How Cognitive Behavioural Therapy can help Obsessive Compulsive Disorder
What is Obsessive Compulsive Disorder?
Obsessive Compulsive Disorder (OCD) is a term which has become overused to describe anyone who demonstrates tendencies towards orderliness and perfectionism. The reality for those who meet psychiatric diagnostic criteria for OCD is that it can be a life altering, debilitating condition, and can lead to additional problems such as depression. It is estimated that 1 in every 100 adults may suffer with OCD.
OCD is characterised by the presence of recurrent obsessions such as persistent thoughts and images which cause distress, and compulsions including ritualistic and checking behaviours (both overt such as washing hands, and covert such as counting) which are carried out with the aim of reducing anxiety. However, obsessions and compulsions are normal and are experienced by most people. So what is the difference between someone who experiences obsessions and compulsions, and someone who is diagnosed with OCD?
Typically the difference lies in their beliefs. For those who suffer with OCD it appears that an intrusive thought or image can trigger beliefs about the significance of that thought/image, for example “If I think it, it must be true”. This belief leads the person to try and control their actions or thinking with certain behaviours. These compulsive behaviours become problematic and can cause additional distress as they impact more and more on the person’s life, and lead to the fear of experiencing fear and anxiety.
CBT: an effective treatment
Cognitive Behavioural Therapy (CBT) is an effective treatment for this highly complex disorder. It aims to help the individual identify and, if appropriate, modify the distorted beliefs that lead to the problematic compulsive behaviours.
The CBT therapist supports the individual to use behavioural experiments to enhance their belief in the potential for change. Behaviours and rituals such as washing and checking reinforce the disorder as the individual comes to believe that these behaviours alleviate the distress caused by their thoughts or images, and so repeats them. But this prevents them from gaining information that would correct their dysfunctional and inaccurate beliefs.
That is achieved by exposure and response prevention, a practice allowing the individual to become accustomed to the physical sensation of anxiety. This enables them to gather important information about the circumstances, thoughts and images giving rise to their anxiety, which in turn helps them to modify dysfunctional beliefs.