ABSTRACT
This chapter provides a case of a 27-year-old man who presents with a 6-month history of increasing repetitive routines. He is now unable to leave the house without undertaking lengthy repetitive checking of locks, taps and switches. He is anxious and gently rubs his hands together without looking at them. His mood is not low subjectively or objectively. In this case he will need to consider how the obsessive thoughts lead to certain other thoughts, sensations, feelings and actions. Cognitive behaviour therapy (CBT) recognizes how these aspects interact in reinforcing cycles. CBT can be time consuming and needs motivation and commitment from the patient. It is usual to keep a diary to help identify individual patterns of thoughts, emotions, bodily feelings and actions. The relationship between these components is explored and techniques devised to help change unhelpful thoughts and behaviours. CBT can be difficult to implement if someone is acutely distressed as it does need a level of clear thinking.
