The Imp of the Mind

January 1, 2001
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.