The general population has experienced a significant elevation in fear and anxiety during COVID-19 both as a direct result of the virus but also due to measures taken to prevent it spreading, such as the need to stay inside and increase hand-washing. Lockdown has been used in many/most countries to prevent widespread infection. The advice and imposed actions are necessary to prevent the virus from spreading, but they might exacerbate the problems experienced by people with a preexisting anxiety-related disorder. The treatment of anxiety-related disorders can be provided while in quarantine. Staying at home in self-isolation does not preclude obtaining psychological treatment for anxiety-related disorders. Dealing with cognitive biases, over-estimations of threat, intolerance of uncertainty, inflated responsibility and excessive safety behavior, are useful clinical directions.

We evaluated a novel, empirically-based cognitive therapy for compulsive checking - a common form of obsessive-compulsive disorder. Twelve adults completed 12 sessions of the therapy. Significant reductions in checking-related symptoms were found pre- to post-treatment, and pre-treatment to 6-month follow-up (moderate to large effect sizes). Participants reported high treatment acceptability after the third session, which was maintained at post-treatment. This pilot trial provides preliminary support for treating compulsive checking using this novel cognitive approach.

Important developments took place during the past decade. Two major nationwide treatment/training programmes were initiated: IAPT and the US Army Resiliency Program. Work on the psychological immune system presages a major advance in scientific knowledge. The reformulation of human actions, moving the emphasis from retrospection to prospection has wide implications. The concept of wellbeing has had a major impact on health psychology. The topics covered include the U.K. scheme for improving access to psychological therapies, resilience training in the military, wellbeing, the psychological immune system, the concept of prospection, some recent trends in psychopathology, mental contamination.

Hans Eysenck's contributions to the growth of clinical psychology in the UK, and to the development of Behavior Therapy are described and evaluated. He construed clinical psychology as an applied science and accordingly the graduate training provided in his Department was based on this view. He was critical of psychodiagnostic tests such as the Rorschach, and criticized the poor quality of research on the effects of psychotherapy. Eysenck was a prolific and accomplished writer and a forceful advocate of Behavior Therapy.

The construct of the psychological immune system is described and analysed. The direct and indirect cognitive influences on the system are discussed, and the implications of adding a cognitive construal to the influential model of a behavioural immune system are considered. The psychological immune system has two main properties: defensive and healing. It encompasses a good amount of health-related phenomena that is outside the scope of the behavioural model or the biological immune system. Evidence pertaining to the psychological immune system includes meta-analyses of the associations between psychological variables such as positive affect/wellbeing and diseases and mortality, and associations between wellbeing and positive health. The results of long-term prospective studies are consistent with the conclusions drawn from the meta-analyses. Laboratory investigations of the effects of psychological variables on the biological immune system show that negative affect can slow wound-healing, and positive affect can enhance resistance to infections, for example in experiments involving the introduction of the rhinovirus and the influenza A virus. A number of problems concerning the assessment of the functioning of the psychological immune system are considered, and the need to develop techniques for determining when the system is active or not, is emphasized. This problem is particularly challenging when trying to assess the effects of the psychological immune system during a prolonged psychological intervention, such as a course of resilience training.

The historical background of the development of behaviour therapy is described. It was based on the prevailing behaviourist psychology and constituted a fundamentally different approach to the causes and treatment of psychological disorders. It had a cold reception and the idea of treating the behaviour of neurotic and other patients was regarded as absurd. The opposition of the medical profession and psychoanalysts is explained. Parallel but different forms of behaviour therapy developed in the US and UK. The infusion of cognitive concepts and procedures generated a merger of behaviour therapy and cognitive therapy, cognitive behaviour therapy (CBT). The strengths and limitations of the early and current approaches are evaluated.

Background: Intrusive imagery is experienced in a number of anxiety disorders, including Obsessive Compulsive Disorder (OCD). Imagery is particularly relevant to mental contamination, where unwanted intrusive images are hypothesized to evoke feelings of dirtiness and urges to wash (Rachman, 2006). Aims: The aim of this study was to examine the nature of imagery associated with mental contamination. Method: Fifteen people with contaminated-based OCD completed a semi-structured imagery interview designed specifically for this study. Results: Ten participants reported images associated with contamination. These images were vivid and distressing and evoked feelings of dirtiness. Participants engaged in a number of behaviours to neutralize their images, including compulsive washing. A small number of participants also reported images that protected them from contamination. Conclusions: In support of the theory of mental contamination (Rachman, 2006), images can lead to feelings of pollution and compulsive washing. Further research is needed to explore the role of imagery in maintaining contamination fears.

The close connection between theory and derived therapy is a strength of the cognitive approach to anxiety disorders, and is well illustrated in the theory and therapy for mental contamination. The specificity of the theory and therapy for mental contamination is a step beyond the unsatisfactorily general explanations for anxiety disorders. In addition to preparing the way for test trials of treatment, the specificity of the theory provides a basis for incisive experimental investigations of the soundness of the hypotheses. On the clinical side, recognition of the large proportion of OCD patients who suffer from mental contamination helps to account for the unsatisfactorily slow progress of the prevailing exposure therapy for OCD. The treatment assumes that all OCD patients who have a fear of contamination avoid physical contact with perceived tangible contaminants, and is treated by planned, repeated, prolonged exposures to tangible contaminants such as dirt and blood . In patients with mental contamination, feelings of internal pollution/dirtiness, most of the exposure is misdirected. The greatest need is to test the validity of the cognitive theory and undertake randomized treatment trials.