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Obsessive Compulsive Disorder (OCD) affects around 2-3% of the Australia population at any given time. OCD can be frightening, can cause intense distress, and can affect our ability to life our everyday life. Fortunately, effective psychological treatments are available for OCD. In this blog we will briefly overview how Cognitive Behavioural Therapy (CBT) is used in the treatment of OCD.
As the name implies, Cognitive Behavioural Therapy, or just CBT, utilises two main components: Cognitive components and behavioural components.
Dealing with Cognitions.
As covered in our blog on CBT, for simplicity sake we can consider the word cognition to be the same as the word thought. That is, CBT for OCD addresses people's thoughts and thinking patterns to help them cope with OCD symptoms. People suffering from OCD can have problems with their thinking in a number of ways. For example, sufferers of OCD experience intrusive thoughts. Learning about thoughts and their impact (or the limits of their impact) can be a big step forward in learning how to deal with OCD. Learning that thoughts are not facts, and that thinking about something bad is not the same as doing something bad, can be very refreshing for someone suffering from OCD. To use a challenging example, if I have the thought of harming someone I love, and I think this must mean I want to hurt someone I love or that I will hurt someone I love, intense distress can follow. But thoughts are not facts, and although we would like to think that we are in control of our thoughts at all times, that's just not the case.
To use the same example above of someone who may have experienced an obsessive thought about harming someone they love, the cognitive component of CBT for OCD helps people to challenge their thinking patterns by looking for evidence. This might include asking "how many of your loved ones have you hurt so far?" or "how many times have you actually lost control and injured someone you care about?". Looking for this kind of evidence for difficult thoughts helps those struggling with OCD to see that they don't act out all the thoughts they have, and that perhaps, the thoughts are not that scary or powerful after all.
These are just some of the components of the cognitive part of CBT in the treatment of OCD.
Dealing with Behaviours.
The behavioural components of CBT for OCD address how we act and behave in response to OCD symptoms. In the simplest of ways, a behaviour is anything that we can observe another person doing. For example, we could see another person run away, slam their hand on a desk, shout out, roll their eyes, clap their hands, or throw a ball. All of these actions are considered behaviours.
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OCD treatment aims to manage behaviours that are unhealthy and which may maintain the symptoms of OCD. If I'm fearful of becoming contaminated by germs (which I might fear will result in me becoming very unwell - an example of a cognition or thought) and so I wash my hands excessively throughout the day, then this behaviour can become a big problem. For one, after a short while I'm likely to get sore, cracked, and maybe bleeding hands. A ton of my time might be lost to this unhelpful behaviour each day. My repeated washing of my hands will also likely feed into my fears (or thoughts) that germs are bad and could make me very unwell, or may even kill me, perpetuating and amplifying my fears around germ.
CBT for OCD treatment aims to alter these behaviours. If I can reduce the number of times I wash my hands by testing out what happens, I might find that I don't become ill or unwell and that no catastrophic issues arise. If this happens, then I might feel less compelled to wash my hands so excessively, and furthermore, my beliefs that germs are terribly dangerous might start to change as well.
At the very core of CBT treatment for OCD is a strategy called exposure with response prevention. This is a form of exposure therapy (a highly effective psychological treatment) that encourages and supports people to engage in behaviours that they might fear of find challenging, while preventing them from performing any subsequent safety behaviours. For example, if I have an intrusive thought that I've left the garage door up, and I feel compelled to turn around and drive back home to check, exposure therapy would encourage you to NOT turn around and check, but rather, to continue driving to your destination. In the therapy room this component of OCD treatment might include not washing your hands before eating some food or not saying a pray after thinking of one of your loved ones getting harmed. Ultimately, when people prevent the safety behaviours that they often use, they find that no catastrophic problem arises. Compulsive behaviours can then reduce until often they disappear completely.
Speaking with a Clinical Psychologist and completing a course of CBT for OCD is a highly effective ways to manage obsessive thoughts, compulsive behaviours, and the full range of OCD symptoms. Not to mention, simply being able to talk openly about your distress is helpful in its own right. Most people who engage in CBT in the treatment of OCD report significantly reduced OCD symptoms, and often full remission of symptoms can occur.
If you would like more information about effective OCD treatments you can contact our Psychologists located on the Gold Coast on 1300 848 072.
Dr Mark Bartholomew is a Clinical Psychologist located in Coomera on the Gold Coast. For well over a decade Dr Bartholomew has been helping people with their OCD symptoms and distress related to OCD.