A recent study concluded that those with obsessive-compulsive disorder might get relief from watching someone else perform compulsions as opposed to having to do them on their own. The study involved ten participants with contamination OCD who were shown various “disgusting scenarios,” and some were asked to touch these “contaminated” objects. Each participant experienced significant relief just by watching a researcher wash his or her hands– even those participants who had touched the object themselves. More trials with more participants are already underway.
While this is certainly an interesting study, is watching “virtual compulsions” something that could actually be helpful to those with OCD? Isn’t it just replacing one compulsion with another one? The premise behind exposure and response prevention (ERP) therapy is that the response (compulsion) should be prevented – not substituted with a different compulsion (watching someone else perform a compulsion). If someone’s compulsion is hand washing, they should work toward not washing their hands, not watching others was theirs.
But what if someone’s hand washing compulsion has left them with red, raw, painful hands? Wouldn’t it be better to watch a video of someone washing their hands than continue to hurt yourself while washing your own hands? I’m thinking it can be seen as more of a stepping stone to response prevention than as a substitute compulsion. The person with OCD could go from severe hand washing to watching someone else washing their hands and then to no hand washing compulsion at all. Those with OCD would still work toward embracing the uncertainty of life by not performing compulsions at all – it would just be a more gradual approach. For those who have skin-picking or hair-pulling compulsions, or any other self-harm compulsions, I think the use of virtual compulsions could be really helpful.
I’m not a therapist, and these are just my own thoughts. If someone is considering using virtual compulsions, I think it is really important to do so under the supervision of an experienced OCD therapist. You don’t want to get stuck just substituting one compulsion for another – you want to always have the end goal of not performing any compulsion.
I’d be interested to hear what those with OCD think of this new finding, and if you feel it might be helpful for some people with the disorder?