OCD Treatment: Therapy

One of the ways to treat obsessive compulsive disorder is through therapy. By far the most important therapy in OCD is the cognitive-behavioral therapy. While it doesn’t promise to outright cure OCD it does much to help one manage the disorder well and lead a normal life.

Cognitive-behavioral therapy is preocupied with two different treatments. One is known as exposure & response prevention while the other is known as cognitive therapy.

Exposure & Response Prevention (ERP)

Exposure & response prevention (ERP) is the most popular therapy for treating obsessive compulsive disorder. Let’s break this down for a better understanding. Exposure means exposing the sufferer to objects or circumstances that trigger anxiety until, in time, those objects or circumstances will trigger less and less anxiety or no anxiety at all. This whole process is also known under the name of habituation. Response prevention regards the compulsions that OCD sufferers perform to reduce the anxiety triggered by their obsessions. Exposure & response prevention therapy tries to help patients unlearn responses – rituals, compulsions – and eventually stop them entirely.

ERP therapy is composed of the following steps:

1. First, the sufferer must make a list of circumstances or actions that help trigger fear and obsession. Such a list is called a hierarchy.

2. The second step is for the patient to go through his own hierarchy and expose himself to the circumstances or actions inside it gradually from lower to higher fear and anxiety. This step will be shorter or longer depending on how fast one is able to feel comfortable with the situations and resist compulsive action. Exposure will usually start with the help of a therapist and they can take from 30 minutes to 3 hours but one will also have to practice exposure at home for at least two-three hours a day between sessions. If exposure isn’t possible inside the therapist’s cabinet then the therapist will try “exposing” the patient to the circumstances and situations that trigger his obsessions through sheer imagination. As you might have guessed, the main objective during these exposures is for the OCD sufferer to abstain oneself from compulsive behavior while engaging in situations that might have otherwise triggered them until the sufferer will abstain oneself altogether with no external help.

ERP therapy takes between three to five months. During all this process, the therapist trains the patient to precisely rate their anxiety levels and track progress precisely, both at the cabinet sessions and at home. Once progress is made, OCD sufferers are encouraged to progress through the hierarchy and expose themselves to tougher and tougher anxiety-triggering situations.

People that show mild symptoms of obsessive compulsive disorder may want to practice ERP therapy themselves without consulting a therapist. For this to be effective one might want to buy a professional step by step guide.

Studies have shown that ERP therapy is effective on over 75% of patients during therapy itself. The majority of patients experience long-term benefits as well, even after a few years from the end of treatment. However, ERP therapy has proven to be less effective for purely obsessional (pure-o) patients or patients suffering severe depression.

Cognitive Therapy (CT)

Cognitive therapy is being used in the treatment of obsessive compulsive disorder in combination with ERP therapy. Just as in ERP therapy, patients are asked to make a list of situations that trigger anxiety also known as a hierarcy and then expose themselves to those situations. Instead of facing them until the compulssions dissapear, in cognitive therapy the patient must pay attention to the feelings associated with those situations and the way they interpret their obsessions, particularly why they think they have them or what do they think is particularly true about them.

Cognitive therapy tries to help patients re-examine their anxiety triggering thoughts and the consequences of getting involved in the adjacent compulsive behavior. As an example, one OCD sufferer might think that turning the lights on and off before leaving a room for 15 times is done to help a loved one from getting hurt but when such a ridiculous belief is challenged by someone else in a thorough manner while at the same time confronting the sufferer it can help improve behavior.

One method used in cognitive therapy to help cure OCD in patients is what it’s called a thought record, whereby patients record their thoughts, obsessions and their own interpretation of them. After they do that, they should then try to objectively seek evidence for and against the obsession, to notice they way they misinterpreted the obsession and to start developing a better response to the obsession. This is done with a therapist but afterward can be done home as well if the therapist recommends it.

Of the studies that were conducted so far most of them have shown that cognitive therapy is usually effective.

As a conclusion, most therapists don’t select one therapy but choose to combine both therapies, ERP & CT, for a certain patient. On top of that patients are usually grouped together for more effective results due to the social proof effect and other such psychological effects.

This concludes our article on the treatment of OCD through therapy. If you want to add on top of what we wrote here or if you’d like to share your experience regarding treating obsessive compulsive disorder through therapy then don’t hesitate to post a comment.

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