Paradoxical intention and anti-exposure in a non-compliant, obsessive-compulsive ritualiser.
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.
Adshead
G
G
St George's Hospital, London.
Drummond
L M
LM
Mercer
S
S
D000328:Adult; D001521:Behavior Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D009042:Motivation; D009771:Obsessive-Compulsive Disorder / Q000523:psychology / Q000628:therapy*; D010349:Patient Compliance