A cognitive theory of compulsive checking

I’ve found a scientific article which very precisely describes how I experience OCD. The article is written by S. Rachman and is available for free as PDF here.

The theory is this:

“Compulsive checking occurs when people who believe that they have a special, elevated responsibility for preventing harm feel unsure that a perceived threat has been adequately reduced or removed. In their attempts to achieve certainty about the absence or the unlikelihood of harm occurring, people with high responsibility repeatedly check for safety. Paradoxically, these attempts to check for safety can produce adverse affects that turn the checking behaviour into a self-perpetuating mechanism.”

Spot on.

Rachman also describes a model of compulsive checking which emphazises INFLATED SPECIAL RESPONSIBILITY as the underlying cause of compulsive checking. That sounds true I think. This has to be dealt with cognitively. Mindfulness is helpful (not included in Rachmans recommendations).

The engagement in compulsive checking behavior starts a vicious cycle that is a self-perpetuating mechanism. I guess we all know that: Checking doesn’t help – but we do it anyway.

According to Rachman checking results in:
– Raised responsibility
– Impaired memory
– Increased danger

In the end an OCD attack results in an increased need to be especially careful and thereby maintaining or even increasing the OCD tendencies.

It goes on and on and on and on.

I have now started to use mindful awareness of the inflated sense of responsibility. The root cause, perhaps.

Rachman also challenges the standard behavior treatments that focus on exposure and response prevention. According to Rachman exposure is not that important. Response prevention still is important. And there has to be more focus on dealing with the underlying assumptions that cause the inflated responsibility. I suggest mindfulness based cognitive therapy or meta cognitive therapy.