Spontaneous exposure and "self-control" in the treatment of compulsive checking.

This case study describes a treatment developed for an obsessional patient for whom neither in vivo nor verbal exposure was effective in eliciting obsessional thinking. The treatment consisted of increasingly more strict temporal parameters the patient was to impose when obsessional thoughts spontaneously occurred. These parameters stipulated the amount of time he was to wait between the occurrence of obsessional thoughts and compulsive checking, and the amount of time he was to spend checking. Over a period of several months, these self-imposed temporal parameters were effective in completely eliminating persistent and intractable obsessional thinking of 11 years' duration.