Video by Dr. Phillipson: The Treatment of the Pure Obsessional and other Matters

Video by Dr. Phillipson

The Treatment of the Pure Obsessional
and Other Matters:

An evening with
Dr. Steven Phillipson

A rarely discussed and minimally researched form of Obsessive-Compulsive Disorder (OCD) involves persons who engage in elaborate problem-solving rituals almost exclusively in their own mind (the Pure-O). These persons typically become aware of an intrusive and unwanted thought and emotionally react with extreme anxiety, guilt, disgust and/or anger. A mother changing the diaper of her new born child may have a thought to harm the child in some way, panic, and seek reassurance within herself that she could never commit such an act or perhaps only change future diapers in the presence of another person who would act as a Guardian. A man engaged in sexual relations with his wife may repeatedly think of his friend Bob just prior to orgasm and engage in endless hours of rumination related to his sexual orientation.

In 1991 the Obsessive-Compulsive Foundation in Connecticut requested that Dr. Phillipson expound upon his ideas and treatment strategies for the purely obsessional disordered client from an article which appeared on the front cover of a nationally distributed newsletter. This presentation was videotaped and temporarily made available for persons interested in learning more about this, rarely discussed, form of the condition. Until this time primitive techniques such as thought stopping and rubber band snapping were thought to be considered state of the art.

In this video Dr. Phillipson presents innovative ideas relating to the purely obsessional form of Obsessive-Compulsive Disorder (OCD). In depth descriptions are given of this particular form of OCD. A conceptual model of how the disorder is maintained and reinforced within ones own mental framework is presented. Very specific treatment strategies are presented. The applications of Cognitive-Behavioral assignments are laid out in great detail. Critical concepts are discussed, such as, the focusing on the response to the aversive thought rather than attempting to eliminate the occurrence of the thought. The necessity of regularly practicing in home based assignments and creating a working hierarchy is expounded.

In addition to the description of the pure-O and the techniques used in its treatment, the video contains a question-and-answer session by a panel of professionals as well as people suffering from pure-O and other variants of OCD. Questions include:

  • What is the interaction between medication and cognitive-behavioral therapy for OCD?;
  • How long is the typical treatment regime?; How effective is the treatment?;
  • Is OCD genetically transmittable from parent to child?

Finally panelists also discuss their own personal experiences with various forms of OCD including the pure-O, hoarding, counting rituals, etc…


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