A cognitive theory of obsessions: elaborations
- Author: Stanley Rachman
- Year read:#read2019
- Subject: (in brackets, can also bracket keywords in text)
- Bibtex: @rachman1998
- Bibliography: Rachman, S. A cognitive theory of obsessions: elaborations. Behav. Res. Ther. 36, 385–401 (1998).
Why and when I was reading this
I was doing a deep dive into the role of cognitions in OCD
- If people make catastrophic interpretations of their intrusive thoughts, the range and potential seriousness of threatening stimuli is increased.
- Ex-consequentia reasoning: “If I am anxious when near children, there must be danger, and I am it!“. “If I am constantly thinking of harming innocent people, it must mean that I am bad and dangerous - I am a significant threat.”
- This triggers avoidance behavior and the catastrophic misinterpretation remains unchallenged
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The theory that obsessions are caused by catastrophic misinterpretations of one's intrusive thoughts/ images/impulses is elaborated in an attempt to explain the frequency of obsessions and why they persist. The internal and external provocations of obsessions are considered, and an explanatory framework for the varying contents of obsessions is set out. The role and functions of neutralization and inflated responsibility are assessed, and the treatment implications of the theory are described.
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It has been proposed that obsessions are caused by catastrophic misinterpretations of the sig- niÆcance of one's intrusive thoughts/images/impulses. It is argued that obsessions persist as long as these misinterpretations continue and diminish when the misinterpretations are wea- kened
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It is argued here that when a person makes a catastrophic misinterpretation of the signiÆ- cance of his unwanted intrusive thoughts, this will increase the range and seriousness of poten- tially threatening stimuli. A wide range of stimuli are converted from neutrality into threat.
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if my catastrophic misinterpretation leads to the conversion of sharp objects from neutral to threatening, then the opportunities for provocation of the unwanted thoughts are greatly increased by the addition of this new and wide range of threats.
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here is also a risk here of what Arntz et al. (1995) have called ex-consequentia reasoning, in which the person deduces a threat from the fact of feeling anxious. ``If I am anxious, it must mean that there is danger present'', and in the present argu- ment, ``If I am anxious when near children, there is a danger present, and I am it!'
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By contrast, if the catastrophic misinterpretation is changed or reduced and replaced by a benign interpretation, the opportunities for the elicitation of the obsessions are reduced. The frequency of the obsessions will decline in large part because of the re-conversion of threat stimuli back to neutral stimuli. There are in this way fewer opportunities for the elicitation of the obsessions.
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he catastrophic misinterpretation of the intrusive thoughts promotes persistence of the obsession
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he obsession will persist for as long as the person remains under threat (e.g. near children, in a kitchen con- taining sharp objects, etc.). Moving away from the threat, where and when this is possible, will temporarily interfere with the persistence of the obsession, only for it to return when the person is re-exposed to potentially threatening stimuli or internal sensations.
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Incidentally, the signiÆcant misinterpretation of the very frequency of the intrusive unwanted thoughts (i.e. they must be important because I am having them so often) may help to explain the puzzle of those rare but baÇing nonsensical obsessions that persist over long periods of time. It is possible indeed that they persist precisely because the person interprets the intrusiveness of the nonsensical ideas, musical phrases etc., as evidence of a hopeless irrationality that is of considerable signiÆcance, perhaps as an early sign of impending mental illness, for example.
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The unwanted intrusive thoughts that are subject to conversion into obsessions are those which have a particular sig- niÆcance for the aected person
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t is perfectly possible for someone to be upset by an unwanted violent thought but to regard it as carrying little signiÆcance. In these instances, no obsession will be generated
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New information can also undermine the idea that the obsessions are of signiÆcance in revealing that the aected person is dangerous, insane, on the verge of losing control. Furthermore, learning that the anxiety dissipates spontaneously can help to weaken the inØated signiÆcance which is given to the obsessio