Understanding OCD
Skills to Control the Conscience and Outsmart Obsessive Compulsive Disorder
by Leslie J. Shapiro
March 2015, 203pp, 6 1/8x9 1/4
1 volume, Praeger

Hardcover: 978-1-4408-3211-6
$53, £40, 46€, A72
eBook Available: 978-1-4408-3212-3
Please contact your preferred eBook vendor for pricing.

Several famous saints have suffered from obsessive compulsive disorder.

One of the most experienced therapists in the world for treatment-resistant obsessive compulsive disorder (OCD) explains the disorder, the treatments available, and the skills needed to overcome and outsmart OCD.

This is an eye-opening study of one of the most common psychiatric ailments diagnosed today—obsessive compulsive disorder (OCD). Written by Leslie J. Shapiro, a renowned therapist at one of the most well known OCD facilities in the world, this reference shares effective treatment strategies and clinical factors for helping therapists, mental health professionals, psychology students, clergy, and others deal with patients coping with this illness. The author offers case examples from her 15 years of residential work with patients, demonstrating how sufferers—even the most treatment resistant—can get control of the condition.

Organized into three sections, this guidebook first reveals how OCD and guilt are intertwined and explores survival instincts, cultural factors, and the nature of thoughts. The second section covers aspects of the obsessive conscience such as scrupulosity, moralosity, and obsessive guilt. The book’s conclusion describes effective exposure and response prevention strategies for these symptoms and examines methods of treatment that augment and help maintain recovery. An in-depth discussion on the differences between compulsive and impulsive behaviors—as well as other treatment impediments—is included.


  • Includes a list of normal "bad" thoughts versus obsessions
  • Features tests to rate one's guilt, scrupulosity, and OCD
  • Examines the ways in which guilt is an interfering factor in OCD treatment and recovery
  • Covers effective strategies for controlling the conscience-related aspects of the disease
Leslie J. Shapiro is a residential-level behavior therapist for treatment-resistant obsessive compulsive disorder (OCD) at the OCD Institute at McLean Hospital. Previously she taught at the Boston University School of Social Work and lectured at Harvard Medical School. She has written several articles published in professional journals, including "Pathological Guilt: A Persistent Yet Overlooked Treatment Factor in Obsessive-Compulsive Disorder" and "Development of a Scrupulosity Severity Scale Using the Pennsylvania Inventory of Scrupulosity–Revised." She received her master's degree in social work from Boston University.


"Impressively well written, exceptionally well organized, and deftly presented, Understanding OCD is very highly recommended for professional and academic library Psychology/Psychiatry instructional reference collections."—Midwest Book Review, October 21, 2015

"The book gives insight into the role of guilt and religion in some forms of OCD and may be useful to those clinicians interested in learning more about obsessive guilt. . . . Recommended."—Choice, December 1, 2015

"Leslie Shapiro has crafted an exceptionally user-friendly book that targets the guilt, shame and moral uncertainty so often caused by OCD. Grounded in research on the brain, human instinct, culture, and religion, this book enables sufferers to distinguish OCD symptoms from reality, and to attack the problem at its core. The author’s keen understanding and ready examples from years of experience shine through as she offers clear explanations and strategies to combat this insidious disease. A great read for sufferers and clinicians alike."—Gail Steketee, PhD, Dean and Professor at Boston University School of Social Work

"The author, Leslie Shapiro, is known to be an experienced clinician, compassionate caregiver, articulate educator, thoughtful scholar, and intrepid pioneer. So it should come as no surprise that she has sculpted such an engaging, artful, and informative volume, which also conveys hope and inspiration. This book will be of value to anyone interested in learning about OCD or supporting those who are confronted by the disorder. In particular, her preeminent expertise in the area of scrupulosity makes it an essential resource for those who wish for a deeper understanding of that under-appreciated phenomenon."—Scott L. Rauch, MD, President, Psychiatrist in Chief and Rose-Marie & Eijk van Otterloo Chair of Psychiatry, McLean Hospital, Professor of Psychiatry, Harvard Medical School

"I worked with Leslie Shapiro in 1994 incapacitated by scrupulosity. She was the one therapist that changed my world in a way I never dreamt possible. I can honestly say, without her dedication, patience, and the highly skilled therapy she implemented, I would not have had the courage to find or be the person I am today. This book is a true gift to all those who suffer with any type of OCD, their supports, and professionals in the field seeking insight." —Robin T., Former Client of Leslie Shapiro and the OCD Institute
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