Using the Hidden Emotion Technique With Obsessive-Compulsive Disorder
In this podcast, David and Fabrice answer questions on OCD (Obsessive-Compulsive Disorder) submitted by three listeners. Is it an organic illness? Are drugs necessary in the treatment? What’s the best book to read if you want to heal yourself? What’s the prognosis?
Drs. Nye and Burns begin by explaining OCD and answering the questions. David emphasizes the importance of using four treatment models when working with OCD—the cognitive model, the motivational model, the exposure model, and the hidden emotion model if you are hoping for a rapid and complete elimination of symptoms. Treatment that focus on only one treatment method, such as exposure and response prevention, may have only limited success.
He describes his treatment of a medical student named Ralph with classic OCD. Ralph was frequently plagued by the fear he was dying of AIDS; then he’d get so anxious that he’d go to the emergency room and insist on having a blood test for HIV. These always came out negative, and this brought temporary relief, but within a few days Ralph would be worrying about AIDS again and feeling the overwhelming compulsion to get yet another blood test.
The case was especially curious because Ralph was engaged and faithful to his fiancé, so there was no rational reason for him to think he had become infected with the HIV virus. However, he’d tell himself, “Maybe I drew blood on a patient with AIDS and then pricked myself with the needle, and then forgot. And how can I know that this didn’t happen?” This are extremely typical of the kind of obsessions that plague OCD patients. Ralph would torture himself with these thoughts until he succumbed to the urge to get another blood test for AIDS.
Although years of conventional psychotherapy had failed this patient, the Hidden Emotion Technique led to an incredible recovery in just a few minutes during a therapy session. You will find this true story inspiring and amazing! And David provides an even more amazing 40-year follow up report!
In the next Feeling Good Podcast, David and Fabrice will describe more examples of patients with severe OCD who experienced dramatic relief because of David’s Hidden Emotion Technique. This technique can be helpful for all anxiety disorders, and not just OCD. However, David emphasizes that this is just one of many techniques he uses in the treatment of anxious patients. He cautions therapists against thinking three is just ONE best technique for any anxiety disorder, including OCD.
See link to podcast #027: Scared Stiff — The Hidden Emotion Model.
This is another amazing podcast. David, you are so gifted. As a kid, I had religious OCD/Scrupulosity that developed into anxiety and phobias. I know first hand how painful it is.
You might be interested to know that a lot of Western Civilization was influenced by people with OCD. Martin Luther, who started the protestant reformation, was afraid of eternal damnation, and I think used to panic during thunder storms because he was afraid God was angry and was going to punish him. I wonder if that influenced his theology of salvation through grace and not works.
Ignatius of Loyola, who started the Jesuit order in the Catholic church, used to be afraid of stepping on two twigs if they were shaped like a cross.
I love when you said, ” I may forget a name or a face, but I never forget a soul.” That is so beautiful!
Thanks, Rob, for another terrific email! When I lived in Philadelphia, I went to teach in St. Louis four or five times. I would usually do a presentation for the general public as well as a workshop for mental health professionals. They were sponsored by a Jesuit group there. I always really enjoyed working with the Jesuits, who seemed very peaceful and non-judgmental. Their center was next to a river there, but I can’t recall the name. I stayed in their dormitory, too, which I also enjoyed due to the simplicity and humbleness of the setting. David
I enjoy your podcasts very much. They are very good reminders of the techniques learned from your workshops. Thank you for sharing them on a regular basis.
Thanks, Barbara. Fabrice and I really appreciate your thoughtfulness in letting us know that you like the podcasts! Very cool!
Thank you for this great podcast. Very helpful.
Glad you liked it, thanks! david
I have been struggling with OCD related to a real event that happened. How would any treatment help with this? I’m ALWAYS on edge and panicky.
Well, since I written many books and many podcasts on just this topic, why not start with one of them, like the Feeling Good podcasts, totally free, or my book, When Panic Attacks, check it out on Amazon. d
Dr. David Burns
You are simply terrific and I am listening to your podcast starting from 001 for the third time.
My question: You said Hidden Emotions is buried in the yesterday or today and never in the past. What do you mean by that? We know that people have OCD for 5 years or 10 years or more. Usually different issues get resolved during long period of time as new kept coming up. Did you mean the patient get hooked on to OCD and hidden emotions gets changing. But how come his symptoms (intrusive thought and compulsion) remains the same.
High Commissioner of Pakistan for Mauritius
Thank you, Syed. I really appreciate thoughtful questions like yours. I have only three brief points. 1. Remember that Hidden Emotion phenomenon is not ALWAYS lurking behind the anxiety of someone with OCD or any type of anxiety, but it is extremely common. 2. The Hidden Emotion phenomenon, or process, is usually a life-long process, where people tend to hide (from themselves and others) certain kinds of “forbidden” feelings. So the things they are sweeping under the carpet will change from day to day, or from week to week, but the anxiety remains and kind of morphs, sometimes, from one thing to another. That is why, perhaps, some people are prone to having lots of different kinds of anxiety at different times, or at the same time, during their lives. So you are right, the hidden emotions can constantly change, like all emotions. 3. You are also right that there is a strong “addictive” component in OCD. The compulsion (like washing your hands repeatedly, or checking the locks over and over, or some counting ritual) temporarily gives you a feeling of safety, and relief, so you get addicted to doing that compulsive ritual. But the relief is short-lived, so you get anxious again and then have a strong drive to do the compulsion again. When you stop the compulsion (this is called “Response Prevention,”) you will have a temporary “withdrawal,” much like drug withdrawal, and you will experience several days of INCREASED anxiety. But if you stick with it, the urge to do the compulsion will diminish and often disappear completely. Sometimes more methods will be needed for the obsessive thoughts which may remain and continue to make you anxious. Thanks again! David
Dear Dr Burns,
Thanks for sharing your wonderful podcasts, they are of immense value.
I have been using your brief mood surveys and though I found it tiresome initially, I realized its value when I I uncovered suicidal thoughts in a patient that came forth only because of repeating the mood survey each session. Further, do you think a brief behavior survey at the start of a session is beneficial to record sleep, eating, and self harm patterns is needed to assess how clients are doing in between sessions? Does it have value?
Recently, a client said she felt suicidal and that made me feel suicidal about how anything untoward happening on my watch! I was ‘scared stiff!’ Please do a podcast if possible on therapist fears and dilemmas.
Thanks for so many continuing insights and for making therapy feel real,
Dear Dr. Burns, I have started listening to your podcasts. I loved reading Feeling Great and am listening in order to reinforce what I learned from that excellent book. You are so generous with your wisdom and I feel so fortunate to be one of the beneficiaries of your generosity. Thanks so much!
Thanks, Deborah! d
I agree with singing your and Fabrice’s praises! Your expertise, approaches, vulnerabilities, and experiences shared, in order to help others is so deeply appreciated, admired, enjoyed, unique, relatable, encouraging, reassuring, meaningful, and, ultimately, significantly useful for chipping away at helping ourselves.
My question after this podcast is: Can you have hidden emotions from hidden emotions?
How can you uncover hidden emotions if you think they are at odds with yourself, your genetics, or things that we can’t completely control or understand?
I ask this in relation to dealing with my own, lifelong, and current depression relapse (by 19th month since onset, worse than I have ever experienced due to present and new symptoms of general and social Anhedonia and a level of apathy/ loss of motivation and discipline I can’t seem to accept and overcome), ADD, anxiety, and OCD tendencies.
I am struggling to get my rational self to take back successful control of my life and health from my defeated, irrational self who has given up.
I don’t know if my question makes sense, but if there is any guidance you can offer, I will be honored and grateful!
I just got your Feeling Great Book to read and use, so I have a starting point in addition to your impressive and wonderful podcasts!
People are still discovering and listening in 2021! I love that you are so down to earth and approachable; you already responded to a recent email from me about finding TEAM CBT therapy in New Jersey!
Your expression of genuine care, above and beyond all you generously share, is what makes the difference for me. You and Fabrice have a forever, East Coast fan in me❣🤩🥰
P.S./ I love the theme music for Feeling Good podcast, it matches so perfectly!
Thank you, Daniella! I appreciate you kind comments and hope you enjoy the new book! All the best, david
I agree with singing your and Fabrice’s praises! Your expertise, approaches, vulnerabilities, and experiences shared, in order to help others is so deeply appreciated, admired, enjoyed, unique, relatable, encouraging, reassuring, and, ultimately, useful for chipping away at helping ourselves. My question after this podcast is can you have hidden emotions from hidden emotions? How can you uncover hidden emotions if you think they are at odds with yourself, your genetics, or things that we can’t completely control or understand? I ask this in relation to dealing with my own, lifelong, and current depression relapse (by 19th month since onset, worse than I have ever experienced due to present and new symptoms of general and social Anhedonia and a level of apathy/ loss of motivation and discipline I can’t seem to accept and overcome), ADD, anxiety, and OCD tendencies. I am struggling to get my rational self to take back successful control of my life and health from my defeated, irrational self who has given up. I don’t know if my question makes sense, but if there is any guidance you can offer, I will be honored and grateful! I just got your Feeling Great Book to read and use, so I have a starting point in addition to your impressive and wonderful podcasts! People are still discovering and listening in 2021! I love that you are so down to earth and approachable; you already responded to a recent email from me about finding TEAM CBT therapy in New Jersey! You and Fabrice have an East Coast fan in me❣
Boy David,Did I ever take the hardway of trying to overcoming self destructive thinking. I read your take on writing down why I wanted to keep it and why I wanted to give it up. The good won out. Your approach was by far the best on all I read and far and the simplest. You are right.You can see the transformtion of a person right away.This has motivated to want to be who I really am. My self esteem and confidence has soared. The bad processes have melted away.Thank you David for your work because I don’t live in fear anymore or in my head or in the past.By the way my obsessions have ended too. It was all tied in together
Thanks, Debby, very cool! Could we read your kind note on a podcast, perhaps just using your first name, or fake name, or any way that appeals to you! I think many people will be encouraged by your thoughtful words! All the best, david
Thank you, Dr. Burns! This is very helpful.
Thanks for kind words! Best, david