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Clinical accounts of obsessive-compulsive disorders (OCD) have appeared in the literature for well over 100 years. First described by Esquirol in 1838, OCD was not formally documented or defined until the beginning of this century (Janet, 1903; Lewis, 1935; Schneider, 1925). Both cognitive and behavioral components have traditionally been included in the conceptualization of OCD.

Although psychiatric discussions of obsessional and compulsive phenomena date only to 1838, literary descriptions of such behavior may be found much earlier. Euripides (480–406 B.c.) and Shakespeare (1564–1616) both provided eloquent descriptions of obsessional jealousy in the plays Medea and Othello. Shakespeare also provided an illustrative description of obsessional guilt coupled with compulsive ritualistic behavior in his portrayal of Lady Macbeth after the violent murder of King Duncan (Coleman, Butcher, & Carson, 1980): It is an accustomed action with her, to seem thus washing her hands. I have known her continue in this a quarter of an hour... .

In this chapter I will briefly summarize the current status of established approaches to the modification of phobic, obsessive, and compulsive disorders, and will then attempt to identify emerging trends and suggest directions for both future research and the clinical application of behavioral methods to these problems.

Since the introduction of the concept of obsessional-compulsive disorder (OCD) well over a hundred years ago, the definition of the disorder has produced little controversy. The main features are difficult to mistake, and recent research has enabled us to clarify and review the concept. Jaspers’s (1963) definition is representative and comprehensive.