Seeking Proxies for Internal States (SPIS): A Social-Cognitive Model of Obsessive-Compulsive Disorder
In the past decade, I have developed with my colleagues a theory of obsessive-compulsive disorder (OCD) that we termed the SPIS model, for Seeking Proxies for Internal States. The model postulates that OCD can be understood in terms of doubt about internal states (such as emotions, preferences, physiological states, feelings of satisfaction) and attenuation of access to these internal states. As a result of these difficulties, according to the SPIS model, obsessive-compulsive individuals seek and rely on proxies, which are relatively discernible substitutes for the internals states, such as objective indices, fixed rules, social norms and the opinion of others.
Seeking proxies for internal states (SPIS): Towards a novel model of obsessive-compulsive disorder
We review the Seeking Proxies for Internal States (SPIS) model of OCD.
The model postulates attenuated access to internal states as a central factor in OCD.
Attenuated access drives people with OCD to seek proxies for their internal states.
Fixed rules and compulsive rituals are understood as proxies for internal states.
We review evidence for the model and discuss open questions and clinical implications.