Bad luck: an underestimated factor in the development of obsessive-compulsive disorder

Our clinical experience with patients with OCD has shown us that a sizeable proportion of patients report previous experiences such as accidents, very unusual events, or serious mistakes that in some cases may predate the onset of OCD by many years. In some cases these events, often perceived as bad luck, still appear to play a major role in supporting faulty appraisals of obsessional thoughts. In these cases it may be very useful to analyse and correct the specific learning experiences offered by these bad luck events. This article presents a series of case examples where specific events appear to have contributed to the development of faulty appraisals or at the least the patient attributes an important role to the event in the development of the disorder. We will also provide examples of some interventions that were useful in correcting the basis of these interpretations. © 1998 John Wiley & Sons, Ltd.