Obsessive-compulsive disorder (OCD) is a mental health condition characterized by unwanted thoughts (obsessions) followed by repetitive behaviors (compulsions).
Obsessions are persistent thoughts, images, or urges that cause anxiety. Some more common obsessions include fears of contamination, harming others, or needing objects to be symmetrical. In response to these obsessions, a person with OCD engages in compulsions.
These are behaviors or mental acts done to reduce their distress or prevent a feared event. Common compulsions include excessive hand-washing, counting, and rearranging. Fortunately, OCD is readily treatable through both medication and psychotherapy.
Gold Standard OCD Treatment: Exposure and Response Prevention Therapy (ERP)
Cognitive-behavioral therapy (CBT) is the most widely recommended and effective treatment for OCD. Specifically, a type of CBT called exposure and response prevention (ERP) is considered the gold standard.
ERP involves gradually exposing a person to their feared objects, ideas, or situations (exposure) without allowing them to engage in their usual compulsive behaviors (response prevention). For example, someone with a fear of contamination might be gradually exposed to touching dirty objects without washing their hands afterward.
Over time, this helps reduce their anxiety that comes with their obsessions. This also decreases their compulsion to perform the ritual.
The key components of ERP include:
Exposure to the feared stimuli in a controlled and systematic manner
Response prevention so that the client avoids engaging in compulsive behaviors
Habituation which allows anxiety to naturally decrease without performing compulsions
Acceptance and Commitment Therapy (ACT)
Acceptance and commitment therapy (ACT) is also a form of CBT that can be effective in treating OCD. It combines CBT strategies of reframing negative thought patterns with mindfulness. Where ERP focuses more on reducing obsessions and anxiety, ACT shifts a client’s perspective on their inner experiences.
It works to change a person’s ideas about what they’re thinking and feeling. When their obsessions and anxieties aren’t internally viewed as “bad” experiences, the client may be better able to let them go without resorting to compulsions.
The key components of ACT include:
-Mindfulness and being fully present in the moment
-Cognitive defusion, which involves learning to perceive thoughts and feelings as separate from oneself
-Acceptance of difficult emotions and thoughts as part of the human experience
Cognitive Therapy
In the context of treating OCD, cognitive therapy helps clients recognize erroneous messages sent by the brain. Through therapy, clients learn to identify these messages and develop new responses to manage obsessions and compulsions. This approach emphasizes the significance we assign to specific experiences and how we may misinterpret them. For instance, if a friend passes by without acknowledging you, you might wrongly conclude, “Mary dislikes me because she didn’t say hello.” Cognitive therapy teaches people to step back from such thoughts, examine the evidence more critically, and adopt a more accurate perspective, such as, “Mary seems preoccupied, but I don’t know why.”
Cognitive therapy for OCD addresses the nature of negative thoughts. While most individuals can easily dismiss these thoughts as trivial, some hold beliefs that all thoughts are significant. This belief can lead to a different reaction, such as thinking, “I’m a bad person for having such a thought!” Research indicates that assigning importance to negative thoughts and trying to suppress them often has the opposite effect, making them more persistent.
Medications
Medications can be an effective part of OCD treatment, particularly for those with moderate-to-severe symptoms. Selective serotonin re-uptake inhibitors (SSRIs) are the most common prescriptions used for treating OCD. SSRIs work by increasing levels of serotonin in the brain, which can help reduce OCD symptoms.
Typically, these medications take several weeks to start working. Some people may also experience negative side effects from some SSRIs. Finding the right medication and dosage isn’t always easy, so it’s important to closely collaborate with a healthcare provider.
Do you struggle with OCD?
OCD is a mental health disorder that requires intervention from a licensed therapist. If you are struggling with obsession and compulsions, a licensed therapist can use OCD therapy to help you learn to live with the fear or anxiety without it taking over your life. Whether you’re interested in a long-term therapeutic approach, medication, or both, you can work with a therapist to develop a treatment plan that’s right for you.
To find out more about the strategies and approaches for treating OCD, contact us today.
