Short-Term Implosive Therapy: Case Study

Abstract

Effective application of implosive therapy is illustrated with a brief case description.Although implosive therapy is not even 10 yr. old, the research and clinical reports of its efficacy are impressive (Hogan, 1966; Stampfl & Lwis, 1967). Especially so are studies by Hogan and Kirchner (1967) and Levis and Carrera (1967) which indicate tha.: implosive therapy leads to significant behavioral changes in a very short peric~d of time. An additional important factor is that implosive therapy is not a stimulus-specific method but rather a broad-based technique where the entire stimulus complex is imploded so that anxiety conditioned to a wide variety of stimuli may be extinguished. These two elements, the brief time and the broad-base of the technique, made implosive therapy a particluarly good choice of therapeutic procedure to be used with the following client.The client was a 20-yr.-old single, male, college senior who was seen at a University Counseling Center. The client reported his major problem to be embarassment over the fact that he was losing his hair, and a related feat that no girl would like him and he'd never marry. He described himself as often being depressed, a chronic worrier suffering from feelings of worthlessness, having vague fears of homcsexuality, and also fears of rejection. Questions by the therapist made it evident that these worries and fears were of an obsessive nature and largely irrational in that his functioning was quite adequate. He was extremely bright, an excellent student, had been accepted to Law School for the following year, and did have a good number of friends and also dates. In addition to this presenting picture he reported a good deal of discomfort about corning to the Counseling Center, and said he'd prefer as short a number of sessions as possible. Obviously he was not at all motivated for longer-term "traditional" therapy, nor did there a p p e r to be serious problems in his behavioral functioning.During this initial session a time-limited ( 3 additional sessions) contract was established to use implosive therapy. The author gave a short explanation of the principles underlying implosive therapy, the techniques, and then focused on beginning to develop scenes appropriate to his irrational fears and worries.The next 2% sessions were spent using the implosive techniques. The scenes centered about his 05sessive worrying about getting dates and eventually marrying, losing his hair and being unattractive, being caught masturbating and feeling humiliated, and failing at intercourse. Since this was a short-term therapy, he was instructed to do "homeworkw-going over the scenes he had been im-

Imagery in Obsessive-Compulsive Disorder: Implications for Symptoms and Treatment

“…Most studies on the disorder have not included systematic imagery data. Part of the difficulty may lie in the fact that both patients and researchers have difficulty differentiating between images and thoughts [4,34]. However, research that does indicate the presence of a significant number of intrusive images includes a study by Parkinson and Rachman [34] that reported intrusive imagery in forty out of sixty nonclinical subjects and a study by de Silva [1] that indicated that thirty-six of seventy-six obsessional-compulsive experiences in forty-eight clinical subjects primarily involved imagery.…”

“…The value of research on imagery for understanding and treating obsessivecompulsive disorder (OCD) seems obvious because not only are certain types of imagery symptomatic of the disorder, but also imagery has contributed positively as a treatment component in a number of studies [2][3][4]. This article examines three primary facets of the interplay between imagery and OCD.…”