The present article examines the existing literature on the role of imagery in the symptoms and treatment of obsessive-compulsive disorder (OCD). Intrusive thoughts and images are conceptualized as falling somewhere along a continuum of normality to pathology. The development of OCD is discussed as resulting from anxious emotional states and dysfunctional cognitive appraisals that occur in response to intrusive cognitions. Four types of imagery evidenced by OCD sufferers are reviewed from de Silva's paper: the obsessional image, the compulsive image, the disaster image, and the disruptive image [1]. The logic and efficacy of an imagery component in the treatment of OCD is discussed, particularly as it pertains to the implementation of imaginal exposure within the framework of the empirically validated cognitive-behavioral treatment of exposure and responsive prevention.
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