There are various treatments for OCD including medications, but psychotherapy remains a cornerstone of effective management. Studies report that certain types of psychotherapy including Cognitive Behavioral Therapy (CBT) and related therapies can be as effective as medication for many people. For others, psychotherapy may be most effective when combined with medication.
CBT is a type of psychotherapy that helps individuals recognize and change negative patterns of thought and behavior. For OCD, the primary CBT approach used is Exposure and Response Prevention (ERP). This specialized form of CBT has been shown to be effective for a significant proportion of people with OCD.
Research shows that this approach effectively reduces compulsive behaviors, even when the person doesn’t respond to medication. The therapist works with the patient to develop an exposure plan. ERP is the most powerful tool for treating obsessive compulsive disorder. Exposure typically begins with symptoms that cause the least amount of anxiety and progresses to the most difficult symptoms.
The principle behind ERP involves systematically and gradually exposing the individual to the feared thoughts, images, or situations that provoke obsessive thoughts. The exposure is done in a safe, controlled and therapeutic environment. Exposure helps to decrease compulsive behaviors.
Along with the exposure, the therapist encourages the patient not to perform the usual compulsive response, or if it’s done, it’s done with a delay. By staying in a feared situation with nothing terrible happening, the patient learns that fearful thoughts are just thoughts. Over time, the patient learns how to cope with their thoughts without relying on ritualistic behaviors. This process aims to decrease the anxiety associated with the obsession and reduce the urge to perform the compulsion.
For instance, a person who fears contamination from germs might be encouraged first to touch a clean surface, and later, as therapy progresses, to touch something they perceive as ‘contaminated’, such as a doorknob. They would then refrain from washing their hands immediately, challenging and confronting their fears in a controlled manner.
While this approach can cause anxiety, patients learn they can control and reduce their anxiety. For most people who stick with it, compulsions decrease.
While ERP addresses the behavioral aspect of the disorder, cognitive therapy focuses on the cognitive distortions associated with OCD. The therapist helps the patient to recognize the distortions and guides the patient to identify and challenge their maladaptive beliefs. They are trained to recognize that their beliefs about the consequences of not performing compulsions are often exaggerated or unrealistic.
For example, a person who has the obsessive thought that not checking the stove will lead to a house fire is guided to explore the probability of that outcome, reflecting on past experiences and evidence to counteract that belief.
Acceptance and Commitment Therapy (ACT):
ACT is an extension of traditional CBT. In ACT, individuals learn to accept their obsessions without acting on them. They’re taught mindfulness skills, helping them to focus on the present and act according to their values rather than being driven by their obsessions.
Dialectical Behavior Therapy (DBT):
DBT combines standard CBT techniques with other interventions like mindfulness, teaching patients to accept their experiences while also working towards behavioral change.
Mindfulness and Meditation:
While not a standalone treatment for OCD, mindfulness practices can be integrated into therapeutic interventions. By learning to observe their thoughts without judgment, individuals can become less entangled in their obsessions, viewing them as passing mental events rather than truths that dictate behavior.
The primary advantage of psychotherapy, particularly ERP, is its effectiveness in reducing both the distress caused by obsessions and the frequency and intensity of compulsions. Many individuals prefer it over medication due to the absence of drug-related side effects.
However, psychotherapy requires active participation, commitment, and can be emotionally challenging, especially during the early stages of ERP when directly confronting fears. It’s essential for the therapist to be adequately trained in treating OCD to provide effective and compassionate care.
Psychotherapy, especially CBT and ERP, has been established as an effective treatment modality for OCD. It addresses the core symptoms by helping individuals confront their fears and reduce their reliance on compulsive behaviors. However, it’s crucial for individuals with OCD to work closely with trained professionals at Mercie Health and Wellness to find the most appropriate and effective treatment approach tailored to their specific needs. As research progresses, the therapeutic landscape for OCD continues to evolve, providing hope for those seeking relief from this challenging condition.
When you or a loved one is experiencing distressing thoughts and behaviors, contact Mercie Health and Wellness in Katy, Texas. We can help. At Mercie Health and Wellness take a humane and personalized approach to treating mental health disorders. Stigma is associated with mental health disorders and can keep a person from seeking help. Don’t let stigma create self-doubt and shame. You will always be treated with respect and dignity at Mercie Health. Contact us to schedule a consultation to learn more about obsessive compulsive disorder, receive the correct diagnosis and all your treatment options.
At a Glance
Dr. Sylvia Udokoro Nwakanma
- Doctor of Nursing Practice (DNP)
- Double Board Certified in Psychiatric Mental Health Nurse Practitioner (PMHNP-BC) and Family Nurse Practitioner (FNP-C)
- SAMSHA Certified Addictions Nurse Practitioner
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