Individuals who suffer from obsessive-compulsive disorder (OCD) are often plagued by incessant self-talk that leads to compulsive checking.
Although the thoughts may be slight — such as checking to be sure the gas stove is turned off — individuals can become debilitated as they become locked in a vicious cycle of fear and doubt.
Canadian researchers at Concordia University are now testing a novel approach to treatment for compulsive checking that they believe could mean vast improvements in the quality of life of countless individuals.
“For years, the best way to treat compulsive checking in OCD sufferers has been through a difficult therapeutic process known as exposure and response prevention, or ERP,” said Dr. Adam Radomsky, a professor in the Department of Psychology.
“By facing their worst fears repeatedly until their anxiety declines, patients learn to diffuse their hypervigilant checking responses — in theory.” In practice, however, this type of treatment often results in patients quickly discontinuing the therapy.
“Refusal rates for ERP are unacceptably high, which is why we need to develop a new and refined treatment that specifically works for compulsive checking.”
The new treatment intervention builds on previous research which found that individuals with OCD who compulsively checked certain aspects of their surroundings did so because of an inflated sense of perceived responsibility.
“If I don’t turn off the stove, the house will burn down,” is a plausible thought that can quickly devolve into an obsessive cycle of checking and re-checking, and can even result in an inability to leave the house. Yet, as shown by Radomsky’s previous research, performing these seemingly senseless repetitions actually results in a loss of confidence.
Radomsky believes that modifying the patient’s inflated feelings of personal responsibility and reducing predictions of seriousness of anticipated misfortunes, can turn the cycle around.
By placing the emphasis on how people think rather than on what they do, the intervention targets people’s faulty beliefs about how responsible they think they are, about their own memories, and about the dangers that they perceive.
Treatment milestones include normalizing inflated responsibility — through restoring confidence in memory — all the way to reducing self-doubt and guilt. The goal of the intervention is to improve the way in which individuals perceive themselves, and the world around them.
Developed in the lab, Radomsky’s research is set to show real promise in the field.
“For me and my team,” said Radomsky, “this work will capitalize on all of our previous experimental research and lead us to testing a new intervention based on our previous findings. It’s our hope that this work will lead to a more substantial test of the treatment, which in turn could influence how people treat OCD in Montreal, in Canada and beyond.”
As first appeared in PsychCentral, April 11 2012.