must meet the following characteristics:

      • This prevents the tic / habit from appearing.
      • Let it last for several minutes.
      • This raises awareness of problematic behavior.
      • Be socially acceptable.
      • Be compatible with normal activity
      • This encourages the antagonistic muscles of unwanted tic / habit behavior.

      4. Motivation

      this phase it is aimed both at the patient and his immediate entourage, generally his family.

      It reviews the drawbacks of the tic or habit problem, encourages social support, encourages one or more people around them to get involved and contribute to the success of the therapy.

      5. General training

      It consists of performing exercises in which the patient must imagine performing the technique in hazardous situations identified in the first phase.

      Disorders in which it is used

      The habit reversal technique it is generally used in all disorders in which there are tics. It should be understood that a tic is a series of movements, more or less involuntary and repetitive, or inappropriate vocalizations which are not typical behaviors for the contexts in which they occur.

      Tics represent a group of interrelated disorders, which include Tourette’s syndrome, obsessive-compulsive disorder, and other anxiety disorders, such as generalized anxiety, social phobia, and post-traumatic stress disorder.

      However, this therapy is particularly useful in trichotillomania and onychophagia, behaviors which, although depending on the degree to which they occur, can be considered more or less severe, are essentially tics. This technique has been shown to be effective in preventing these behaviors, which involve varying degrees of harm to a person’s life.

      Use in trichotillomania

      Trichotillomania is a disorder in which the person suffers from a chronic stress to tear their hair, which involves loss, notoriously, of hair, as well as stress and social problems. In this behavioral disorder not only the hair is plucked, but also a ritual with plucked hair is usually performed, Such as eating the root, palpating the lips, or plucking other hair that “meets the desired characteristics.”

      While this may seem like a rare and quite rare problem, the truth is that it is one of the most common pathological behaviors, with a prevalence between 0.6% and 2.5% of the general population. . It is especially high in high stress groups such as people with psychopathology, students, or people with severe neurosis.

      This is why the habit reversal technique is often used in people who exhibit these types of tics. In this particular case, the patient is shown why he chooses to pull his hair out, he is told how stressful situations occur and what prompts him to choose this behavior. and not for a healthier one, like chewing gum or trying to relax. It’s about incorporating behavior that prevents the person from tearing their hair out.

      Use in addictions

      This technique is also used in situations of substance dependenceAs is the case with addictions, the patient, aware that he has a problem and has overcome it, consciously tries to stop using. However, there are certain behaviors that are difficult for you to overcome, either because you think they have nothing to do with your problem or because you have automated them so much that there is no way. for you to turn them off.

      Among these behaviors we could find, for example, lighting a cigarette the same way he did with a “leek”, entering the same bars where he got drunk, although now only takes the little- lunch, stay in touch with the people who introduced him to addiction …

      These problems are generally the subject of interventions in addiction treatment, but are often not properly addressed, so that a number of factors that can cause a person to fail in their fight against substance use are overlooked or underestimated..

      This is why the habit reversal technique can be useful in approaching the therapeutic approach of those behavior patterns that induce a relapse into addiction. While, as we said earlier, it is more focused on chronic tics, it can also be helpful in turning off behaviors that predispose to reuse.

      It incorporates habits that prevent the person from consuming, such as drinking a glass of water when they feel like drinking or smoking, having them play an instrument, chewing gum …

      Bibliographical references:

      • Azrin, NH and Nunn, RG (1973). Habit inversion: a method for eliminating habits and nervous tics. Behavioral Research and Therapy, 11 (4), pages 619-628.
      • Carr, JE and Chong, IM (2005). Treatment of tic habit reversal: a methodological critique of the literature. Behavior Modification, 29 (6), pages 858-875.
      • Piacentini, J. and Chang, S. (2005). Habitat reversal training for tic disorder in children and adolescents, behavior modification, 29 (6), pages 803-822.
      • Ruiz, MA, Díaz, MI and Villalobos, A. (2012). Manual of cognitive-behavioral intervention techniques. Bilbao: Desclée de Brouwer.

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