Associations are deeply imprinted and ingrained in the human brain as a result of evolutionary processes, and therefore indicating no requirement of specific individual learning, most mental connections depend on learning and experience. Thoughts will come and go. Experimental studies show that most of the thoughts vanish within a few hundred milliseconds. However, during this time new thoughts are activated and spread like viruses. This happens automatically—irrespective whether one wants it or not.
What to expect?
Persons suffering from OCD often have idiosyncratic and, at the same time, very lopsided associations. A person who is excessively fearful of murdering his or her children with a knife will, when seeing a knife, more likely to associate it with those obsessive concerns or experience visions of horror, rather than a neutral cognition like spoon, fork, or cutting up vegetables. OCD patients also experience neutral associations, but they are buried and/or their intensity is much weaker.
How does it work?
Total control over the flow of thoughts is neither sensible nor possible for an individual. When one speaks, one may to some extent be able to direct one’s talk to a certain point. But it is not possible to plan the exact wording and intonation beforehand. Pre-conscious processes, in the form of strong association assemblies, navigate our thinking.
The technique, called association splitting, is founded on the way in which associations and cognitions work, as described in the preceding paragraph on associations. It makes use of two basic mechanisms: The linking of new cognitions with existing thoughts, or the strengthening of older associations, automatically leads to a weakening of competing associations. Another important aspect of this method is the fact that the strength of cognition A in relation to B is not necessarily as powerful as the strength of cognition B in relation to A! Obsessive thoughts may be viewed as firm assemblies of associations that mutually strengthen each other, creating a vicious circle.
Giving in to these obsessive thoughts by performing compulsive rituals, or by avoidance or safety behavior (see last section) may bring about short-term relief and reduce anxiety. However, the obsessive network is strengthened. The associations become stronger, and the subjective perception of immanent danger is cemented).
From this perspective, obsessive thought circles differ from other associative circles in the following ways:
1. Cognitions in the obsessive network are strongly intertwined, yet the number of other associations is reduced.
2. At the same time, there are one-way connections between neutral and obsessive thoughts maintaining obsessive worries.
Reduction in obsessive thoughts using association splitting
The technique is almost identical to the explanation above made. At the core of it lies the need to expand the repertoire of the shared cognitions associated with the obsessive thought, that is, new associations have to be created and currently weak associations to neutral or positive cognitions have to be strengthened. At the same time, everything that perpetuates obsessive thoughts must be avoided. It is important not to initiate fruitless brooding and not to suppress obsessive thoughts. The more one try to rid oneself of them, the stronger these thoughts will become.
When is it used?
Association splitting is predominantly used in intervention of patients suffering from Obsessive compulsive disorder and also at time introduced with patients showing symptoms of anxiety disorder.
Role of therapist:
These interventions should preferably be facilitated by a therapist and are not intended as self-help treatments. It includes:
Exposure in vivo or in sensu
Confrontation with obsessive thoughts
Clarifying the exaggerative nature of obsession
Distinguishing between thoughts and actions: