Repeatedly watching a video of themselves touching a filthy bedpan reduced people's OCD symptoms

Posted on January 15, 2019

Photo: pexels

Nearly half of people with Obsessive Compulsive Disorder (OCD) are afraid of touching something they feel is “contaminated”, such as pressing the lift button or holding on to bus handrail. After touching something “contaminated”, they have the urge to constantly scrubbing their hands, and sometimes even until they bleed.

The common treatments for OCD include a combination of a prescription drug and cognitive behavioural therapy (CBT) which help only about 60 per cent of people with OCD, hence it is important for a more effective treatment. Researchers from the University of Cambridge presented initial data suggesting that a simple video intervention, delivered via a phone app, might increase the effectiveness of treating OCD.

For this study, the researchers recruited 93 people without a diagnosis of OCD but displayed a higher than average of fears about contamination. The reason being for such recruitment decision was to avoid worsening the symptoms of people who are diagnosed with OCD by their experimental treatment.

Fortunately, their intervention showed significant improvements after a week for the participants in the two intervention groups, whereas the participants of the control group did not. The study started with all the participants completing an initial battery of questionnaires and a clinical interview. The participants were then allocated into two intervention groups which were videoed for 30 seconds either touching toilet paper inside a bedpan that had been mocked up to look and smell as though it contained faeces or washing their hands in a sink. The control group participants were videoed making arbitrary hand gestures. These videos were loaded into a smart-phone app, which prompted the participants on four occasions daily over the next 7 days, to watch their own video.

This study suggested that watching the bedpan video serves as a much less confronting, less time-consuming and less expensive method of standard exposure-based CBT therapy. By watching the bedpan video, it allows the participants to be exposed to “contaminated” object such as a toilet seat, which causes anxiety. Despite experiencing anxiety, the participants were prevented from washing themselves. This method allows the participants to gradually decrease their anxiety level without washing and learn to overcome their contamination fears. While watching the bedpan video allow the participants to be exposed to contaminated object, the hand-washing video aimed to allow a kind of vicarious cleansing, relieving the participants’ worries about contamination without them washing their hands.

All the participants were asked to visit the lab for a follow-up testing on the eighth day. The researchers measured the participants with the Yale-Brown Obsessive-Compulsive Scale and it indicated that both the intervention groups showed a significant decrease in OCD symptoms, in which they displayed a better performance at a test of cognitive flexibility. However, their scores on the contamination fears scale did not decrease. The researchers suggested that the duration of this experiment is not sufficient for the participants to recognize changes within themselves. The participants of the control group showed no changes in any of the measures.

Several participants shared their own experiences. One participant who was in the hand-washing condition group reported the absence of need in washing hand after using the app. While one participant who was in the bedpan condition group claimed that he/she will not dispose the cloth which was used for wiping a kitchen worktop and will clean the cloth for using it another time.

The researchers suggested that these interventions were worth investigating to find out if they can work as a mode of treatment for OCD as they are inexpensive and accessible which can be tailored for individual patients. Also, these interventions have the potential to reach communities that do not have access to adequate mental health care.

Category(s):Obsessions & Compulsions (OCD)

Source material from BPS Digest