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How are CBT and mindfulness used to treat OCD?

Obsessive compulsive disorder (OCD) is a serious mental health condition that typically results in two distinct types of symptoms: ‘obsessions’ and/or ‘compulsions’. These OCD symptoms can cause significant distress and impairment in social, occupational, or other important areas of day-to-day life.

Obsessions are characterised by recurrent and persistent thoughts, images or urges that are intrusive and unwanted by the individual, and usually cause them intense anxiety. Compulsions refer to mental or physical rituals that people with OCD feel they have to perform.

There are a number of different methods that can be used to treat OCD, including cognitive behavioural therapy (CBT) and mindfulness.

Examples of OCD obsessions include:

  • Having an overwhelming fear of germs or contamination
  • Repetitive thoughts that you may harm another person, or say something inappropriate
  • Worrying that you forgot to turn off an appliance or lock a door
  • Experiencing intrusive sexual thoughts or constantly questioning your sexuality
  • Experiencing persistent, morally repugnant thoughts

Examples of OCD compulsions include:

  • Repeating ritualistic actions a set number of times or for a certain amount of time e.g. turning a light switch on and off
  • Continually counting or repeating certain words over and over again
  • Only touching certain objects with a tissue or avoiding objects that may be contaminated
  • Washing your hands or bathing multiple times each day, regardless of need
  • Rearranging objects so they are aligned, symmetrical or ‘just so’

The symptoms of OCD can take up a lot of time and seem impossible to stop or control. They can also cause OCD sufferers to feel distressed and confused. However, OCD is treatable and with effective therapy, it’s possible for individuals to regain control over their obsessions and compulsions, and resume the meaningful and valued life that they deserve.

OCD treatment options

It’s important to recognise that intrusive thoughts are a normal human experience; research shows that virtually everyone experiences unwanted thoughts, images or urges at some point in their life. However, the difference between OCD sufferers and the rest of the population is the meaning they give to the occurrence and content of these thoughts, images or urges. Because intrusive and unwanted thoughts are normal, OCD treatment does not aim to help people control, change or prevent them. Instead it encourages them to accept them for what they are - just thoughts, images and urges that the person finds unpleasant - and helps them to accept and tolerate any negative emotions that may result from them.

Mindfulness and CBT for OCD

Two of the most common treatment methods for OCD are CBT and mindfulness, both of which can take place in the form of one-to-one therapy or group therapy, depending upon the most appropriate format for you.

Here, we explore how these therapeutic techniques are used in the treatment of this complex condition.

How is CBT used to treat OCD?

CBT is a highly effective therapeutic method that is used worldwide in the treatment of a range of mental health conditions, including OCD. This technique is based on the principle that OCD develops and intensifies as a result of dysfunctional, deeply ingrained thought patterns that cause individuals to evaluate and respond to thoughts, emotions and physical sensations in unhealthy ways.

The aim of CBT for OCD is to help you to develop a new relationship with, and a more effective way of responding to your obsessions and compulsions, that doesn’t maintain your anxiety and dysfunction in the long-term. It also involves helping you test out specific predictions, identify and question the cognitive processes that maintain your OCD symptoms, as well as the meaning you attach to these.

CBT for OCD also consists of exposure and response prevention techniques. This involves gradually introducing an individual with OCD to objects or situations which trigger their obsessions and compulsions, until they learn to cope with their anxiety and distress. Ultimately, this technique helps you to confront your fears, learn to tolerate anxiety, and resist using compulsive behaviours.

You will also receive ‘homework’ following your CBT sessions, which usually consists of you engaging in daily exposure and response prevention tasks between your therapy sessions, to keep building on these techniques and reducing the obsessive thoughts and rituals that are characteristic of OCD.

CBT has been found to result in long-lasting benefits in OCD patients, and also aims to provide you with a more effective way of managing unwanted thoughts and feelings that doesn’t impair your functioning in the long term.

How is mindfulness used to treat OCD?

Mindfulness is a well-known therapeutic method that encourages you to focus on the present moment, in a non-judgemental way, whilst accepting and processing any negative thoughts without becoming overwhelmed by them, attaching meaning to them, or trying to stop or change them.

In the context of OCD, people with this condition often don’t live in the present, and instead constantly focus on ‘what if's?’. For example, you may struggle with an obsessive thought that makes you believe that you’re going to harm another person, causing you to constantly question “what if I hurt someone?” OCD also causes individuals to be incredibly judgemental about themselves. Again, in the harm obsession example, having these thoughts may cause a sufferer to judge themselves as being a horrible and dangerous person. However, if an individual without OCD had this thought, they would probably wonder “where did that come from?”, before letting the thought pass them by. This is what mindfulness seeks to achieve; it teaches people to simply acknowledge their intrusive and obsessive thoughts in the present, before letting them go without dwelling on them, or making assumptions about their meaning.

Once you have learned the principles of mindfulness as part of your therapy sessions, you will be able to practise mindfulness in the future, enabling you to continue processing feelings and thoughts in a healthy way, without becoming overwhelmed or distressed by them.

There is emerging evidence that mindfulness is effective in the treatment of OCD, and can also be complemented by relaxation techniques such as yoga, meditation and breathing exercises.

Seek help for your OCD

OCD can be difficult to cope with, which is why it’s so important to seek the expert support that you need. Our specialist OCD psychiatrists and therapists at Priory will be able to help you every step of the way towards overcoming your obsessions and compulsions, and resuming the healthy, happy and fulfilling life that you deserve.

Blog reviewed by Dr Ashley-John Brewer (BSc, MSc, PhD, Psy.D.), Clinical Psychologist at Priory Hospital North London

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