More on OCD — Cognitive Flooding
Warning: This podcast includes raw and disturbing material that may be upsetting to some listeners. If you are concerned that your own feelings may be triggered, it might be wise to skip the program.
Fabrice begins with another question on OCD—if you successfully extinguish the symptoms with Exposure and Response prevention, would they just resurface in some other form, such as worrying, or some other anxiety disorder. David agrees, and describes the solution to this problem.
Then David describes his treatment of a pregnant woman with OCD who was afraid her baby would be switched at the hospital so that she’d end up with the wrong baby. Although she rationally recognized that this fear was irrational, she could not shake it from her mind, and obsessed about it constantly.
After trying more than 30 CBT techniques that did not work, David used the What-If Technique to pinpoint her deepest fear, which turned out to be quite shocking, to say the least. He then encouraged her, with some reluctance, to confront this fear using Cognitive Flooding.
After describing the surprising outcome, David and Fabrice discuss the fact that 75% of American therapists are afraid to use Exposure Techniques because of the fear that the patient is too fragile, or they will re-traumatize the patient. David reminds us that this is “reverse hypnosis,” where the patient hypnotizes the therapist into believing something that is not true. If the patient is successful, and the therapist agrees not to use Exposure, the prognosis for effective treatment is quite poor. David gives an example of a therapist who was afraid to ask an OCD patient to drink one ounce of coca cola—something the patient feared would drive him into insanity!
Thank you,this is great
Glad you liked it! d
Hi Dr. Burns,
I have a client in his 20s, has fear of driving and being stuck in traffic, is generally agoraphobic or afraid of freaking out in front of people, and has fear of speaking in front of groups or his classmates, while is fine with one-on-one. I admit I am lost. He has exposed himself to some degree, to each of these things, but he doesn’t find relief. He fears it just traumatizes him more. I suspect I have to try an array of techniques I don’t yet know, and push him further than he’s gone thus far. Any thoughts would be appreciated! Thank you,
Michael
Thanks, Michael. Are you trained in TEAM-CBT. It works best as a package, and not as techniques to apply to patients or problems. Maybe some sulpervision of your work with this individual, plus basic TEAM training if you haven’t had it, would be helpful. david
It’s fantastic, I can’t get over it!
Thanks you, greatly appreciate your kind comment, and agree 200%. Warmly, david