Having intrusive thoughts is a normal part of human experience; however, some intrusive thoughts that cause anxiety, discomfort, and tension result in obsessive-compulsive disorder. This is a sign that you might need professional help. OCD is associated with problematic thoughts that lead to anxiety and frustration. This article explains the nature of OCD and the scientifically proven psychotherapies for treating the symptoms of OCD. 

What is Obsessive Compulsive Disorder?

Obsessive-compulsive disorder is a mental illness in which a person experiences unwanted thoughts, known as obsessions. These thoughts can have various themes, such as fear of contamination, symmetry and order, and doubts. The person feels compelled to ease these obsessions by constantly washing hands, arranging and re-arranging things, and seeking reassurances. These are known as compulsions. Obsessions and compulsions are time-consuming and often disturb the normal functioning of life.  

Symptoms and diagnostic criteria for OCD

Symptoms of both obsessions and compulsions may occur in individuals with OCD. To get diagnosed with OCD, a person must have at least one of the following symptoms.  

Common symptoms of obsessive thoughts include: 

  • Uncontrolled fear of dirt or germs
  • An urge to organize things in order
  • Need for constant reassurance
  • Constant doubts about locks or the stove
  • Unusual sexual or religious thoughts

Symptoms and diagnostic criteria for OCD

Signs of compulsion include: 

  • Repeatedly washing hands 
  • Constantly organizing things
  • Constantly checking the locks or the stove 
  • Counting

If these symptoms are taking up your time and are causing major discomfort, you are qualified for the treatment of OCD. 

What does OCD look like? 

People with OCD have unwanted thoughts and urges, and have constant anxiety that they might get dirty, fear of committing blasphemy or public embarrassment, unnecessary religious and moral concerns, constant self-doubt, and worry about being disorganized.

These thoughts perturb them. So they do certain tasks repeatedly, such as washing hands, arranging things frequently, and asking questions like “What if I harm someone?” 

What does OCD look like

Treatment and Management of OCD

Treatment methods depend on the severity of the disorder. These may include:

  • Psychotherapy (CBT, ERT, ACT) 
  • Regulatory or Inhibitory Medication

Psychotherapies for OCD

Psychotherapy, also known as talk therapy, is used to treat several mental disorders, including OCD. There are many types of psychotherapies to treat OCD, however, Exposure and Response Prevention Therapy (ERP) is considered the best psychotherapy for managing the symptoms of OCD. Sometimes, therapists use a combination of two or more therapies to meet the desired mental health needs of the individuals. 

Cognitive Behavioral Therapy (CBT)

CBT is an evidence-based treatment that has proven effective for treating anxiety associated with OCD. CBT is a type of talking therapy. It is based on the principle that thoughts, feelings, and behaviors are interconnected. CBT targets unsettling thoughts and beliefs by intervening in thoughts and behaviors and changing them into helpful ones. 

For OCD, CBT helps the person identify the intrusive thoughts that cause anxiety and challenge them in a way to reduce them. 

Exposure and Response Prevention Therapy (ERP)

Exposure and response prevention therapy is a form of CBT. Exposure-response therapy is considered the best treatment for OCD. In exposure response therapy, the patient is exposed to triggering stimuli. For example, if someone fears getting contaminated by germs, they are made to touch an unclean object. The patient is then prevented from performing the compulsive ritual that eases their anxiety. For instance, the therapist asks the individual to touch a dirty object but does not allow them to wash their hands right away. Gradual exposure to different levels of stimuli makes the person habituated to the stimuli. Thus, the triggering element is not seen as a threat. 

Significance 

In ERP, people usually find their fears less threatening than imagined. Therefore, ERP helps them gain confidence and face challenges.

Acceptance and Commitment Therapy (ACT)

Acceptance and commitment therapy is also a form of CBT. As the name suggests, this therapeutic technique involves the acceptance of the obsessive thoughts or images. ACT works on the principle that thoughts themselves are not bad or problematic, but our dependence on them is taxing. Moreover, according to ACT, the more we struggle against those unwanted thoughts, the more we find ourselves trapped in them. Therefore, through ACT, people find ways to see their thoughts as they are.

ACT for obsessions 

With the help of ACT, an individual learns how to experience their obsessions. It focuses on the acceptance of recurring thoughts rather than controlling them through repeated rituals. 

ACT for compulsions 

ACT for OCD allows the person with OCD to consider compulsions as optional. It teaches the individual to develop multiple rituals as a response rather than just one ritual. In this way, individuals break free from the cycle of obsessions and compulsions and move towards their values and beliefs that are truly significant. 

Significance

  • ACT lets people accept who they are.
  • It allows for mindful acceptance of their thoughts without trying to battle with them. 
  • Mindfulness is an important aspect of ACT. It provides non-reactive awareness of the thoughts. 
  • Dialectical Behavior Therapy (DBT)

 

DBT is also a form of Cognitive behavioural therapy. DBT is for those people who are struggling with emotional distress. DBT is based on the idea that two opposing things can co-exist. In therapy, it means that you can accept your thoughts and emotions and still move on from them by changing them into productive thoughts and emotions. 

For people with OCD, Dialectical behavior therapy helps manage distressing emotions that direct one’s behaviors and compulsions. In other words, with DBT, people become able to regulate those negative emotions that are involved in making the person do compulsive activities. 

 

In DBT, a person learns the skills of emotional regulation and distress tolerance. DBT is not the first-line treatment for treating OCD. However, it has proven effective when incorporated with ERP for treating OCD. 

‘Acceptance’ in DBT

  • Understanding yourself 
  • Making sense of why you might do certain things, such as recounting, or not touching door knobs. 

‘Change’ in DBT

  • Challenging your unproductive thoughts
  • Encouraging you to find alternate ways of coping with anxiety

Three aspects of DBT make it work for OCD. These are: 

  • Mindfulness

In DBT, people learn to develop awareness of their thoughts and emotions in the present moment. Persistent thoughts can be decreased by practising mindfulness. 

  • Distress tolerance 

This technique is specifically helpful in dealing with the anxiety and fear caused by the intrusive thoughts.  

  • Emotional regulation

The response to obsessive thoughts puts the mind under emotional stress.  In DBT, people learn to improve their emotional regulation. It involves identifying and labelling their present emotions. 

Significance 

In DBT, therapists balance the idea of making you accept who you are in the moment while moving you towards positive change. DBT aims to develop long-term skills in people.  

  • Psychodynamic Therapy

It is a non-cognitive behavioral intervention. Psychodynamic therapy explores the patient’s past experiences and finds their link with the present emotions and behaviors.  

It is not an evidence-based therapy for treating OCD. However, short-term psychodynamic therapy (STPP) has significant benefits in managing the symptoms of OCD. This is founded on psychoanalytical theory, in which a person’s unconscious emotions dictate their current thoughts and sentiments. 

Short-term psychodynamic therapy is distinguished from long-term psychodynamic therapy based on duration of the therapeutic process and number of sessions. STPP is conducted for less than a year and has fewer than 40 sessions. 

  • Imaginal Exposure

In this therapy, an individual with OCD is exposed to those thoughts that generate fear in them with the help of their imagination. This might not work for every individual, but a lot of people have successfully managed their OCD symptoms with the help of Imaginal exposure therapy. 

Imagination and scripting are the basic methods used to confront one’s triggers.  Scripting means writing off your unwanted thoughts and practising them repeatedly to ward off the anxiety associated with those thoughts. 

  • Habit Reversal Training (HRT)

Habit reversal training is a behavioral therapy. It is used to treat the ritualistic behaviors in OCD. The following are the steps used in HRT: 

Step 1. Awareness 

The first step is to develop an awareness of the recurrent behaviors. During this process, a person is supposed to perform a certain compulsion in front of the mirror and recognize the bodily movement.  

Step 2. Competing response 

This step involves a subtle change in movement while you are doing the compulsive behavior. For instance, if you feel like recounting, reorganizing any object, or cleaning your hands, your therapist advises you to do something else with your hands, like making a fist instead of performing the compulsion. 

  • Mindfulness-Based Cognitive Therapy (MBCT) 

Mindfulness-based Cognitive Therapy combines the elements of cognitive behavioral therapy and mindfulness. Mindfulness refers to being aware of the moment at hand. It involves focusing on the thoughts that are occurring in the moment without judging them or being afraid of them. This therapy is similar to exposure response therapy, in which you confront your thoughts without interacting with them. 

Significance 

With the help of mindfulness techniques, like meditation practices and breathing exercises, therapists teach individuals to stay in thoughts without resisting them and then gradually accept them as they are. 

  • Family Therapy

Family members are often affected by the demands of the member living with OCD. The other members of the family need to be educated about what OCD is, what it does to the well-being of the person with OCD, and how to help them in times of crisis. Therefore, in family therapy, the therapist involves the family members in the therapeutic process. 

 

The therapist educates them and enhances communication among the members of the family. This therapy is specifically crucial for parents if their child has OCD. Moreover, families learn to help the patient deal with the symptoms of OCD. 

Significance

Family therapy involves psychoeducation that not only helps a person suffering from OCD but also reduces the stigma around mental illness. 

  • Trauma Therapy 

OCD can sometimes be triggered by some traumatic events from the past. People with post-traumatic stress disorder may also have overlapping OCD. Therefore, trauma therapy such as Eye-Movement Desensitization and Response (EMDR) can be a beneficial treatment for OCD. In this therapy, you move your eyes bilaterally from left to right. This method stimulates the brain, helping it to desensitize the information about the traumatic event. For OCD, this therapy can help if the cause of OCD is a traumatic memory. 

Medication for OCD 

Anti-depressants are usually prescribed to treat the symptoms of OCD. Selective serotonin reuptake inhibitors (SSRIs) are a class of antidepressants that are considered to be most helpful in managing OCD symptoms. The following are some of the FDA-approved antidepressants for obsessive-compulsive symptoms: 

  • Fluoxetine (Prozac)
  • Fluvoxamine (Luvox) 
  • Sertraline (Zoloft)
  • Clomipramine (Anafranil) 
  • Paroxetine (Paxil) 

Medication for OCD

Closing Thoughts

Obsessive Compulsive Disorder, or OCD, is a neurodivergent disorder. It occurs when someone has persistent unfavourable thoughts known as obsessions. These thoughts lead to emotions like anxiety and distress. Anxiety, in turn, compels the person to pursue repeated behaviours or actions, the compulsions. 

Treatment of OCD includes different psychotherapies and medication. The most widely used psychotherapies for OCD are CBT and ERP. Other therapeutic methods, such as DBT, ACT, and EMDR, are incorporated depending on the severity of the condition. A combination of therapy and medication is sometimes the ideal treatment option for many individuals. 

If you or a loved one is struggling with intrusive thoughts and compelling behaviors, find professional therapy at Advanced Mental Health Group. Our mental health experts utilize evidence-based therapeutic approaches in a home-like space to address the unique challenges faced by people with OCD. So, don’t wait for OCD to completely retard your life and get started with us. Book a consultation at Advanced Mental Health Group today and get rid of unpleasant thoughts. 

FAQs

  • Q: Are there any treatments for OCD?
    A: Yes, treatments for OCD are available and generally include psychotherapy and medication; sometimes, a combination of the two is effective.
  • Q: What is the best therapy for OCD?
    A: Exposure Response Therapy (ERP) is thought to be the best psychotherapy to treat OCD.
  • Q: What medications are effective for treating OCD?
    A: Antidepressants are widely prescribed for treating the symptoms of OCD. These include Prozac, Luvox, and Zoloft.