Salkovskis's Theory on Obsessions
Obsessions are thoughts, images or impulses that you turn over and over in your mind and can never let go. Everyone experiences obsessions to some degree. Salkovskis’s theory on obsessions helps us understand why they happen and how to prevent them.
Although it’s true that some people are more likely to suffer from these cognitive intrusions, it’s still a very normal occurrence for the developed brain. Consequently, it would be a mistake to label obsessions as pathological.
The fact that you have some obsession or other doesn’t define you as a person. Obsessions simply appear. It’s similar to what happens when you dream. It’s normal to dream about things that have nothing to do with your values or way of thinking. When you wake up, it’s easy not to place too much importance on the content of the dream and let it go.
For some people, however, letting go isn’t that simple. Instead, they place too much value on their thoughts. People with obsessive-compulsive disorder often believe that the simple act of thinking about harming someone actually harms the person in real life. Or they think they’re a bad person because they have a negative thought.
With all that in mind, Salkovskis proposed one of the first cognitive explanations for anxiety and obsessive-compulsive disorder.
You have thousands of thoughts every day, from the time you wake up to the moment you fall asleep. Some of these thoughts relate to your personality in some way (egosyntonic). Others seem distasteful, which is why you don’t want anything to do with them.
Salkovskis’s theory: Thoughts versus obsessions
Salkovskis set out to study the processes that we’ve talked about. In 1985, he laid out his cognitive theory. Salkovski’s theory differentiated between automatic negative thoughts and obsessions. Automatic negative thoughts are subjective reactions that you have in response to certain circumstances. One crucial element of automatic negative thoughts is that you don’t process the thoughts very deeply, thus the name “automatic” (Rachman 1981).
In Salkovskis’s opinion, it’s possible to establish important differences between automatic negative thoughts and obsessions. These differences are based on the degree of the perceived intrustion, the degree of accessibility of awareness, and the degree to which they’re consistent with the person’s belief system.
This last difference is the most important. An obsession is disturbing and causes distress because it relates in some way to something that the person values very highly.
Salkovskis’s theory argues that obsessive thoughts act as a stimulus that can cause a particular type of automatic thought. The available evidence brings to light the fact that the non-clinical population experiences these intrusions quite often without experiencing a high degree of distress.
These thoughts become a problem only when they give way to a series of automatic negative thoughts through the interaction of said intrusions that are unacceptable for the individual. Thus, distress means something different for each patient.
Taking too much responsibility
Patients with obsessive-compulsive disorder tend to overestimate the limits of their responsibility. The minimal possibility of harm, real or imagined, becomes intolerable for the individual. They’ll try anything they can to neutralize that possibility. This tendency could be the consequence of having to take on a lot of responsibilities from a very young age.
This premature sense of responsibility, at an age when you aren’t capable of dealing with that kind of pressure, can lead to some problematic ways of thinking, such as:
- Believing that having a thought about an action is the same as carrying out that action.
- Failing to stop harm is the same as causing harm.
- The low probability that something will happen doesn’t relieve you of responsibility.
- Not carrying out the neutralization ritual when you have an obsessive thought is the same as wanting to do harm.
- A person can and should always control their thoughts.
Taking the blame when things go wrong
Automatic thoughts or images triggered by obsessions revolve round this sense of responsibility. Thoughts such as “If things go wrong, it’s my fault” are very common. What’s worse, this guilt doesn’t just come up in response to actual occurrences but also imagined scenarios. The patient feels like a bad person just for having a particular thought.
It’s as if you could be accused of sin simply for thinking about something that qualifies as such. Consequently, the patient feels the need to prevent harm and relieve the guilt they’re feeling. They engage in neutralizing rituals to “solve” the problem. Neutralizations, according to Salkovskis’s theory, are attempts to avoid or reduce the possibility of being responsible for potential harm.
The issue is that the “solution” becomes the primary problem. The individual gets trapped between their obsessions and compulsions, which extremely limits the way they live their life.
This theory invites the patient to treat these cognitive intrusions as “noise”. In other words, to take away their power. To differentiate between thoughts, reality, and who they really are. To do that, cognitive therapy is crucial. It helps the patient learn how to stop performing their rituals and let go of their beliefs related to harm and personal responsibility.