«Do I love her or not?!»
Teresa Cosentino, Francesco Mancini
In this article we present a patient with obsessive-compulsive disorder (OCD), treated with cognitivebehavioural
therapy (CBT). The patient was afraid of behaving immorally and of being despised by
others or by himself because of his behaviour. We focused on his acceptance of the possibility that
one could be despised instead of focusing on intrusive thoughts and compulsive behaviour (originating
from his fear), as is the usual approach in CBT. We expected a decrease in the OCD symptoms and
reduced vulnerability to future relapses by reducing the patient’s efforts in guilt and scorn prevention.
The outcome confirmed our hypothesis. Although dysfunctional behaviours (i.e. rumination and
avoidance behaviour) were not treated directly, they decreased spontaneously during treatment. This
outcome was maintained after a one year follow-up.
Keywords
Obsessive-compulsive disorder, acceptance of threat, fear of being despised,
imagery exposure and in vivo exposure.
