Paradoxical intention in the treatment of obsessional flatulence ruminations

Milan, Michael A.; Kolko, David J.

doi:10.1016/0005-7916(82)90062-3

Cited by 16 publications

(8 citation statements)

References 14 publications

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“…To our knowledge, disturbances in biological and psychological processes in ORS have not been studied, although preliminary (uncontrolled) reports of improvement in ORS with pharmacotherapy or psychosocial treatment (behavioral therapy [15, 48], cognitive-behavioral therapy [62], and paradoxical intention [63]) indirectly support the presence of such underlying mechanisms. In addition, excessive grooming behaviors in animals offer a possible ethological model for human ORS [64].…”

Section: Resultsmentioning

confidence: 99%

Olfactory reference syndrome: issues for DSM-V

2010

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The published literature on olfactory reference syndrome (ORS) spans more than a century and provides consistent descriptions of its clinical features. The core symptom is preoccupation with the belief that one emits a foul or offensive body odor, which is not perceived by others. This syndrome is associated with substantial distress and disability. DSM-IV and ICD-10 do not explicitly mention ORS but note convictions about emitting a foul body odor in their description of delusional disorder, somatic type. However, the fact that such symptoms can be non-delusional poses a diagnostic conundrum. Indeed, DSM-IV also mentions fears about the offensiveness of one’s body odor in the social phobia text (as a symptom of taijin kyofusho). There also appears to be phenomenological overlap with body dysmorphic disorder, obsessive-compulsive disorder, and hypochondriasis. This paper provides a focused review of the literature to address issues for DSM-V, including whether ORS should continue to be mentioned as an example of another disorder or should be included as a separate diagnosis. We present a number of options and preliminary recommendations for consideration for DSM-V. Because research is still very limited, it is unclear how ORS should best be classified. Nonetheless, classifying ORS as a type of delusional disorder appears problematic. Given this syndrome’s consistent clinical description across cultures for more than a century, substantial morbidity, and a small but growing research literature, we make the preliminary recommendation that ORS be included in DSM-V’s Appendix of Criteria Sets Provided for Further Study, and we suggest diagnostic criteria.

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Section: Resultsmentioning

confidence: 99%

Olfactory reference syndrome: issues for DSM-V

2010

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“…2. Earlier reports of success using paradoxical intention with obsessive-compulsive and phobic clients (Gerz, 1966) tend to have been confirmed in recent, adequately designed and controlled studies (Ascher, 1981;Lamontagne, 1978;Mavissakalian et al, 1983;Milan & Kolko, 1982;Solyom et al, 1972).…”

Section: Assessing Paradoxical Interventionsmentioning

confidence: 83%

Paradoxical intervention in psychotherapy

Griffin

1985

Australian Psychologist

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by interpreting a programme [or anorexic patients in terms of several common paradoxical procedures. The techniques 0 1 symptom prescription, relraming, restraining, written messages and positive interpretations are outlined and discussed together with Frankl's logotherapeutic techniques of paradoxical intention and dereflection. It is noted that various schools of therapy have contributed to the use of these techniques. Several theoretical and conceptual issues pertinent to the utilization o f paradoxical interventions in psychotherapy are briefly discussed. The notions of client resistance and the double bind seem central to most paradoxical manoeuvres, and possible difficulties with these are commented upon. It is suggested that a clarification of paradoxical procedures could be aided by a consideration of non-paradoxical explanations and by distinguishing between a focus on systems versus individuals. An attempt is made to define paradoxical interventions as a class by concentrating on rundamental components. Finally, the current status of paradoxical psychotherapy is summarized and possible future developments noted.The diverse and complex field of paradoxical psychotherapy is introduced Requests for reprints should be sent to Michael W. Griffin,

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“…Despite its methodological shortcomings (Ascher, 1980;Weeks & L'Abate, 1982), this study provides some support for paradoxical intention in eliminating obsessive thoughts. Milan and Kolko (1982) reported the effective use of symptom prescription in the treatment of a 33-year-old woman with a ten year history of obsessional flatulence ruminations that had proved resistant to other forms of therapy. The patient reported an obsessional worry that she was constantly surrounded by an unpleasant odor of flatus, which became more intense as her level of anxietv increased.…”

Section: Insomniamentioning

confidence: 99%

“…These latter findings are especially interesting since they raise the possibility that the presence of coping statements may well contribute to the maintainence of the anxiety component in some agoraphobics. Ascher (1980) (Milan & Kolko, 1982;Solyom et al, 1972). Solyom et al (1972) compared the effects of paradoxical intention applied to a "target" thought with an untreated control thought in ten patients complaining of multiple obsessions.…”

Section: Insomniamentioning

confidence: 99%

“…For example, in the case of an individual complaining of obsessive ruminations, the therapist may prescribe the thoughts themselves (Solyorn, Garza-Perez, Ledwidge, & Solyom, 1972), or the subject matter of the thoughts (i.e., the behavioral counterpart) (Milan & Kolko, 1982). In agoraphobics, symptom prescription may be directed at the cognitive component (e.g., Ascher,198 l), the parienr being requested to bring about the feared disastrous consequence of prolonged, intense anxiety (e.g., heart attack, fainting, vomiting, "going crizf"), and/or at facilitating such physiological correlates of anxiety as sweating, blushing, or heart palpitations (Mavissakalian, Michelson, Greenwald, Kornblith, & Greenwald, 1983 (Ascher, 1980).…”

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confidence: 99%

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