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Sep 2014 by PCI College

Bite-Sized Book Review 'Overcoming Obsessive-Compulsive Disorder' by David Veale & Rob Wilson

PCI College President Eoin Stephens reviews 'Overcoming Obsessive-Compulsive Disorders' by David Veale and Rob Wilson

This book, 'Overcoming Obsessive-Compulsive Disorder' is part of the useful series published by Robinson, each applying CBT to a particular area of Mental Health (Anxiety, Depression, Low Self-Esteem, etc), which are available under the UK NHS “Books on Prescription” initiative. Each book is written by a leading practitioner/researcher in the particular area of concern. Although they are written as self-help books, they can also be useful to therapists as a practical introduction to working with a problem area. In some cases, therapist and client may work together using the book as a resource.

In this particular book, Veale and Willson outline the nature of OCD and the CBT approach to it. They point out that the use of the word “obsession” in everyday language is different from its meaning in the context of OCD. Here it refers to any distressing thought, image or urge, “…associated in the person’s mind with the power to prevent harm occurring”. Such obsessions are therefore associated with Safety-seeking Behaviours (an important concept in CBT for Anxiety Disorders) which tend to maintain the obsession.

Other important concepts described are
•    The over-importance of thoughts.
•    Inflated responsibility & Magical thinking.
•    Overestimation of danger.
•    Perfectionism.
•    Attention biases.

In relation to recovery from OCD, the main approach described is that of Response Prevention, which has been well established for a long time as one of the most effective OCD interventions. Veale and Willson sum up the process as follows:
1.    Develop a hierarchy of triggers
2.    Face your fear
3.    Make exposure long enough
4.    Make exposure frequent enough
5.    No anxiety-reducing strategies
6.    If you do a ritual, repeat the exposure
7.    Monitor progress

Other approaches described include Mindfulness Meditation and the “Theory A/Theory B” approach (where different possible interpretations of the client’s thoughts and feelings are tested using behavioural experiments).

Eoin Stephens (September 2014)
PCI College President

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