Cue Exposure and Relapse Prevention

Abstract

Compulsions and addictions are very similar in many respects. In both, there is a strong urge to do something which is difficult to resist. They often lead to a reduction in anxiety but are sometimes difficult to stop, and then, if prolonged, they are associated with an increase in anxiety and a feeling of helplessness. Frequently, both compulsions and addictions are so powerful that family or work responsibilities are ignored, and both, when severe, involve repetitive stereotyped actions. Both addictions and compulsions are prime examples of the irrational self-destructive behavior which is part of the human condition, and both are generally considered to be among the most intractable of problems. If they are similar in so many ways, then there may be some advantage to be gained from applying a “compulsion model” to alcoholism, especially since there have been recent advances in the treatment of compulsive disorders (e.g., Meyer, 1966; Rachman & Hodgson, 1980; Rachman, Hodgson, & Marks, 1971). It has been clearly demonstrated in a number of studies that compulsions can be modified by an extinction procedure involving prolonged exposure to those cues which trigger, or at least influence, the compulsive ritual. The compulsive hand washer is persuaded to touch “contaminated” objects and then resist the urge to wash so that the imaginary contamination is spread to all and sundry. A person who feels compelled to check and recheck gas taps off as quickly as possible without checking.