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Unread April 28th, 2006, 10:37 PM
Neil Levitsky Neil Levitsky is offline
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Join Date: Dec 2005
Posts: 7
Default Re: Understanding Obsessive-compulsive Disorder

Interesting article!
I'm quite interested in OCD; I see a fair bit of it in my practice. This article makes me think of an excellent review book :Cognitive Behavioral Therapy Of OCD, by David Clark (the Canadian David Clark, as opposed to the British David Clark), which is a recent text giving a superb overview of theory, treatment, etc.
Clark's view, I think, essentially considers both components, Salkovskis' and the metacognitive. If I understand his formulation (and please excuse me if I am totally misstating it), there are 2 problems with OCD. the first is a distorted interpretation of the intrusion itself; this would be where the classic OCD distortions of excessive responsibility, intolerance of uncertainty, etc come into play (I believe the Obsessive Compulsive Cognitions Working Group has a specific list). Then, there is a secondary appraisal, of how well controlled the intrusion was. this sounds like the idea of a metacognition; I am curious if others would agree, or am I missing something?

While I'm at it, any suggestions from anyone on helping an OCD patient who suffers from perfectionistic patterns of fearing making any mistake. He ends up taking hugely excessive amounts of time buying things, paying bills, filling out forms, etc, because each decision has to be thought through to make sure it is the right one. He won't let a grocery checkout clerk start scanning items until everything is on the belt, because he feels he has to watch for any mistakes. Aside from challenging the belief "I must not make mistakes", and doing exposure via intentional mistakes or setting time limits on tasks, any other suggestions?
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