INFERENCE PROCESSES IN OBSESSIVE-COMPULSIVE DISORDER - SOME CLINICAL OBSERVATIONS

In this paper we outline a cognitive model of Obsessive-Compulsive Dis order (OCD) which proposes that the core belief of OCD evolves through a series of illogical inferences. These faulty inference processes in volve inferring the plausibility of events on the basis of irrelevant associations, dismissing actual evidence on the grounds of going beyon d surface reality to a deeper reality, and finally inferring that a co mpletely fictional narrative is a remote probability. A therapy aimed specifically at changing these inference processes is illustrated with case examples of OCD clients who had not benefited from conventional behavior therapy. The inference based approach (IBA) complements exist ing cognitive-behavioral therapy but suggests that in certain cases, t he conventional cognitive therapy view of OCD beliefs as exaggerated f ears of remote possibilities may actually reinforce the obsessional be lief since even remote events are real. The IBA on the contrary sugges ts that an important goal in therapy is to highlight this confusion fo und in OCD between imagination and reality and illuminate for the OCD client how their compulsions, far from reassuring them about a remote possibility, actually take them further away from reality and reinforc e their imaginary doubt.