CBT Treatment of OCD

What is Obsessive Compulsive Disorder (OCD)

Think about your email that gets filled up with lots of emails every day. We have our inbox for important emails and we have a junk mail folder for things that don’t really matter. Now imagine that our email didn’t know how to organise from what is important and what was junk, and they all ended up in the inbox. On top of this, all those emails from the Prince of Nigeria offering you money are flagged as ‘high importance’. This is like a brain with someone with OCD. They are unable to sort out thoughts that are helpful and unhelpful, and so all the thoughts we have, get stuck in the brain. When there is a distressing thought, it gets put on high alert…then the anxiety starts. Thankfully, CBT Treatment for OCD can help!

OCD is characterised by distressing thoughts or fears (obsessions) that lead people to act on certain urges or behaviours (compulsions). These behaviours may be logically linked with the thoughts (e.g. my hands feel dirty, so I need to wash them) however, not always (e.g. I fear something bad might happen to Mum, so I need to make sure that all my toys are lined up perfectly).

You often hear people say “I need everything clean or I get stressed”, and call it OCD, but for individuals with OCD, the distress they feel from the obsessions are significant and the behaviours that they are performing are excessive, to the point where it impacts on their everyday functioning.

This blog takes a look at the different kinds of Obessions and Compulsions and how Cogntiive Behavioural Therapy (CBT) treatment can help you and your OCD.

The Cycle of OCD

There is a reason why it is so hard for anyone with OCD to break out of their habits. It is because we get stuck in a cycle.

Obsessions –> Anxiety –> Compulsions –> Relief –> Repeat

The content of the obsession is distressing and therefore, causes us anxiety. Like a lot of us, when we feel anxious, we want to lower this anxiety as quick as possible. That’s where our compulsion comes in. We do our compulsion because we believe that it will prevent the feared event from happening.

AWESOME! … Right? Now we feel better, so all is good in the world? Unfortunately not. The more we do these compulsions, the more power and validation we give to the obsessions and compulsions, so the OCD ends up coming back.

The Different ‘Faces’ of OCD

When people think OCD, they often think it is about needing things to be clean and organised. However, there are many different other faces of OCD that are less commonly known. Different obsessions include:

• Aggressive Obsessions (e.g. hurting themselves or hurting someone else)
• Contamination Obsessions (e.g. catching a disease, germs)
• Doubting (e.g. telling yourself repetitively you didn’t do a good job, or not sure they did something)
• Nonsensical thoughts (e.g. Hearing songs or sentences over and over again)
• Hoarding or Saving (e.g. saving things you don’t need, because if you don’t, something bad will happen)
• Religious or Satanic (e.g. excessive worry about god or the devil)
• Symmetry/Exactness (e.g. something bad will happen if things aren’t in exactly the right order)
• Miscellaneous (e.g. gross thoughts, something being wrong with your body)
• Thoughts about Sex (e.g. Bothered by thoughts of sex)
• Others

Different compulsions can include:

• Cleaning and washing (e.g. hands, showering)
• Checking (e.g. checking locks, toys, doors, etc.)
• Counting (e.g. counting things over and over again a special number of times)
• Hoarding and Collecting (e.g. saving old papers, string, bottles)
• Repeating (e.g. doing homework over and over again, going in and out of doorways, getting up and down out of chairs, rereading, rewriting)
• Ordering or Arranging (e.g. lining things up in a certain way, needing this to be even)
• Miscellaneous (e.g. touch, tap, rubbing, reassurance seeking, telling on self, hair pulling, verbal rituals, eating things in a certain order)
• Others

CBT Treatment of OCD

Cognitive Behavioural Therapy (CBT) is an evidenced based treatment of Obesessive-Compulsive Disoder (OCD).

The approach to CBT is always different and is tailored to the individual. Typically, it can involve but is not limited to:

• Comprehensive assessments of OCD
• Education around OCD and helping individuals to identify what thoughts OCD are giving them. This gives the person the ability to fight back against the OCD.
• Anxiety management strategies including breathing, relaxation, and mindfulness
• Exposure and Response Prevention.
  • This involves directly facing the OCD. We put individuals in the situation that trigger the OCD thoughts. This is conducted in a gradual manner starting from an easier task and building up to harder tasks. During this, the individual learns to respond to the OCD in a different manner, as to break away from their usual cycle. Thus, avoiding carrying out their usual compulsion. With time, individuals can learn that even without doing their compulsion, they are able to cope with the distressing thoughts, and the anxiety from the OCD will decrease even without the compulsions.
• Cognitive Therapy
  • This can be used to help people in challenging and fighting back the thoughts that OCD are giving them. This might including looking at past experiences, the likelihood of events, thinking of more helpful thoughts.
  • It may also include the opposite, which is to notice the thoughts however allowing them to pass without giving them any judgment

If you or someone you know struggles with OCD, consult with your doctor about a referral to a psychologist. A psychologist can help you get back in control of your OCD, which will help to reduce your anxiety and free up your time for more important things. If you wish to consult a CBT Professioanls psychologist, download our Referral Sheet here and take it with you to your GP.