New perspectives for a cognitive theory of obsessions

Abstract

Salkovskis (1985, 1989) proposed a cognitive‐behavioural theory to account for the development and persistence of clinical obsessions. The model considers two cognitive processes central in the development of obsessions. First, the obsession‐prone person attributes excessive personal responsibility of possible harm occurring to self or others in response to an unwanted intrusive thought. Secondly, in an attempt to deal with the discomfort and sense of responsibility associated with the intrusion, the individual develops overt or covert neutralising rituals that, in turn, increase the frequency and salience of the intrusion. In This paper we examine the empirical support for Salkovskis' theory and conclude that partial support can be found for the model. Consideration of the thought suppression research of Wegner and his associates (Wegner, in press) suggests a number of processes that may be involved in a reduced ability to control unwanted intrusive thoughts. The thought suppression research is reviewed and possible implications for obsessions are discussed. We then present a revised cognitive model of obsessions that focuses on the development of obsessions as the result of (a) dysfunctional beliefs concerning the need to control one's thoughts and (b) various cognitive processes involved in a general breakdown of the obsession‐prone person's mental control ability. The two models are discussed in terms of their implications for the treatment of obsessions.