Do you experience sudden episodes of intense and overwhelming fear that seem to come on for no apparent reason? Read More

Clinical Disorders and Problem Areas

Extensive research on Cognitive and Behavioural Psychotherapies has been carried out. It has been shown to be an effective form of treatment, particularly for the following:

Obsessional OCD

Obsessional-OCD/Pure O

Obsessional-Obsessive-Compulsive Disorder (O-OCD) is a specific type of OCD sometimes called Pure O.  People experiencing O-OCD report experiencing obsessions without observable compulsions. These obsessions often manifest as thoughts, impulses or “mental images” of committing an act they consider to be harmful, violent, immoral, sexually inappropriate or sacrilegious. For individuals with O-OCD these thoughts are very frightening and upsetting precisely because they conflict strongly with their own values and beliefs.

Some examples include:

Intrusive thoughts or mental images of killing one’s spouse, parent or child

Repeatedly worrying that one has or will cause harm to another person, for example running over a pedestrian while driving a car or pushing somebody into the road or onto railway track

Recurrent fear of molesting a child

Repetitive thoughts that one has said or written something inappropriate, such as swearing at one’s employer, writing hate filled letters to a friend or making racist comments

Recurrent fears that one might be a homosexual when in fact he or she is not

Intrusive thoughts or mental images that one considers to be sacrilegious or blasphemous such as wanting to worship Satan or have sex with Christ


While it may at first appear that these individuals experience obsessions without compulsions, careful assessment frequently uncovers numerous covert compulsive/neutralising behaviours, “mental compulsions” and avoidance behaviours. These behaviours are not as easily recognisable as compulsions associated with OCD like hand washing and lock checking, but they are clearly compulsive responses to unwanted obsessions. Some common examples of these compulsions include:

Continually ruminating about obsessions in an attempt to prove to oneself that he or she has not done and/or will not do anything inappropriate

Repeatedly asking for reassurance that one has not and/or will not commit an act that he or she perceives as being “wrong” or “bad”

Silently praying or repeating certain phrases in an effort to counteract or neutralise thoughts that one considers to be immoral or sacrilegious

Repeatedly confessing to people, sometimes total strangers, that one has had thoughts, which he or she considers to be unacceptable

Avoiding numerous situations in which he or she fears the possible onset of their obsessions.

Cognitive-Behavioural Psychotherapy utilises a technique known as exposure and response prevention (ERP), which is proven to be successful with the above difficulties. A variant of ERP has been developed, which involves the use of “imaginable exposure” and uses key phrases or short stories based on the client’s obsessions, which may be written or audio taped and then used as ERP tools, therefore allowing the client to experience exposure to situations that cannot be experienced through traditional “real life” ERP. When combined with standard ERP and other Cognitive-Behavioural techniques, this type of imaginable exposure can greatly reduce the frequency and magnitude of these intrusive obsessions as well as the individual’s discomfort in response to the thoughts and mental images.