Haunting Thoughts: The Problem of Obsessive Mental Intrusions

Abstract

Unwanted, ego-alien distressing intrusive thoughts, images, or impulses (i.e., obsessions) are a hallmark of obsessive compulsive disorder (OCD). Until recently the psychological processes involved in the origin, persistence, and treatment of these perplexing intrusive mental repetitions have not been well understood. Over the past decade, a new cognitive perspective on OCD has emerged that has provided new insights into the pathogenesis and treatment of obsessions. In this article we briefly consider recent findings on normal and abnormal obsessions, their relationship to mood disturbance, and the status of key cognitive processes implicated in the pathogenesis of obsessions as discussed in publications by Salkovskis, Rachman, Freeston, Clark, Purdon, and others. We conclude with a discussion of treatment implications and whether the inclusion of cognitive strategies that directly targets change in dysfunctional beliefs and appraisals will enhance standard behavioral treatment of OCD.