Obsessive Compulsive Disorder (32 page)

BOOK: Obsessive Compulsive Disorder
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These are just a few examples of intrusive thoughts to give you an idea of what we’re looking at. People have lots of different thoughts.

Important

Please write down two thoughts like these that you have had in the last week: 173

174

Appendix C

1

2

The questions on the next two pages are about any intrusive thoughts like these you have had in the last week. On the next page are some ideas that might go through your mind when you have unpleasant intrusive thoughts.

Frequency

We’d like to know how often you had the ideas below, when you were bothered by these intrusive thoughts. Circle the number that shows how often you had these ideas
over the last week
: 0 I never had this idea.

1 I sometimes had this idea.

2 I had this idea half of the times when I had worrying intrusive thoughts.

3 I usually had the idea.

4 I always had the idea when I had worrying intrusive thoughts.

4

4

4

4

4

4

4

4

4

4

4

4

4

4

4

this idea

Always had

3

3

3

3

3

3

3

3

3

3

3

3

3

3

3

this idea

Usually had

2

2

2

2

2

2

2

2

2

2

2

2

2

2

2

time

Half the

1

1

1

1

1

1

1

1

1

1

1

Sometimes

had this idea

0

0

0

01

0

0

0

0

01

0

01

0

0

0

01

Never had

this idea

esponsible.

ong it is up to me to

’t happen.

’m not being r

e these thoughts.

om my own mind, I must want to

, bad things will happen and it will be

eally bad to happen.

ol of my thoughts.

e these thoughts.

e something awful won

’t let them happen.

esponsible to ignor

’t think this type of thing.

’t be r

’ve thought of bad things happening, I must do

e I don

’t try to stop these thoughts, I

’t do something now

’ve thought of this I must want it to happen.

ong to ignor

’t risk this thought coming true.

’ve thought of things that could go wr

’s wr

If I don

I could cause something r

I can

If I don

my fault.

I need to be sur

I shouldn

It wouldn

I’ll feel awful unless I do something about this thought.

Because I

something to stop them.

Since I

Now I

make sur

Thinking this could make it happen.

I have to get contr

It

Because these thoughts come fr

have them.

176

Appendix C

Belief

Over the last week
, when these worrying intrusive thoughts bothered you, how much did you believe each of the ideas below was true? Mark the point on the line that shows how much you believed the idea at the time you had the intrusive thought.

I did not believe
0 10 20 30 40 50 60 70 80 90 100
I really believed
this
this idea at all

idea was true

0

0

0

0

0

0

0

0

100

100

100

1

100

100

100

100

1

100

1

100

100

100

1

0

0

0

0

90

90

90

90

90

90

90

90

90

90

90

09

09

09

09

80

80

80

80

80

80

80

80

80

80

80

08

08

08

08

70

70

70

70

70

70

70

70

70

70

70

07

07

07

07

60

60

60

60

60

60

60

60

60

60

60

06

06

06

06

50

50

50

50

50

50

50

50

50

50

50

05

05

05

05

40

40

40

40

40

40

40

40

40

40

40

04

04

04

04

30

30

30

3

30

30

30

30

3

30

3

30

30

30

3

0

0

0

0

20

20

20

2

20

20

20

20

2

20

2

20

20

20

2

0

0

0

0

10

10

10

1

10

10

10

10

1

10

1

10

10

10

1

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

esponsible.

ong it is up to me

’t happen.

’m not being r

e these thoughts.

om my own mind, I must

, bad things will happen and it will

eally bad to happen.

’t let them happen.

ol of my thoughts.

e these thoughts.

e something awful won

esponsible to ignor

e I don

’t think this type of thing.

’t be r

’ve thought of bad things happening, I must do

’t try to stop these thoughts, I

’t do something now

’ve thought of this I must want it to happen.

ong to ignor

’t risk this thought coming true.

’ve thought of things that could go wr

’s wr

If I don

I could cause something r

I can

If I don

be my fault.

I need to be sur

I shouldn

It wouldn

I’ll feel awful unless I do something about this thought.

Because I

something to stop them.

Since I

Now I

to make sur

Thinking this could make it happen.

I have to get contr

It

Because these thoughts come fr

want to have them.

Appendix D

Diaries

178

day:

day:

day:

uesday:

ednesday:

uesday:

ednesday:

uesday:

ednesday:

How many times did you get this

obsession during the day?

Monday:

T

W

Thursday:

Friday:

Satur

Sunday:

Monday:

T

W

Thursday:

Friday:

Satur

Sunday:

Monday:

T

W

Thursday:

Friday:

Satur

Sunday:

y

‘ver

’ and 10 is

‘not at all

e 0 is

essed did this make you?

’)

essed

10 wher–

How distr

(0

distr

What was the intrusive

thought or image that

came into your head?

riggering situationsT What was going on? Who was around?

What happened after

that? What did you do?

10%)?–

How did this make you

feel?

How bad did you feel

(0

e?

100%)?–

What went through your head when

you had the thought/pictur

What did it mean to you?

How much did you believe this at the

time (0

What was the intrusive

thought or image that

came into your head?

What was going on?

Who was around?

Appendix E

Experiments

181

’t

, the shelf

f, the

f, the therapist will

f the chair

ne and my motherfi

, the shelf will be

ne. All of this means that thoughts donfi

f the chair

PREDICTIONS

If OCD is right about thoughts causing things to

happen then: the light will go of

be sick, the therapist will fall of

will collapse and my mother will be harmed.

If OCD is a liar then the light will not go of

therapist will not be sick, the therapist will not fall of

will be

cause harm.

oved

ning

oom

f a chair while asking the

f by thinking or imagining it.

event harm.

ole models an attempt to make

’s mother goes for walk the child has a

. Simultaneously, the child does not

epeating the experiment.

f a light). The child copies the therapist.

DISCUSSION AND EXPERIMENTS

Build motivation for experiments by asking the child to make a list of (1) all the times when their thoughts made something bad happen and (2) all the times

when they had a bad thought and nothing bad

happened. Discussion focuses on the concept of

coincidence. If something bad has happened in the

past, the idea that this is just bad luck can be pr by r

The therapist r

something happen by thinking about it (e.g. tur

of

The therapist tries to make someone in the r

collapse by thinking about it. The child is then asked to make the therapist sick by thinking about it. The therapist jumps on and of

child to make them fall of

The child is ask to cause structural harm by thinking about it (e.g. thinking about a shelf collapsing).

While the child

bad thought on purpose or waits for a bad thought to naturally occur

carry out rituals to pr

BELIEF

Thinking about harm means

it will happen.

e

ong.

ous then the

ead the futur

e danger

ect lottery numbers and I

edictions will be wr

ges ar

edict the corr

edict all eight numbers written down by the

ges on their own do not cause harm.

If OCD is right about my ability to r

then I will pr

will pr

therapist.

If OCD is a liar my pr

If OCD is telling the truth then cake will appear or my thought will come true.

If OCD is a liar then cake will not appear and my

thought will not come true.

If OCD is right that ur

therapist will hurt her neck and the child will hurt someone.

If OCD is a liar nothing bad will happen because

ur

ds

e).

ovide

oviding lots

om one to

ence of the

e. Pr

esponsibility pie

edict every single

ges by pr

ous, they just feel a bit

t with who you arfi’t

ous (everyone should be

edicted the futur

edict the winning lottery numbers

ecall times when they accurately

e not danger

. Discussion focuses on the idea thatwo

e truly danger

.

’t matter how many times you think about it.

native explanations for the occurr

ges wer

Ask the child to r

and inaccurately pr

alter

event (e.g. bad luck, coincidence, r

charts).

Ask the child to pr

this week.

Therapist writes down eight numbers fr

100 and the child attempts to pr

number

Ask the child to think about a cake suddenly

appearing. Then ask the child to think about this 20

times in r

thoughts do not make things happen and that it

doesn

The therapist and the child practise saying a scary thought out loud 20 times. Discussion focuses on

why it is okay to play this kind of game with wor

(i.e. thoughts ar

horrible because they don

Normalise violent and sexual ur

of examples and carrying out surveys with at least

seven people. Ask the child what would happen in

the world right now if intrusive violent and sexual ur

BOOK: Obsessive Compulsive Disorder
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