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. 2024 Feb;21(1):63-78.
doi: 10.36131/cnfioritieditore2023060104.

Treating Guilt-Inducing Self-Talk in Ocd with Dramatized Socratic Dialogue: A Step by Step Intervention

Angelo Maria Saliani  1 , Claudia Perdighe  1 , Vittoria Zaccari  1   2 , Olga Ines Luppino  1   3 , Alessandra Mancini  1   3 , Katia Tenore  1   3 , Francesco Mancini  1   2
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Treating Guilt-Inducing Self-Talk in Ocd with Dramatized Socratic Dialogue: A Step by Step Intervention

Angelo Maria Saliani et al. Clin Neuropsychiatry. 2024 Feb.

Abstract

Objective: Fear of moral guilt and conseque:nt increased attention to personal actions and intentions are the main ingredients of the self-criticism in patients suffering from obsessive-compulsive disorder (OCD). This pathogenic attitude takes shape in a typical guilt-inducing self-talk.The purpose of this work is to describe in detail a novel cognitive therapeutic procedure for OCD called "Dramatized Socratic Dialogue" (DSD).

Method: DSD is a theory-oriented intervention that combine elements of Socratic dialogue, chairwork, and cognitive acceptance strategies derived from Mancini's model, which posits that obsessive-compulsive (OC) symptoms stem from a fear of deontological guilt.

Results: DSD appears to have many strengths, being a theory-oriented treatment and focusing, as a therapeutic target, on the cognitive structures that determine pathogenic processes and OC symptoms. Furthermore, it is a short, flexible and tailor-made intervention.

Conclusions: Detailed description of the intervention could foster future research perspectives and thus be used in evidence-based effectiveness studies to establish whether DSD reduces OC symptoms and to investigate its mechanism of action.

Keywords: cognitive-behavioral therapy; dramatized socratic dialogue; guilt-inducing self-talk; moral self-criticism; obsessive-compulsive disorder.

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Conflict of interest statement

Competing interests: None.

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