Treating OCD

Inference-based Cognitive Behavioral Therapy (I-CBT)

This treatment modality is relatively new (within the last 25 years) and considered a “gentler” approach to OCD treatment.

Unlike Exposure with Response Prevention (ERP), the older and more conservative approach to treating OCD, I-CBT uses your inherent strengths and wisdom of your own mind and body. It does so by teaching you to rely less on long-programmed default modes of reasoning (doubt-based) and fearful imagination, and more on your 5 senses & a wise internal voice (sometimes called “common sense”). Scroll down to read more.

Exposure with Response Prevention (ERP)

This is the classical behavioral approach to extinguishing our deeply conditioned, avoidant patterns of behavior.

Exposure therapy dates back to 1950’s treatment of phobias. It is considered a classical cognitive-behavioral model, since it deals with cognitions (thoughts) and behaviors (actions)- with the aim of behavior modification in order to change how we think. While historically considered the gold-standard approach to treating OCD, some people are not interested in exposure therapy, and luckily there are other evidence-based approaches available.

Acceptance & Commitment Therapy (ACT)

This orientation is a general counseling theory, but can be used to treat OCD effectively.

Acceptance is a compassionate inquiry which investigated our feelings about a particular experience with curiosity and non-judgment (you don’t have to like something in order to accept it!). Using the tools of mindfulness, ACT helps people to relieve distress around intolerable experiences and intrusive thoughts which make compulsions feel mandatory. When we have tools to sit with things as they are, the need to do something lessens. (I usually use components of ACT along with another treatment approach).

In I-CBT, clients learn the following:

OCD follows a sequence.
People with OCD have reasons behind believing their obsessional doubts. The reasons aren't the problem. It is how they are applied to the present moment through the Obsessional Reasoning Process that is causing the sufferer pain.
How OCD constructs a convincing story.
How to identify their Feared Possible Self, and why they get the specific obsessional doubts they get.
How to identify reasonable vs obsessional doubts and the importance of direct evidence from the senses.
How something being possible doesn't make it relevant without direct evidence from the senses to back it up.
Why OCD narratives feel so real
How to gain back trust in the senses
How to tap into a narrative about Reality instead of OCD's story
Specific ways that OCD hijacks the reasoning process that makes OCD seem like it has solid evidence
Who they are in Reality compared to their false Feared Possible Self.
Relapse Prevention

From Bronwyn Shroyer

Some Common
Obsessions

Contamination
Aggression/Harm
Doubting
Religion/Moral/Scrupulous
Symmetry/Exactness/Order
Sexual/Sexual Orientation/Gender Identity
Pedophilia
Loss of Impulse Control
Relationship
”Just Right”
Perfectionism
Postpartum
Health
Real Event
Hyper-Responsibility
Hyper-Awareness
Death/Existential
Meta OCD (obsessing about obsessing)
Body Image
Panic
Social Anxiety
Phobias

Some
Common
Compulsions

Washing/cleaning
Checking
Locking
Ordering/arranging/evening/moving
Repeating/erasing/redoing
Touching/tapping
Confessing
Praying
Camouflaging
Staring
Superstitious behaviors
Reassurance seeking
Behavioral or cognitive avoidance
Rumination/solving
Apologizing
Lucky words/numbers/phrases
Cognitive restructuring
Counting