Abstract
Two chronic and 2 acute cases of obsessive-compulsive disorder have maintained their improvement after exposure and response prevention in this University Hospital. Concrete methods of therapy in each case are described, and issues during the learning process and techniques in practical sessions are speculated on. In acute cases, the fear-evoking stimulus and the evoked avoidance response (obsessive action) were loosely connected. After a few sessions of exposure, the evoked response soon subsided. In chronic cases, the evoking stimulus/evoked response junction was close, and the evoked response was even ritualized. Their improvement was after many sessions of therapy. The effective factors of this therapy were considered as follows : exposure to the fear-evoking stimulus until the evoked response subsided was relatively simplified in procedure, because the stimulus used was fixed in each case ; and the therapist could carry out response prevention so sufficiently to get them accustomed to the stimulus, because the main symptoms of the patients were obsessive actions. In cases having intense fear, reciprocal inhibition to fear was associated in therapy, which produced effectiveness in sessions. Patients who fell into a severe obsessive state were attempted to join recreations and occupations in hospital. It seemed important as well to motivate patients to be treated, by making cognitive changes of their obsessive state.
