Manual Association Splitting (English)

To receive our evidence-based self-help treatment manual "Association splitting" against obsessive/intrusive thoughts and obsessive-compulsive symptoms please click

Foreword (edited excerpt from the manual):

Dear patients, family members, and colleagues,

Our research group has been involved in the research and treatment of obsessive-compulsive disorder (OCD) for many years. Since 2005, we have been developing and conducting research on a new treatment method termed ‘association splitting’. The method aims to reduce one-sided negative associations that are typical of OCD by creating new associations (Jelinek et al., 2009, 2014).

In a pilot study with 30 patients with OCD, we found that association splitting resulted in an average reduction in obsessive-compulsive symptoms of 26%; the intensity of obsessive thoughts was reduced by 25%. After three weeks of treatment, up to 42% of participants showed a decline in symptoms of at least 35%. Further studies by our group and others (Moritz & Jelinek, 2011; Rodriguez-Martin et al., 2013) have confirmed these findings, and have provided initial supportive evidence for its effectiveness among other patient groups (Musiat et al., 2014). Association splitting therefore represents a promising treatment strategy for a subgroup of patients.

This method is aimed at people who suffer from specific obsessive thoughts (e.g., excessive concern with contaminating others; uncertainty about having run over a pedestrian; fear of causing a catastrophe by failing to place things in a particular order or not saying a certain prayer).

Despite its success among a large subgroup of patients, the method may not be beneficial for the following individuals:

  • Individuals who perform compulsive actions with no preceding obsessive thoughts. Compulsive actions may include excessive washing of one’s own body, checking (e.g., oven, door lock), sorting, and excessive hoarding. Mental compulsive actions, such as counting or mental rituals, may also be employed to “prevent” obsessive thoughts or their feared consequences. In most cases, obsessive thoughts precede compulsive actions (e.g., an exaggerated fear of having been contaminated [obsessive thought] is followed by a washing ritual [compulsive action]).
  • Individuals who do not at least partially acknowledge the exaggerated nature of their thoughts. Individuals, who are convinced that their thoughts, concerns, and actions are entirely justified and rational are not likely to benefit from the method.

If you experience no positive effects from association splitting, please do not give up hope. There are other effective therapy options for OCD, especially cognitive behavioral techniques. Consult a clinician who specializes in OCD or a self-help organization. To receive the "association splitting" manual against obsessive/intrusive thoughts and obsessive-compulsive symptoms please click


We are interested in your feedback to help us improve the association splitting technique and to make the manual as user friendly as possible. Please send your feedback to Steffen Moritz ( You can download the manual here:

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