The potential application of obsessions to reduce compulsions in individuals with obsessive–compulsive disorder

Summary 

Obsessive–compulsive disorder is characterized by obsessions that cause distress and compulsions that temporarily alleviate that distress. Despite numerous pharmacological and psychotherapeutic approaches available for treating obsessions and compulsions, their effectiveness is limited. Exploring the etiologies of obsessions reveals how obsessions develop to cause distress. It is hypothesized that the strength of obsessions can be used in a self-talk technique to reduce the frequency of compulsions. The patient would incorporate the self-talk technique while engaged in a compulsion meant to lessen the distress caused by an obsession. While performing the compulsive behavior, he or she then identifies a separate obsession, and applies a limit to stop the compulsive ritual while telling himself or herself that the second obsession will occur unless the limit is met. Although the technique has potential as a flexible tool that may be incorporated into other treatments to reduce compulsions, the therapist who chooses to use it should closely monitor its effectiveness and discontinue the technique in case of adverse effects.