The act becomes a key method of avoiding or reducing

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Unformatted text preview: that people happen upon their compulsions quite randomly. In a fearful situation, they happen just coincidentally to wash their hands, say, or dress a certain way. When the threat lifts, they link the improvement to that particular action. ComFun6e_Ch04_C!.indd 125 BETWEEN THE LINES Origins of Superstitions Avoid walking under a ladder: Egypt (3000 B.C.) << Knock on wood: North America (2000 B.C.) << Carry a rabbit’s foot: Western Europe (pre-600 B.C.) << Break a wishbone: Italy (pre-400 B.C.) << Cross fingers: Western Europe (pre-100 B.C.) << Avoid broken mirrors: Rome (first century) << Hang a horseshoe: Greece (fourth century) << Avoid black cats: England (Middle Ages) << (Panati, 1987) 12/10/09 11:16:33 AM ://CHAPTER 4 Bill Pugliano/Getty Images 126 Getting down and dirty In exposure and response prevention, clients with cleaning compulsions might be instructed to do heavy-duty gardening and then resist washing their hands or taking a shower. They may never go so far as to participate in and enjoy mud wrestling, like these delightfully filthy individuals at the annual Mud Day event in Westland, Michigan, but you get the point. After repeated accidental associations, they believe that the action is bringing them good luck or actually changing the situation, and so they perform the same actions again and again in similar situations. The act becomes a key method of avoiding or reducing anxiety (Frost & Steketee, 2001). The famous clinical scientist Stanley Rachman and his associates have shown that compulsions do appear to be rewarded by a reduction in anxiety. In one of their experiments, for example, 12 research participants with compulsive hand-washing rituals were placed in contact with objects that they considered contaminated (Hodgson & Rachman, 1972). As behaviorists would predict, the hand-washing rituals of these participants seemed to lower their anxiety. If people keep performing compulsive behaviors in order to prevent bad outcomes and ensure positive outcomes, can’t they be taught that such behaviors are not really serving this purpose? In a behavioral treatment called exposure and response prevention (or exposure and ritual prevention), first developed by psychiatrist Victor Meyer (1966), clients are repeatedly exposed to objects or situations that produce anxiety, obsessive fears, and compulsive behaviors, but they are told to resist performing the behaviors they feel so bound to perform. Because people find it very difficult to resist such behaviors, therapists may set an example first. Many behavioral therapists now use exposure and response prevention in both individual and group therapy formats. Some of them also have people carry out selfhelp procedures at home (Foa et al., 2005). That is, they assign homework in exposure and response prevention, such as these assignments given to a woman with a cleaning compulsion: ◗ ◗ ◗ ◗ ◗ BETWEEN THE LINES Losing Battle People who try to avoid all contamination and rid themselves and their w...
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