You’re made to lie down on the sterile medical bed with your buttocks exposed, and advised—helpfully—to grip the bed to help you cope with the pain. Then you receive 30 lashes with a willow branch—right across the backside—enough to leave a mark, but not enough to draw blood or cause lasting damage. You’d be forgiven for thinking this is a watered down tale of sadomasochistic sexual fetishism, but the people who perform this treatment persist that it is no such thing. In fact, the Russian doctors who provide this technique believe it could be a powerful new tool in tackling drug and alcohol addiction, among other psychological conditions. The sessions cost about $99 (3,000 roubles, in local currency) and generally consist of counseling followed by a beating. This happens around twice a week for a treatment period of three months (along with monthly follow-ups for a year), working pretty much like any treatment regimen but with added corporal punishment. Men and women of all ages (17 to 70) receive the treatment (although it’s generally performed by a member of the opposite sex), and it appears to have been enjoying some success. Natasha’s Case Study The Siberian Times tell the story of Natasha, a young woman who fell into addiction as the result of her boyfriend’s heroin habit. She fell in love with him at age 16, and after she developed her own addiction, he died of an overdose. Her mother saw the damage it was doing to her life, but Natasha refused to stop—regularly stealing from her family to fund her habit and spending nights in gutters. Everything in her life was falling apart, and her mother took her to various hospitals and conventional treatment programs. She couldn’t get clean and she was desperate; even trying a religious retreat as a cure, despite never showing an interest before. Her cravings remained—nothing appeared to be working—so she turned to the unconventional treatment method. The lashings are accompanied by comments about the dangers of drugs and the risks of addiction, Natasha commenting that, “With each lash I scream and grip tight to the end of the surgical table. It’s a stinging pain, real agony, and my whole body jolts. Often I cry, and the doctor sometimes asks what I am feeling, and if I am OK.” Patients are hooked up to a heart monitor at all times to ensure there is no risk of a shock-related heart effect. Her life has now turned around. She’s free of drugs, and has managed to both find a job and hold it down. She said, “It’s a simple job, but for me it is a start. I feel I have my self respect. So far I don’t have a new boyfriend but when the right man comes along, I now feel I could cope with a relationship again.” Additionally, she says her cravings are getting easier and easier to deal with. Is There Any Benefit to It? There are a couple of realistic ways in which the therapy could work. Firstly, the most obvious problem (that of a patient attending for sexual thrill) is addressed by the fact that the practitioners immediately cease treatment if the patient appears to be getting any sexual enjoyment from the experience, and are obviously subject to all the expected scrutiny that would prevent a healthcare worker inappropriately abusing his or her position. With that covered, the classical conditioning and release of endorphins are the main ways in which the therapy could be beneficial. Classical conditioning is illustrated by the well-known story of Pavlov’s dog, which was “conditioned” by a ringing bell whenever he ate. Eventually, the sound of the bell itself was enough to make it salivate (in anticipation of the food), so a conditioned response was set up to the stimuli of the bell. The inverse is shown by the “Little Albert” study, in which a boy was given a crippling fear of white fluffy things by experimenters in the 1920s. They did this by clanging a hammer against a steel bar (the loud noise producing fear in the 11 month old) when he played with a laboratory rat (among other things). Similarly, the focus on telling patients about the dangers of drugs during the lashing could have this effect. There’s also the fact that pain stimulates the release of endorphins, which can be thought of as the body’s natural opiates. This is because they interact with the same receptors in the brain as drugs such as heroin do. The therapy would then stimulate the release of these substances, thus having a comparable effect to a low dose of a replacement medication such as methadone. What Does the Future Hold? So, is the lashing set to become a key part of addiction treatment? Probably not. The main problems are obvious, and then there’s the fact that the majority of treatment is counseling. This is the key psychological intervention required by people struggling with addiction (and many other conditions), so the benefit of the lashing itself hasn’t really been demonstrated. They have sampled 30 patients, but the positive results of this small sample size are very limited. If more thorough research is conducted, which should evaluate the benefits of the approach in a more robust and methodologically sound fashion, perhaps then its benefits could be confirmed or refuted. However strangely heart-warming Natasha’s story is, she is merely one patient. It isn’t proof; just an anecdote. There are additional problems with the approach, namely that you can also produce endorphins as a result of non-painful activities, such as exercise, massage therapy, acupuncture or even sex. So why choose lashings? Similarly, just as negative reinforcement can be effective, positive reinforcement can be too. So why focus on the negative? The theory may be sound, but the numerous questions the practice raises render it more of an oddity than a genuine possibility for the future of treatment.