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Paradoxical Intention and Anti-Exposure in a Non-Compliant, Obsessive–Compulsive Ritualiser

Published online by Cambridge University Press:  02 January 2018

Gwen Adshead ,
Lynne M. Drummond  and
Shirley Mercer
Gwen Adshead
Affiliation:
St George's Hospital, London
Lynne M. Drummond
Affiliation:
St George's Hospital, London
Shirley Mercer
Affiliation:
St George's Hospital, London
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Abstract

A woman with persistent obsessive-compulsive rituals showed limited improvement with exposure therapy, because of her refusal to comply fully with treatment and a lack of homework practice. She was negativistic towards therapists. Following a relapse, she was asked to try anti-exposure and to increase rituals. Paradoxically, this led to marked self exposure to the feared situation, and self-imposed response prevention, with resultant improvement, whereas anti-exposure instructions are generally anti-therapeutic in obsessive-compulsive disorder.

Type
Brief Reports
Information
The British Journal of Psychiatry , Volume 153 , Issue 6 , December 1988 , pp. 821 - 823
Copyright
Copyright © Royal College of Psychiatrists, 1988 

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