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The Imp of the Mind


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Table of Contents

The Imp of the MindPreface
Part One: The Problem of Bad Thoughts
1. The Imp of the Perverse
2. Thoughts of Harming Children
3. How Can I Be Certain They're Just Thoughts?
4. What Causes Bad Thoughts?
Part Two: Treatment of Bad Thoughts
5. Facing Your Fears Head-on: Exposure Therapy
6. Questioning Your Bad Thoughts: Cognitive Therapy
7. Blasphemous Bad Thoughts
8. Medications for Bad Thoughts
9. A Plan of Action

About the Author

Lee Baer, Ph.D., is an internationally recognized expert in the treatment of OCD and related disorders. Author of Getting Control: Overcoming Your Obsessions and Compulsions and The Imp of the Mind, Baer is an associate professor of psychology at Harvard Medical School and the director of research of the OCD unit at Massachusetts General Hospital as well as of the OCD Institute at McLean Hospital.


Specializing in the diagnosis and treatment of obsessive-compulsive disorder, psychologist Baer (an associate professor at Harvard) turns the spotlight on a little-known but common form of obsession, "bad thoughts." According to Baer, these "intrusive" thoughts fall into a few basic types: violent, sexual and blasphemous words, and images of a religious nature. Borrowing from Edgar Allan Poe, Baer blames such mental torment on "the imp of the perverse," that little devil inhabiting all human minds, cross-culturally and across time, "who makes you think the most inappropriate thoughts at the most inappropriate times." For most people, the imp proves no more than a "fleeting annoyance" most of the time, but for Baer's patients, these impish thoughts create extreme fear, guilt and worry. Attempting to suppress them only makes them stronger, leading the afflicted to avoid places, people and situations that provoke them. A new mother who obsessively thinks about harming her infant, for example, may increasingly avoid daily caretaking activities. Tending to be perfectionist and "overly conscientious," these people are highly unlikely ever to act on their bad thoughts, Baer explains. The most successful treatment, he says, involves desensitizing individuals by increasingly (and safely) exposing them to the situations that provoke their "bad thoughts"; cognitive therapy is also helpful for many patients. Finally, such prescription drugs as serotonin reuptake inhibitors, like Prozac, have also proved highly effective in the treatment of this disorder. With an easy-to-read style, Baer offers a comprehensive and accessible look at this fascinating topic. (Jan. 15) Copyright 2000 Cahners Business Information.

People with obsessive-compulsive disorder (OCD) suffer from excessive concerns about germs, appearance, or the possibility of doing harm to themselves or others. To combat these fears, they develop rituals such as checking and rechecking locks, hoarding goods, washing constantly, or pulling out hair. A conservative estimate is that one in 40 adults is afflicted with OCD, which until recently was considered almost untreatable. However, new antidepressants and behavioral therapy techniques have led to great improvements in the condition of sufferers of this biologically based illness. Psychologist Penzel has written a do-it-yourself guide that outlines in great detail procedures for a self-administered program of behavioral therapy. While it seems doubtful that such a program would be of much use to anyone as seriously disabled as some of the people described here, Penzel reminds us that many sufferers either won't seek help or can't obtain it because they are poor or live in an area underserved by the medical community. He even discusses programs that provide medications to people who can't afford them. For those of us out in the boondocks, a book on mental health acknowledging that many sufferers have, at most, only a general practitioner to whom they can turn is most welcome. This title is the most useful of the recent books on OCD and is highly recommended to all public libraries. Baer (psychology, Harvard Medical Sch.) presents a more narrowly focused work that concentrates on those whose primary problem is disturbing thoughts. It covers much the same ground as Penzel's work but in less detail. While The Imp of the Mind would make a useful addition to larger public libraries, Ian Osborn's Tormenting Thoughts and Secret Rituals: The Hidden Epidemic of Obsessive Compulsive Disorder (Pantheon, 1998) is a better companion to Penzel's title and should be a higher purchase priority.DMary Ann Hughes, Neill P.L., WA Copyright 2000 Cahners Business Information.

"One of the most creative and lucid thinkers in the area of OCD... A marvelous book for the millions who suffer from painful thoughts."-Michael A. Jenike, M.D., professor of psychiatry, Harvard Medical School

"Baer provides a compassionate and understanding voice for millions of people."-Chicago Tribune

Praise for Getting Control

"One of the world's leading experts on obsessive-compulsive disorder and on methods of self-help. This excellent third edition includes recent advances in the assessment and treatment of this disorder. Sufferers, relatives, and friends can benefit greatly from reading this book."-Isaac Marks, M.D., FRCPsych, author of Living with Fear

"Very few clinicians are as experienced as Dr. Baer in the treatment of OCD."-Sabine Wilhelm, Ph.D., Harvard Medical School; director, OCD and Related Disorder Program, Massachusetts General Hospital

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