Behavioural and Cognitive Psychotherapy

Fight Fire with Fireflies! Association Splitting: A Novel Cognitive Technique to Reduce Obsessive Thoughts

Steffen Moritz a1c1, Lena Jelinek a1, Ruth Klinge a1 and Dieter Naber a1
a1 University Medical Center Hamburg-Eppendorf, Germany

Article author query
moritz s   [PubMed][Google Scholar] 
jelinek l   [PubMed][Google Scholar] 
klinge r   [PubMed][Google Scholar] 
naber d   [PubMed][Google Scholar] 


A novel cognitive technique, termed “association splitting”, aimed at reducing obsessive thoughts, is introduced. Association splitting draws upon the so-called “fan effect” of associative priming. Transposing this principle to the treatment of obsessive-compulsive disorder (OCD), we hypothesize that the sprouting of new and the strengthening of existing neutral associations to core OCD cognitions will reduce their fear-evoking properties by depriving the chain of OCD-related cognitions of associative strength. To test the feasibility and efficacy of this approach, an internet intervention study was implemented. Initially, 38 subjects with OCD obsessions took part in a survey. After completion of the survey they were then sent a self-help manual. Three weeks later, participants were re-contacted. One-third of the participants responded to the treatment (at least 35% decline on the Y-BOCS scale). The completer analysis revealed a response rate of 42%. It is suggested that association splitting may lead to symptom relief in a subgroup of participants and may represent a useful addition to the tool box of cognitive-behavioural techniques.

Key Words: Obsessive-compulsive disorder; obsessions; cognitive therapy; outcome.

c1 Reprint requests to Steffen Moritz, University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Martinistrasse 52, 20246 Hamburg, Germany. E-mail: