The link between fear of self and OCD



Fear of self appears to be at the root of a number of OCD subtypes, including aggressive obsession and impulse phobia. 

You check your oven ten times to make sure it's off, place your cans in the pantry in alphabetical order and are terrified of germs. You're likely suffering from obsessive compulsive disorder, or OCD, which affects 750 000 Canadians. For 40% of them, cognitive-behavioural therapy does not help control their obsessive behaviours. According to Frederick Aardema, researcher at the Institut universitaire en santé mentale de Montréal Research Centre, part of the solution lies in addressing a fear of self, which therapy does not currently consider.

Fear of self appears to be at the root of a number of OCD subtypes, including aggressive obsession and impulse phobia. Some sufferers may stay away from children because they are convinced they could abuse them. Others never keep knives in their home because they believe they could use them to attack someone. These individuals have developed a fear of self: anxiety about what they could do if they acted on their thoughts. 

Frederick Aardema and his team looked to a literature review and clinical studies to develop a questionnaire to diagnose and change this false self-perception. They then tested their therapeutic approach on 93 patients to determine whether it helps reduce fear of self and alleviate OCD symptoms. The findings are conclusive: by combining the questionnaire and cognitive-behavioural therapy, patients are better able to distinguish the obsessive doubts they imagine from normal ones and better control their OCD. 

The approach could also be used to treat eating disorders, anxiety and body dysmorphic disorder—an obsession with a perceived physical flaw—which are linked to a fear of self.

To take part in an OCD study led by Frederick Aardema at no charge, contact Philippe Valois by e-mail (pvalois.iusmm@ssss.gouv.qc.ca) or telephone (514-251-4015, ext. 3585).