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Obsessive Compulsive Disorder

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Obsessive Compulsive Disorder (OCD)

Scientific evidence has demonstrated CBT (cognitive behavioural therapy) to be the most effective in successfully tackling Obsessive-Compulsive Disorder (OCD). Research has shown that 75% of people with OCD are significantly helped by CBT. Furthermore, unlike other therapies, CBT does not have any risks or side effects associated with it, which is why it remains the treatment of choice for tackling OCD by the National Institute for Health and Clinical Excellence (NICE).

OCD can produce alarming levels of anxiety following intrusive thoughts for example. While for most people, their response to anxiety provoking situations is for the anxiety to slowly decrease after the initial event. For someone with OCD, the anxiety is maintained and often increases, and this typically is because they overestimate perceived threat levels. Alternatively, sufferers can experience distressing obsessions and/or develop compulsive behaviours (e.g. checking lots of things or cleaning excessively) to the extent that these problems interfere with their daily lives. Will CBT be able to help your form of OCD, if for example you don’t have obvious physical compulsions? Perhaps you don’t check, or wash, or count, or do any of the things that people usually associate with OCD. But remember, OCD is a chameleon – it appears in many forms in different people. One of the great things about CBT is that however the problem manifests itself, now or in the future, the same tools are useful in getting rid of it.

CBT utilises two evidence-based behaviour techniques, Cognitive Therapy (C) that looks at how we think, and Behaviour Therapy (B) which looks at how this affects what we do. CBT helps OCD sufferers to identify and modify their patterns of thought that cause the anxiety, distress and compulsive behaviours. Though therapy, patients learn new of thinking (C), and how this may positively affect their behaviour (B). (B). The behavioural approach incorporates Exposure and Response Prevention therapy (ERP) to help explore alternative ways to respond to obsessional thoughts or doubts.

During the first few sessions your therapist will spend a fair amount of time focussing on making sense of how the OCD affects you and what maintains this problem in your life. The cyclical nature of OCD problems can be illustrated by the diagram below developed by Professor Paul
Salkovskis:

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Understanding how this applies to you is important because the more we understand the factors that keep your OCD alive, the better equipped we are to take the next step, which is to think about alternative ways of viewing the problem and what we can then do to change it.
Through CBT, sufferers can learn to become their own therapist as they are provided with the knowledge and tools to continue working towards complete recovery from OCD.

Make sure you are receiving CBT!

Recent research suggests that people sometimes believe that they are receiving Cognitive Behavioural Therapy (CBT) from their counsellor/therapist whereas in fact they are receiving another form of ‘talking’ therapy’ such as psychoanalysis or counselling, which we know from evidence to be less effective in treating OCD. It is widely recognised that CBT is the most effective treatment for OCD because it focuses on the ‘here and now’ of the problem as opposed to other talking therapies which tend to focus on ‘past problems’ or spend time continually talking about childhood. Remember, if you in doubt, just ask!