Book Reviews

*****

Finally a book that has a logical explanation for the desire component in my OCD, which is for me the most confusing part. It is making my sexual obsessions unbearable, feeling wanted and unwanted at the same time. Every behavioral therapist should have read about this, the therapists who treated me did not know about this. There is a great danger to misclassify patients like me. Martin Johannson, Germany 

'The book considers pure obsession in three different ways: from Edwards’s perspective, from a therapeutic standpoint, and with fresh scholarship on OCD. Considerations of OCD are expanded upon with a variety of source materials, including both personal and professional work… The book’s more scholastic material draws upon reputable personality and psychiatry studies, delivering concrete advice to alleviate OCD suffering. It proposes therapeutic interventions, including cognitive behavioral therapy and exposure response prevention…’ Clarion Review 

'This is a very demanding piece… I'm sure that you are onto something. I long puzzled about obsessions and addictions, not least in my own case!!' Comment prior to publication by Professor F. Toates, author of "Obsessive Compulsive Disorder and Biological Psychology". 

'Desire-Intrusive Thoughts draws upon personal experiences with OCD to deliver professional advice about how to help others. The book’s primary focus is on the pure obsession component of obsessive-compulsive disorder. Early on, it contrasts obsessive thoughts with compulsive actions, then enters into a broad overview of OCD-associated issues related to sexuality, self-harm, and religion. It argues that all obsessions, including sexual ones, are involuntary and cause unnecessary alarm in those who hold them. Its foci include addictions, pedophilic thoughts, and intrusive incestuous thoughts, all of which it claims can make people on the OCD spectrum internalize a sense of “moral wrongness” about themselves... Deep examinations of concurrent disorders, like anxiety and depression, are later used to suggest therapeutic approaches like progressive exposure to stimuli and conditioned responses. Foreward Reviews 

'It (The book) proposes therapeutic interventions, including cognitive behavioral therapy and exposure response prevention. Verbatim dialogues are included to illustrate how such tools work, as with a lengthy conversation between a woman and her therapist that raises concerns around personal orientation, with the woman seeking constant reassurance that she is not gay. The book’s neuroscientific information is technical in nature... Most geared toward mental health practitioners, Desire-Intrusive Thoughts is a dense text that draws upon personal experiences with OCD to deliver professional advice about how to help others.' Clarion Review cont... 

More than helpful, very descriptive of the causes and how to handle the devastating effects it can have. Kevin Roberts, UK 

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Hi Carol, Congratulations on getting your book published and thank you for speaking with me. To start, tell us what inspired you to write this book?

I wanted a better understanding of why some people who have sexual, religious, and harm obsessions in obsessive-compulsive disorder (OCD) endure false arousal.

That is interesting. Can you summarise your book in one to three sentences as if you were speaking to someone unfamiliar with your book and its topic?

Some people mistakenly think they like the feelings or urges that come from sexual, religious, and harm obsessions, and several struggles with the erroneous belief that they might act on them. My book discusses this issue in-depth.

What is the overall theme of your book?

The overall theme is about absorption in sexual, religious and harm obsessions and how false desire might affect obsessional involvement. When one is absorbed in an obsession, it can lead to a term known as dissociation peculiar to OCD (Dr Nirit Soffer-Dudek, 2018). It isn't to be confused with dissociation that involves the experience of derealisation and depersonalisation. Instead, it's when somebody's attention is lost in the imaginary story (the obsession). In that case, they need to re-establish the ability to engage in treatment.

It sounds like it was a complicated topic to pursue, with a more scholarly leaning. Would you agree?

Perhaps, although I didn't invest my time naively. The problem affects people's lives, and I believe it deserved a comprehensive evaluation. I'm happy with the result of my research. 

So, the audience? Where do you think the audience for this book is?

People appear to suffer from the central topic of my book worldwide. So it extends to a global community in which many will identify, including therapists who treat OCD. Also, families who do not fully understand what their loved ones are going through.

I see. So how do you make sure that people across various strata identify with your book then?

I portray a true-life story of living with OCD, coupled with the researched information. It's important to my readers and me that I tell part of the story through my lens. I believe it helps people identify with the obsessive-compulsive problem and offers hope that recovery is a reachable goal.

That is indeed a great approach. I agree that a slice of life is more relatable. So tell me, how is this book different from the plethora of books available on the subject? 

I'd say it provides specific information that appears to be missing in the educational handouts for people who struggle with the desire-aversion concept. Many want answers, say about groinal response, but the rebuttals knock them back. For example, it is correct to say, it's just your OCD and also right not to give reassurance as a compulsion. Still, such feedback doesn't answer the question directly. It's often about an understanding that correlates with the problem that people want, not reassurance, or to be told something they already know.

What about relevance to today's society. How is your book relevant?

It's relevant to today's society because of how many people suffer from intrusive thoughts. The NICE guidelines report 5.5% of sufferers of OCD have obsessions related to sexual thoughts, and 4.3% have obsessions related to harm. Add to the number of people who struggle with suicide obsessions yet are misdiagnosed with suicide ideation, and it brings more relevance. My book also brings attention to the distinction between harm-intrusive thoughts and non-suicidal self-injury. People's struggling with dissociation peculiar to OCD that involves my desire-aversion theory means the book could become even more relevant to people worldwide.

You've mentioned dissociation in OCD. Can you explain the concept of dissociation peculiar to OCD in a little more detail, say with the example of a suicide obsession?

Yes. Let's assume a person who struggles with suicide-intrusive thoughts mistakenly thinks she should end her life. She might set plans, such as setting a suicide date repeatedly. But what she doesn't know yet is that the dates are the compulsion to relieve anxiety. When the ritual doesn't work anymore, it's because she's become more deeply absorbed in the obsession. Therefore, it's crucial that clinicians are aware because the rituals can turn hazardous in this type of situation. 

How might the desire component play a role in a suicide obsession, then?

Well, let's suppose the obsession involves thoughts that make some people think they have a desire or calling to end their lives. For example, to please God. Well in that case, religious OCD would morph itself into the suicide obsession where rituals could become dangerous. My book explores this problem in detail and how to overcome it.

Ah, I see. So what about self-harm intrusive thoughts versus non-suicidal self-injury, how would you describe the difference?

Magical thinking is an example of self-harm intrusive thoughts. For example, someone might slap themselves to prevent something terrible happening or harm coming to a loved one, pretty much like someone else might tap an object to ward off danger. In contrast, people who self-injure do so to regulate emotions due to a build-up of stressors. I explain this more fully in my book that includes treatment interventions.

Wow. It is so important to understand the difference so as to be able to offer the correct intervention. On a different note, is there any subject currently trending in the news that relates to your book for sexual-intrusive thoughts?

I haven't seen anything currently trending in the news from my desire-aversion concept. However, there are articles and books out there on sexual, religious and harm obsessions. I've noticed that some psychological professionals have written about the groinal response, and others talk about sexual non-concordance. One book is Sexual Obsessions in Obsessive-Compulsive Disorder by Monnika T.  Williams & Chad T. Wetterneck. Another one is Pure by Rose Bretecher, which features the author's true-life story of living with sexual-intrusive thoughts. It was also made into a TV drama in the UK. 

Sexual non-concordance? What is it? Are you covering it too, in your book?

Legitimately, it means that people can feel physically aroused even though they aren't thinking about sex or thinking of sex but not getting physically aroused. From my book's perspective, it's about grasping that if you have a sexual obsession and experience genital arousal, it doesn't mean your mind agrees with that sensation and vice versa. More specifically, since OCD instigates it, it is seen as an anxious or somatic response. It means the thoughts and bodily sensations are not about sex but an obsession with the intrusive content. Since the content is invalid, people cannot respond to it reciprocally. I talk about sexual non-concordance in my book and its correlation with the groinal response and unwanted arousal in OCD.

Do you believe the evidence-based treatment, exposure-response prevention, is the right intervention for the problems discussed in your book?

Yes, definitely. The most important thing is discussing how people can stay on track with their exposures and use response prevention. 

Let's explore more about exposure-response prevention (ERP). How does it work for people who have the desire component?

Well, first, ERP helps prevent the actions people do in response to intrusive thoughts, including those who have the desire component. So when people do ERP, they learn to face their fears in small steps (this is the EXPOSURE) and then resist the compulsions in response to the obsession (this is RESPONSE PREVENTION). Over time, it helps them build a tolerance for anxiety and leads to reduced symptoms or remission. The only difference is that when a therapist treats a patient struggling with a deeper level of absorption, they would need to enhance the treatment approach. For example, it would require helping the patient to learn how to pick up on the cues, such as identifying when they are getting too involved in the obsession and immediately redirecting them back to response prevention. Again, much of this is explained in my book.

What else do you want readers to take away from your writing that relates to desire-intrusive thoughts?

Mostly to reiterate that since all intrusive thoughts are empty of meaning, it explains that the desire component is also false. It has no reciprocity between obsession and self. It is crucial to have this education to improve treatment outcome. When behaviours appear illegal (e.g., someone's watching illegal porn to prove they are not a predator), it may help, too. That is, if a therapist or family member suspects certain behaviours are suspicious and could land a person in trouble, the education could be helpful. It is crucial to treat them for OCD, not punishment for a disorder they're trying to make sense of, and that isn't their fault.

It is such a unique take on the disorder. Can you tell your readers where they can purchase the book?

It can be purchased worldwide on Amazon and Barnes & Noble and also my book's website www.intrusive-thoughts.com.

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