What Is Obsessive-Compulsive Disorder?

Find a therapist to treat OCD

In psychotherapy, bibliotherapy can be useful. But can a theme from a horror film be good therapy? A central idea from the Nightmare on Elm Street flicks can ground a technique in psychotherapy that I have found useful in working with clients with intrusive thoughts.

In one case, a client was referred to me with “pure O,” a type of obsessive-compulsive disorder that is not manifested in compulsive behavior but rather purely obsessive thoughts. This client worked as a limo driver and had the intrusive thought of his right foot becoming paralyzed when driving a passenger to their destination. The thought of the thought led the client to take time off from his job; he contemplated a different line of work to avoid the thought. However, the thought began to emerge while driving and not on the job.

My approach uses logic-based therapy (LBT), a form of rational-emotive behavior therapy I created that utilizes philosophy and logic to help clients overcome self-destructive emotions. One technique I use with clients suffering intrusive thoughts is philosophical imagery, in which the client first imagines themselves being back in a previous situation in which a thought intruded into their mind space. The client then assesses how bad the thought feels by using a negativity scale of 0 to 10, where 10 is the worst and 0 is neutral. Next, the client examines the thought while imagining it, contemplating a resonant philosophical mantra, combined with mindful breathing and supportive imagery. The client then rates the thought on the same scale while in this state of mindful breathing and contemplation.

In LBT, every flawed or irrational way we speak has a specific positive character trait or virtue that can fix it. Catastrophizing is matched to courage. This means identifying a philosophy that builds courage........

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