Role Of Responsibility Biases And Maintenance Of Ocd Philosophy Essay

Obsessive compulsive disorder (OCD) is an anxiety disorder that effects around 1-3 percent of the population although this is only estimation; the true prevalence is still unknown. OCD is made up of two separate components, Obsessions and compulsions, although both of these elements usually co-occur with each other. Obsessions are unwanted intolerable intrusions of thought that are repetitive and difficult to control. They cause stress to the person, even though the person having these thoughts recognises their irrationality, they can be disgusted by their thoughts. The person who is having these obsessions attempts to defend against them by neutralising these thoughts by thinking about something else or doing something to neutralise them, or ignoring and stifling them. They are not normal things that people worry about; they are out of character for the person. Salkovkis found that these thoughts are very common, in fact 90% of the population experience these intrusive thoughts (Rachman). However , it’s not having the thought that is the problem it is appraising the thought which leads to the obsessions, as thoughts are appraised which indicate an increase in responsibility. An example of an intrusive thought would be a loving mother thinking "I want to shake my baby ". Most people may think nothing of this thought, but people with OCD interpret the thought differently and think that the thought is meaningful.

In most clinical research it has been found that when obsessions occur, compulsions are usually close to follow. Compulsions are repetitive acts that either have to be physically done; such as washing hands, or locking doors etc, or the people with OCD can have mental compulsions such as mental counting etc. People who have OCD feel determined or obsessed to complete these compulsions either in reaction to an obsession, or due to a set of rules that the person has applied to themselves. People who have the disorder recognise that the compulsions that they have to complete are extreme and unnecessary, but they feel that they have to do them, as if they didn’t something bad might happen, or just to reduce the stress they are feeling about the compulsion. However this is just a vicious cycle, as neutralising leads to intrusive cognitions to be more frequent and salient, which is then followed by a greater need to neutralise. However people with OCD often find completing the compulsion to be a stressful task within itself, as it can take the person a long time to carry out the compulsion to the standard that they have set.

Responsibility biases can occur with OCD, based on Becks earlier cognitive model it was suggested that problems with OCD occur when people interpret their intrusive thoughts, that they are responsible for the prevention of harm to other people. The main cognitive distortion is that if they have any influence over the outcome of the thought, then they are directly responsible for the outcome. This was developed by Salkovkis "dysfunctional responsibility schemata". It has been found that conscious increase in responsibility can be result in considerable increased checking. Previous studies have that in the absence of responsibility very little to no checking takes place. Excessive responsibility can be due to many things but two examples at either end of the spectrum are; in dysfunctional families, in which the child can develop an exaggerated belief in responsibility. Or at the other end, if a child is from an extremely overprotective family and they have been shielded from responsibility, when they leave home and it thrown upon them they compensate by being overly responsible. Salvokis found that there are 5 responsibility biases with OCD, these are; when a person thinks about actions, it is equal to performing the action. If the person fails to prevent harm or to prevent harm to oneself or others, then they are the reason for the harm to be caused. Any influence the person has over the outcome equals their responsibility for the outcome. IF the person with OCD does not neutralise when an intrusion occurs, it means that the person wants harm to come to the person involved, and the intrusion can actually happen. Finally Salkovkis found that if one can control their thought, then it is irresponsible to ignore dangerous thought. Furthermore researchers have found, that people think that these thoughts can be potentially dangerous, for example if a person with OCD has a thought of poisoning their mother, and felt that they may act on this thought if the person were to be left alone with her. They could feel frightened of their lack of control and that potentially could do this.

Similar to Salkovkis' research , that the idea of associating thought and action with an extreme feeling of responsibility for harm, an example of this would be "If I think about my dog dying, it will cause it to happen". Rachman and Shafran came up with another model called " thought action fusion" (TAF), this is where when you believe that just thinking about an action is the same as actually doing the action. For example if you randomly started thinking about your fish dying, you would believe this to be as bad as actually harming your fish. They find the intrusive thought and potential action morally equivalent. Rachman found that TAF works in two different ways, the first is TAF likelihood, in which the belief that having this intrusive thought increases the likelihood for the event to happen. The second type is moral TAF in which the person with OCD feels that the intrusive thought is morally equivalent to carrying out the negative act. Although this notion of TAF is slightly unusual, an example with people who do not have OCD would be the fact that most people tell little lies, such as "my computer broke" or "the train broke down "but it is very unlikely for someone to lie saying "my mother died", this is because they don’t want to tempt fate or they would find it offensive. This is a normal process, but this normal process is also a contributing factor in people who have OCD.

Some ways to treat OCD can be through cognitive behavioural therapy (CBT), it can be used by getting rid of irrational thought processes, and challenged people’s beliefs, and it can help people with OCD to stop neutralising. One of the processes of CBT is exposure response prevention, in which you confront the things that you fear and would usually avoid. For example in Salkovskis’ television programme "The House of Obsessive Compulsives "in which he got a woman with OCD, that was completely afraid of germs to put her hand down the toilet, and then to eat a packet of crisps. And if the person who preventing a normal OCD response, that they have a ritual that they must complete to do something they will not be allowed to do so. However in this process it is in important that there is a graded hierarchy of exposed fear.

The aims of CBT for OCD patients is to help the person start to believe that the intrusive obsession thoughts, are nothing to do with their actions, and that these intrusive thoughts that they are having can only be reduced by changing their interpretation, and that they have no need to try and control their thoughts. That nobody has the power to control all their thoughts if we did then we would have no imagination and it would be very mundane. Further to this the person who has OCD need to alter their original beliefs about what their thoughts and responsibilities are, and understand that their problems that they are experiencing are of thought not of reality. CBT helps in the maintenance of OCD by using exercises to help suppress thoughts and rituals, and by sing responsibility pie charts. Another type of therapy is for the therapist to draw up a written contract accepting all of their client’s responsibility and they are liable if anything happens, this is a recent therapy which is shown to have some positive results. After the contract with the therapist is completed, the client then draws a contract with their spouse which allows them to take responsibility, until the client is finally comfortable to let go of the excessive responsibility they feel.

In conclusion there is a lot of research that supports the fact that the role of responsibility in OCD symptoms is a major factor, but treatment is difficult as it can often fail, if the person is not completely committed to the treatment.