COGNITIVE PSYCHOLOGY 213
See also: Joseph Wolpe 86–87 ■ Fritz Perls 112–17 ■ Albert Ellis 142–45 ■
Aaron Beck 174–77
They feel responsible
for any harm implied by
these intrusive thoughts.Compulsive behavior rituals are
attempts to control intrusive thoughts.We all have unwelcome intrusive thoughts.But some people have trouble shaking them off, and the
thoughts become over-important and obsessional.They overestimate the threat
posed by these thoughts.They therefore feel compelled to take action to counter
the threats and control the thoughts.Paul Salkovskis
A graduate of the Institute
of Psychiatry, London in 1979,
Paul Salkovskis took up a post
at the University of Oxford
in 1985 to research panic
disorders. His interest in the
application of cognitive theory
to anxiety disorders led to
his appointment as a Senior
Fellow and later as Professor
of Cognitive Psychology.
While at Oxford, the
emphasis of his work moved
to the treatment of obsessive-
compulsive disorder using
cognitive behavioral therapy.
In 2000, he became Professor
of Clinical Psychology and
Applied Science at the
Institute of Psychiatry,
and Clinical Director in the
Centre for Anxiety Disorders
and Trauma. Since 2010,
Salkovskis has been based
at the University of Bath,
where he is establishing a
specialist CBT research and
treatment center.Key works1998 Panic Disorder
1999 Understanding and
Treating Obsessive-
Compulsive Disorder
2000 Causing Harm
and Allowing Harm
(with A. Wroe)Obsessive thoughts of catching and
passing on a deadly disease, for
example, may result in compulsive
cleaning or hand washing. There is
also a feeling of a responsibility to
act, even if the action is out of
proportion to the risk. The resulting
compulsive actions can become
ritual behavior patterns, carried out
repeatedly in an attempt to gain
control over a perceived threat.
Cognitive behavioral therapy
combines cognitive and behavioral
techniques to address both the
cause and the symptoms of OCD
to great effect. First, the patient is
helped through cognitive therapy to
recognize the obsessional thoughts
for what they are, making a more
rational appraisal of the risk and,
crucially, of how much responsibility
he or she has for taking preventative
action. This cognitive approach
helps reduce the distress. Alongside
this, behavioral therapy techniques,
such as desensitization (gradual
exposure to the perceived threat)
help the patient to control his
or her compulsive behavior.
Salkovskis uses CBT techniques
to successfully treat anxiety,
panic attacks, and phobias. ■