Acceptance of being guilty in the treatment of obsessive-compulsive disorder

Teresa Cosentino, Francesco Mancini (2012): «Do I love her or not?!» Intervention on fear of being despised: An obsessive-compulsive disorder case presentation. In: Psicoterapia Cognitiva e Comportamentale, 18 (2), pp. 1-3, 2012.


In this article we present a patient with obsessive-compulsive (OCD), treated with cognitive-behavioural therapy (CBT). The patient was afraid of behaving immorally and of being despised by others or by himself because of his behaviour. We focused on his acceptance of the possibility that one could be despised instead of focusing on intrusive thoughts and compulsive behaviour (originating from his fear), as is the usual approach in CBT. We expected a decrease in the OCD symptoms and reduced vulnerability to future relapses by reducing the patient’s efforts in guilt and scorn prevention. The outcome confirmed our hypothesis. Although dysfunctional behaviours (i.e. rumination and avoidance behaviour) were not treated directly, they decreased spontaneously during treatment. This outcome was maintained after a one year follow-up.