Still Cognitive After All These Years? Perspectives for a Cognitive Behavioural Theory of Obsessions and Where We Are 30 Years Later: A Commentary

Abstract

Salkovskis and Millar (this issue) observe a number of shortcomings in our paper entitled “New Perspectives for a Cognitive Theory of Obsessions” (Clark & Purdon, 1993), which include: (a) an under‐emphasis on the role of responsibility, (b) an under‐emphasis on the influence of neutralisation; and (c) an over‐emphasis on the relative importance of mental control in the pathogenesis of obsessions. They also contend that our emphasis on ego‐dystonicity as a defining feature of obsessions has been discredited. We agree that certain aspects of our original cognitive model of obsessions may have been overstated in light of the past 22 years of research but several key points have been upheld, especially the importance of failed mental control in the persistence of obsessional problems. This paper addresses each of these criticisms in turn.