Salkovskis (1985) · Obsessive-compulsive disorder
Salkovskis (1985)
Intrusive Thought / Image
A normal, unwanted intrusive thought, image, urge or doubt — e.g. 'what if I left the door unlocked?', a harm-related or taboo image. Such intrusions are common in the general population.
Appraisal / Meaning
The intrusion is appraised as personally significant — typically inflated responsibility for harm ('having this thought means I must act to prevent it', 'thinking it makes it more likely', 'not preventing harm is as bad as causing it').
Distress / Anxiety
The appraisal produces distress — anxiety, guilt and a strong sense of responsibility — which is uncomfortable and demands action.
Compulsion / Neutralising
Compulsions and neutralising acts aimed at reducing the distress or preventing the feared harm — checking, washing, repeating, mental rituals, reassurance-seeking, thought suppression and avoidance.
Temporary Relief
Temporary relief, or a sense that it 'feels right'. This negatively reinforces the compulsion, strengthens the responsibility appraisal, keeps the intrusion salient, and prevents the person learning that the feared outcome would not have happened.
The published model, shown for reference. Switch to “Blank” to see the empty template you complete with a client.
Nearly everyone has odd, unwanted thoughts pop into their mind — disturbing images or doubts that seem to come from nowhere. This model shows how, in OCD, the problem isn't the thoughts themselves but the meaning they're given.
An intrusive thought, image or urge appears ('what if I left the cooker on and the house burns down?'). For most people it's just mental noise. But if it's taken to mean something important — that you're responsible for preventing harm, or that thinking it makes it more likely — it becomes very distressing.
That distress creates a strong urge to put things right: to check, wash, repeat, seek reassurance, or try to cancel out the thought. Doing so brings relief for a while.
But the relief teaches the brain that there really was danger and that the ritual is what kept you safe — so the next intrusion feels just as urgent. Checking and neutralising also keep the thought in mind and stop you finding out that nothing bad would have happened anyway. So the cycle repeats and tightens.
How to introduce the model, guided-discovery questions, treatment targets and a behavioural experiment are available to signed-in therapists.
This diagram is a reconstruction of the published model for clinical and educational use, grounded in the sources above.
Formulate provides educational CBT resources for use with a qualified therapist. They are not a substitute for professional assessment, diagnosis, or crisis care.
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