The role of traumatic experiences in the genesis of obsessive-compulsive disorder.

This paper discusses the role of traumatic stress in the genesis of obsessive-compulsive disorder. While the early classical conditioning theory of the onset of obsessive-compulsive disorder has only limited empirical support, authorities have always recognised the role of stress in precipitating this disorder, and in triggering relapse in those who have been successfully treated. Here, clinical cases are cited that show a causal link between severe trauma and the onset of obsessive-compulsive disorder. The nature of the traumatic reaction and the possible mechanisms by which it leads to frank obsessive-compulsive disorder are discussed. The apparent links between this and posttraumatic stress disorder are also explored. Finally, implications for therapy are considered.     

Girls' identity formation in the changing social structure of Sri Lanka.

Adolescent girls (N = 118) from diverse social backgrounds in Sri Lanka described their views of womanhood. Qualities of the ideal woman considered most important were kindness and honesty, liking children, intelligence, and having a good job. Although the traditional role of the Sri Lankan woman is that of homemaker, most girls in the study (55%) drew the ideal woman working outside the home, often as a teacher or a doctor. Nevertheless, adolescent girls emphasized traditional qualities of the woman at both work and home as self-sacrificing and serving others.     

Amnesia by post-training infusion of glutamate receptor antagonists into the amygdala, hippocampus, and entorhinal cortex.

The blockers of glutamate receptors, aminophosphonovaleric acid (AP5) (5.0 micrograms) and cyano-nitroquinoxaline-dione (CNQX) (0.5 microgram), were infused bilaterally into the amygdala, dorsal hippocampus, or entorhinal cortex of rats through indwelling cannulae 0, 90, 180, or 360 min after step-down inhibitory avoidance training. Animals were tested for retention 24 h after training. In the amygdala or hippocampus, AP5 was amnestic when given 0 min after training and CNQX was amnestic when given 0, 90, or 180 min after training. In the entorhinal cortex, AP5 was amnestic when given 90 or 180 min after training and CNQX had no effect. The results suggest that a phenomenon sensitive first to AP5 and then to CNQX in the amygdala and hippocampus, probably long-term potentiation (LTP), is crucial to post-training memory processing. LTP in these two structures could underlie their role in memory consolidation and could explain the late involvement of the entorhinal cortex in post-training memory processing.     

Buddhism and Counselling

The relevance of the principles and practices of Buddhism to the field of counselling is discussed. Buddhist techniques have already been used by the helping professions in many settings (e.g. Japan, Sri Lanka). The extension of their use to a wider range of settings, and to a wider group of clients, is both feasible and desirable. In addition to the obvious relevance of Buddhist techniques to clients who have a Buddhist background, it is argued that they have a wider applicability. As Buddhism espouses the notion of a productive and healthy lay life, it offers ways not only of dealing with problems and difficulties, but also of improving psychological well-being in general. Examples are cited of relevant Buddhist techniques and their application. It is argued that, once systematically evaluated, many of these could profitably be incorporated into the repertoire of techniques used in present-day counselling and therapy.     

Buddhist psychology: A review of theory and practice

This paper gives an account of some of the major aspects of Buddhist psychology. The survey is confined to the texts of Early, or Theravada, Buddhism — that is, the canonical texts and their early Pali commentaries and related expository texts. The importance of psychological concepts in the philosophy and practice of Buddhism is highlighted. The problems inherent in the study of Buddhist psychology are discussed, including the problem of translation and interpretation. The paper then describes and analyzes several key Early Buddhist psychological notions including: basic drives that motivate behavior, perception and cognition, consciousness, personal development and enlightenment, meditation, and behavior change. The relationship between theory and practice in Buddhist psychology is commented on, with special reference to meditative techniques and other behavior change strategies. Finally, comments are made on the possible interaction between Buddhist and modern psychology. An earlier version of this paper was presented at the Annual Conference of the British Psychological Society, St. Andrews, April, 1989.     

Does escape behaviour strengthen agoraphobic avoidance? A preliminary study

Two groups of agoraphobic patients were treated with one of two forms of exposure-based therapy. In one group, the patients stayed in the target situation until their self-rated anxiety dropped by half (Endurance condition). In the other, the patients were required to leave the fear situation when their anxiety reached a high pre-set level, without waiting for anxiety to drop (Escape condition). The patients in both groups improved, in contrast to those in a Waiting-list control group. There were no significant differences between the two treated groups. The results are discussed in terms of Mowrer's theory of fear and avoidance from which it can be predicted that patients in an ‘escape condition’ should not improve. Contrary to a Mowrerian prediction, patients who were taught to escape when still fearful, did not show increased avoidance behaviour.     

Exposure and fear-reduction

Boyd and Levis (1983, this issue, pp. 143–149) have contested the main argument of our earlier paper on exposure and fear-reduction (de Silva and Rachman, 1981). In this reply, our original argument is briefly restated and the position explained. Boyd and Levis' argument that exposure is necessary, is critically examined and it is concluded that the search for alternative (and additional) explanations of fear-reduction is a valid and useful exercise. Further investigations of the mechanisms of exposure and of non-exposure methods, are warranted.     

Prepared phobias and obsessions: Therapeutic outcome

Sixty-nine phobic and eighty-two obsessional patients, treated at the Maudsley Hospital, were rated for ‘preparedness’, the evolutionary significance of the content and behaviour of the disorder. Reliable ratings (r = 0.78 and 0.90) of the dangerousness of the object or situation to pretechnological man indicated that the content of the large majority of the phobias and obsessions are judged as evolutionarily significant. Degree of preparedness, however, did not predict outcome of therapy, suddenness of onset of the disorder, severity of impairment, intensiveness of the treatment received, or age of onset. Nor was there any significant relationship between preparedness and certain other variables in the obsessional sample: stimulus generalization, effect on life style, impaired reproductive capacity and abnormal personality. The implications of these findings for the hypothesis that human phobias and obsessions are prepared, and for the clinical usefulness of the concept of preparedness, are discussed.