Profs Present: “Why Are Compulsions so Compelling?”
Speakers: Christine Purdon
Dr. Purdon completed her PhD in Clinical Psychology at the University of New Brunswick. After completing her Residency in the Anxiety Disorders Clinic at the Centre for Addiction and Mental Health she joined the Department of Psychology at the University of Waterloo where she is now a Professor and Director of Clinical Training for the PhD program in Clinical Psychology. Her research focuses on the persistence of anxiety and obsessive-compulsive disorder (OCD). Dr. Purdon has 65+ published papers and 15+ book chapters, and co-authored a self-help book on OCD that has sold over 50 000 copies. Dr. Purdon has given numerous workshops on treatment of OCD and was a consultant on the OCD module for the Ontario Structured Psychotherapy program.
Leading psychological treatment of OCD focuses on reducing the emotional response to obsessional thoughts via exposure with response prevention (ERP) and cognitive restructuring of appraisal of the obsession (that is, de-toxifying the obsession), the assumption being that if distress over the obsessional thoughts resolves the compulsion becomes obsolete. Exposure with response prevention is the most effective treatment of OCD to date. However, when treatment refusal and drop out rates are considered, it is only about 50% effective, and even when “successful” is associated with only a 40% reduction in symptoms. ERP can be a hard sell for clients because compulsions are, well, compelling. Research in the past decade clearly suggests that compulsions are very difficult to resist and, once initiated, a number of self-perpetuating mechanisms kick in, resulting in their persistence. In this talk I will review factors involved in the persistence of compulsions and implications for treatment. By taking the compelling features of compulsions into account we may be better able to help people resist compulsions and improve willingness to do ERP.