OCD “case study”
The context for this artistic endeavor was that I was working at the Institute of Psychiatry, London with Dr Ray Hodgson at the Addiction Research Unit and he had been researching the treatment of anxiety in general and compulsive behavior in particular with professors Isaac Marks, a psychiatrist, and Jack Rachman, a leading behavioral psychologist. They had been developing a technique called Cue Exposure with Response Prevention which was based on the idea that if you get people to face their fears rather than avoid them,anxiety will diminish. This led to some interesting scenarios with OCD sufferers. For example, I remember standing in, around and on garbage containers with people suffering from OCD contamination fears, ostensibly to show that nothing terrible happens when you expose yourself to germs (except you do tend to smell a bit).
The technique has proved useful in other areas, and my PhD was based on showing that you could use the technique to diminish craving and increase self-control in addicts. I composed this on my way to work one morning and Dr Rachman, an inveterate prankster who happened to be not only one of the leading psychologists of his time but also the editor of the journal Behavior Research and Therapy, published it.
Published in Behavior Research and Therapy
CASE HISTORIES AND SHORTER COMMUNICATIONS
Successful treatment of a compulsive limerick composer by behavioural methods
Summary: An odd patient is briefly explained, and the methods by which she was trained, to rid her in time, of compulsive rhyme, so that very little remained.
There are several syndromes quite new
That occasionally come into view
They appear in the clinics
And create many cynics
As to what should be done and by who.
This patient who hailed from Leeds
Was troubled by compulsive deeds
This led to the capers
Of searching through papers
To learn how treatment proceeds.
But to my deep and utter chagrin
I could nothing discover therein
That would serve as an aid
In my treating this maid,
And ridding her fully of sin.
The problem she had at this time
Manifested itself as a mime
For whenever she spoke
She either would choke
Or emit only five lines in rhyme.
Of all the patients to pick
I’d got one who really was sick
It was not a pose
There just was no prose
A slave to that old limerick.
A couple of weeks on one pill
Had little effect on this ill
Neither it seems
Did talking of dreams
Or toasting her lobe on the grill.
While walking one day in Belgravia,
Considering my role as her saviour
I suddenly thought
That I really ought
To look at my patient’s behaviour.
Having made a number of starts
I looked at the various parts
And immersed in my tables
And numerous labels
I explored this science of charts
From the consequent huge mass of data
Divulged by this suffering prose hater
A quick plan was mooted
And then instituted
That would help her sooner or later.
As aversion had ended in sparks
And implosion afforded no larks,
Off I did toddle
To try out the model
of Rachman, Hodgson, and Marks.
What this meant was response prevention
Which was well within my comprehension
While she fought with her urge
Her rhymes did she purge
Shouting phrases I could not right mention.
Proof that she’d lost her paralysis
Came in the MULVAR analysis
For no one can shun
A point 0 0 one*
Or talk of statistical fallacies.
After weeks of this kind of session
She partly had lost her obsession
Starting to write
All times of the night
In forms that did not really rhyme properly or scan.
As treatment progressed in this way
More words was she able to say,
That did not rhyme or scan in any manner. In fact, she could talk quite normally and hold perfectly reasonable conversations with all sorts of different people in any number of different situations. She would occasionally hiccup in rhyming couplets but it was felt that this too could be treated if it did not recover spontaneously.
At follow-up three months later
I collected a little more data
For she’d had a relapse
Brought on by collapse
And eventual demise of her pater.
However these problems were soon overcome and I am glad to report that this patient continues to make excellent progress. Replication of this unusual study is eagerly awaited.
Limerick Research Unit l0l Denmark Hill London SES 8AF, England
Rachman S., Hodgson R. J. and Marks I. M. (1971)The treatment of chronic obsessive-compulsive neurosis. Behav. Res. & Therapy 9.237-247.
* normally written .oo1 or p<.001 meaning that the finding is likely to occur less than one in a thousand times.