Obsessional-compulsive problems: A cognitive-behavioural analysis
Cognitive-behavioural approaches have made no impact on research and treatment in obsessional-compulsive disorder, despite the obvious link between thinking and psychopathology that characterizes this disorder. A close examination of cognitive and behavioural models leads to the suggestion that intrusive thoughts are best regarded as cognitive stimuli rather than responses. Cognitive responses (negative automatic thoughts) to these stimuli are typically linked to beliefs concerning responsibility or blame for harm to self or others. A cognitive-behavioural model based on this view is outlined and illustrated by clinical material derived from a case series. The model is used to explain a wide range of phenomena observed clinically, and a number of specific predictions are made. Implications for cognitive approaches to therapy are discussed. © 1985.