Salkovskis’s Theory Of Obsessions

Obsessions are thoughts, images or impulses that resemble that portion of meat that we chew and chew and cannot swallow. All human beings, to a lesser or greater extent, have ever experienced them.

While it is true that there are people with a greater tendency to suffer intrusions, these are still a normal phenomenon, typical of a developed brain. Therefore, we would fall into error if we came to conceptualize them as something pathological.

The fact of having one type of intrusion or another does not define the person. They just appear. It is something similar to what happens when we dream: it is normal to have dreams that do not correspond to our values ​​or way of thinking, but once we wake up, we are able to not give them too much value and let them pass.

What happens in some people is that they go through a process of fusion with their own mental contents. They add importance and value to them that they don’t really have. In obsessive compulsive disorder, it is normal for the person to believe that they are bad or that they are going to hurt someone just because they had a thought that told them this.

Salkovkis, taking into account the above, presented one of the first cognitive formulations on anxiety, and specifically, on OCD.

Salkovskis Theory: Thoughts vs. Obsessions

With the purpose of beginning to study the processes that we have commented, Salkovskis, in 1985 proposed his cognitive theory. The author differentiates between negative automatic thoughts and obsessions. A negative automatic thought is a subjective report that occurs in the face of certain circumstances without these being processed in depth (Rachman, 1981).

And it is this last difference, namely the degree to which they agree with our belief system, that is most central. An obsession is disturbing and causes discomfort because it has to do with something that is very valuable to the person.

Salkovskis argues that obsessive thoughts function as a stimulus that can provoke a particular type of automatic thinking. The available evidence shows that intrusions occur frequently in a non-clinical population without generating a high degree of discomfort.

These will become a problem only if they give rise to a series of negative automatic thoughts, through the interaction of these unacceptable intrusions for the individual. The discomfort, therefore, depends on the specific meaning for that patient. 

Responsibility as a scheme

Patients with obsessive compulsive disorder often overestimate the limits of their responsibility. The slightest possibility of harm – real or imagined – becomes intolerable for the person, who will try by all means to neutralize it. This tendency could be a consequence of having collected obligations at a very young age.

This responsibility scheme, when the person by maturity had few means to manage this pressure, would have led to the formation of different assumptions / automatisms :

• Having a thought about an action is like taking that action.
• Failure to prevent harm is the same as causing harm.
• Liability is not attested for other factors such as the low probability of occurrence of an event.
• Not carrying out neutralization when the intrusion occurs is like wanting to do harm.
• A person must and can control his own thoughts at all times.

The automatic thoughts or images triggered by obsessions revolve around this responsibility – “if things go wrong, it will be my fault” -. This guilt not only arises in the face of reality, but also in the face of the imagined possibility. Just by having the thought, the individual already feels a bad person and responsible.

It would be something like sinning by having a thought mediated by something that can be qualified as such. Therefore, the patient feels the need to stop the damage and guilt he is feeling with what he performs different neutralizations as attempts at a solution. Neutralizations, from Salkovskis theory, are understood as attempts to avoid or reduce the possibility of being responsible for the damage that may be caused.

From this theory, the patient is invited to consider these intrusions as if they were ” noise “; strip them of value, not make a fusion between thought, your person and reality. For this, in addition to cognitive therapy, it will be necessary to prevent the performance of rituals, thereby achieving habituation and dismantling beliefs about harm and personal responsibility.