Behavioural Experiments in CBT – Adam Radomsky walking the walk

Many CBT Therapists will be familiar with the work of Dr  Adam Radomsky who directs an anxiety and  obsessive compulsive research laboratory focusing  on the research and treatment of OCD in Montreal.  He has made a  significant contribution to the  understanding  and  importance of  cognitions, thoughts and memory  in OCD and other anxiety disorders as well as conducting  new investigations into compulsive checking and contamination based OCD.

Count yourself  lucky if you’ve  had the pleasure of hearing him present at BABCP  events over the years. If  that’s you then you’ll know about his  relatable, engaging style and excellent communication skills. This 7 minute clip showcases these skills and demonstrates simply but powerfully the  harmful effects of excessive self- doubt on confidence. His research has revealed that excessive checking makes a person less sure, interferes with memory  and disrupts confidence. This is really important to remember when we are faced with patients struggling with OCD. Imagine waking up every day , weeks, months and often years without being sure of whether your actions will cause a catastrophe. Then try to imagine the corrosive effect these experiences will have on your ability to trust yourself.

I recently had an experience that powerfully  highlighted  how   easy it is for confidence to become diminished and why excessive checking is not your friend.  It was about 8.30 pm and I  was driving home from a long day at work   I was taking my usual route , one  that I have driven many , many times and to keep me company Radio 4 was burbling away in the background about to announce a major literary prize. I got engrossed in the coverage and at the last minute realised that emergency roadworks had sprouted up on the motorway  overnight and  I was in the wrong lane to  continue my journey. I indicated and tried to pull over but there was no space and so I ended up travelling in the wrong direction.  Crap, crappity crap is what  I said but no matter I’ll  just turn around at the next junction and get back on route. Only I was so spooked by my error I missed that turn off as well and found myself driving even further away from home.

A period of deep breathing and calm self talk  led to me correcting my mistake and I got home.  Eventually . I think I might have opened a bottle of something red. All’s well and all that. Only the next evening as my clinic ended  I started to become anxious about making the same mistake and found myself excessively checking road work signs and the traffic in my rear mirror in an attempt to calculate whether there was sufficient time and space for me to ensure I was in the right lane. The more I checked my mirrors the less sure I became about the  safety of the lane and by the time I arrived home  my neck, shoulders  and arms felt like rigour mortis had crept in.

Hello anxiety my dear friend but hang on a minute ,  not so fast. I know how you work. I’m a CBT therapist for God’sake. Don’t for one minute think that you are going to barge your way in here and tell me I can’t  be trusted to drive a  car. I’ve been driving for over 30 years. I’ve driven little cars and big cars. I’ve enjoyed road trips all over the UK, Europe and America. I’ve driven at  rush hour past  the Arc de Triumph and along the Champs Elysee where they drive like crazy fools. I’ve had loads of driving practice  and I’m a confident driver. Hell no,  I’m a really good driver. Reminding myself of all this history ,all that driving practice  was reassuring and  steered me away from taking the wrong psychological fork in the road.

I treat a lot of patients who have developed driver and/or passenger anxiety as a result of road traffic accidents.  I think they would be proud of me.  Maybe it’s OK for second hand car dealers to be all talk but   CBT Therapist’s have to practice what they preach. This lovely clip from Dr Radomsky reinforces this message.

@mspmurphy