This preview shows page 1. Sign up to view the full content.
Unformatted text preview: orld of all
germs are fighting a losing battle. While
talking, the average person sprays 300
microscopic saliva droplets per minute, or
2.5 per word. << ComFun6e_Ch04_C!.indd 126 Do not mop the floor of your bathroom for a week. After this, clean it within
three minutes, using an ordinary mop. Use this mop for other chores as well
without cleaning it.
Buy a fluffy mohair sweater and wear it for a week. When taking it off at night
do not remove the bits of fluff. Do not clean your house for a week.
You, your husband, and children all have to keep shoes on. Do not clean the
house for a week.
Drop a cookie on the contaminated floor, pick the cookie up and eat it.
Leave the sheets and blankets on the floor and then put them on the beds. Do
not change these for a week.
(Emmelkamp, 1982, pp. 299–300) Eventually this woman was able to set up a reasonable routine for cleaning herself and
Between 55 and 85 percent of clients with obsessive-compulsive disorder have been
found to improve considerably with exposure and response prevention, improvements
that often continue indefinitely (McKay,Taylor, & Abramowitz, 2010; Abramowitz et al.,
2008). The effectiveness of this approach suggests that people with this disorder are like
the superstitious man in the old joke who keeps snapping his fingers to keep elephants
away. When someone points out, “But there aren’t any elephants around here,” the man
replies, “See? It works!” One review concludes, “With hindsight, it is possible to see that
the [obsessive-compulsive] individual has been snapping his fingers, and unless he stops
(response prevention) and takes a look around at the same time (exposure), he isn’t going
to learn much of value about elephants” (Berk & Efran, 1983, p. 546).
At the same time, research has revealed certain limitations in exposure and response
prevention. Few clients who receive the treatment overcome all their symptoms, and
as many as one-quarter fail to improve at all (Foa et al., 2005; Frost & Steketee, 2001).
Also, the approach is of limited help to those who have obsessions but no compulsions
(Hohagen et al., 1998). 12/10/09 11:16:34 AM Anxiety Disorders The Cognitive Perspective
Cognitive theorists begin their explanation of obsessive-compulsive disorder by pointing out that everyone has repetitive, unwanted, and intrusive thoughts. Anyone might
have thoughts of harming others or being contaminated by germs, for example, but most
people dismiss or ignore them with ease (Baer, 2001). Those who develop this disorder,
however, typically blame themselves for such thoughts and expect that somehow terrible things will happen (Shafran, 2005; Salkovskis, 1999, 1985). To avoid such negative
outcomes, they try to neutralize the thoughts—thinking or behaving in ways meant
to put matters right or to make amends (Salkovskis et al., 2003).
Neutralizing acts might include requesting special reassurance from others, deliberately thinking “good” thoughts, washing one’s hands, or checking for possib...
View Full Document