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Cognitive Behavioral Therapy (CBT) for Obsessive Compulsive Disorder (OCD)

Cognitive behavioral therapy, or CBT, is the type of therapy most commonly used to treat anxiety disorders such as OCD. CBT has 3 main components—exposure therapy, cognitive restructuring and relaxation training. This article will provide an overview of how CBT is used to treat OCD and how you can recreate CBT type treatment in your own home.

Cure For OCD?

Therapy is effective, but so are some at home options. Take my free 7 minute anxiety test to find out what some of these options are and how they work.

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Therapy for OCD

CBT for OCD is something that can be effective, and has been verified in the research. In fact, CBT is a great choice for all anxiety disorders, provided you are willing to commit to it and spend the substantial costs. If you want alternative ideas, make sure you take my anxiety test now.

When you use CBT for obsessive compulsive disorder, you'll often go through various parts of the following:

Exposure Therapy

Exposure therapy is a type of therapy that involves exposing the client to an anxiety trigger in a relaxed and controlled environment.

In cases of OCD, this may involve exercises such as touching a doorknob without immediately washing hands (for people with contamination-based compulsions), or purposefully imagining oneself as a murderer (for people with purely obsessional OCD).

In a therapeutic setting, emphasis should be placed on the client’s willingness to participate in such activities. If the client complains about being “forced” to resist their compulsions or ignore their obsessions, the therapist should offer a gentle reminder that they agreed to do it.

A person with OCD will have extreme negative feelings associated with resisting their compulsions and ignoring obsessions, and may find it more psychologically comfortable to imagine that they would not voluntarily choose to do so. Facing the fact that they can choose to do so without any tangible negative consequences represents a step towards being able to resist and ignore obsessions and compulsions without any reservations.

If the client is unwilling or unable to participate, they should be taught further coping mechanisms before undergoing exposure therapy to avoid this type of therapy worsening their condition.

DIY Tips:

  • Relax Learning mental and physical techniques to help you relax beforehand and stay relaxed during the exercise is important, as purposefully exposing yourself to an anxiety trigger and panicking will only serve to reinforce your preexisting anxiety reactions and make it harder for you to undergo further exposure therapy. Mental techniques that can help to relax you before and during exposure therapy will be discussed in the following two DIY sections.
  • Establish Willingness Prior to exposure, spend some time contemplating the logic and benefits of resisting your compulsions and/or overcoming your obsessions, and deciding that because of these potential benefits you are, in fact, making the decision to participate in the exercise.
  • Challenge Yourself There are any number of challenges you can pose to yourself in your own home, such as leaving a table crooked or purposefully not washing your hands for a certain period of time. Before your set time period ends, use the mental and physical techniques you know to attain relaxation in the presence of the phenomenon that usually makes you uncomfortable.

Cognitive Restructuring

Cognitive restructuring is about identifying the underlying beliefs and thought patterns that form the basis of your obsessions and/or compulsions.

For someone who engages in compulsive behavior, such beliefs may include the thought that germs will kill him or her, or that something terrible will happen if they fail to follow through with the compulsion (such as counting, cleaning, or organizing). For someone with primarily obsessive OCD, underlying beliefs may involve the fear that they are secretly a dangerous person, such as a murderer or pedophile.

Once the beliefs and thought patterns are identified, the therapist works with the client to acknowledge that the beliefs are false, and to teach them healthier and more positive thinking.

DIY Tips:

  • Keep a Journal Writing in a journal about your daily experiences with phenomena that set of obsessive and/or compulsive behaviors can help you to identify the underlying beliefs and thought patterns that escalate your anxiety. Once you are aware of these beliefs and thought patterns, you can spend some time thinking about other beliefs that you hold that may be more useful to contemplate when you encounter such phenomena. A journal may also be able to help a therapist understand your thought processes and to treat you more effectively.
  • Make a List of Positive Affirmations Creating a list of positive affirmations, particularly affirmations that are catchy or rhyme, can give you positive and relaxing ideas with which to interrupt your usual negative thought spirals, reducing their intensity and ideally stopping them from interfering with your daily functioning.

Relaxation Training

Relaxation training is training that teaches you how to cope with environmental and psychological triggers of OCD in a healthy manner.

Normally, people with OCD experience intense anxiety when faced with such triggers, imagining that something bad will happen or even contemplating fatalistic scenarios that could result as a consequence of ignoring their compulsions.

Relaxation training gives people with OCD useful tools for dealing with these situations. Breathing exercises, visualization routines and creating physical or mental triggers for relaxed, positive feelings can help to curtail the anxiety associated with the situation and build positive associations with the stimulus to replace the usual negative ones.

Reducing OCD the Right Way

OCD is a difficult and inconvenient disorder to have. CBT is proven to be the most effective treatment for this disorder, and doing CBT self-help exercises can help you realize that you can have an effect on your disorder and keep its effects from interfering with your life.

The problem isn't that CBT doesn't work. The problem is that it's simply not right for everyone. Not everyone wants to go to a therapist all the time, spend lots of money, and talk to a stranger.

If you're looking for alternative options and saving CBT for a last resort, make sure you take my free 7 minute anxiety test now. You can use it to learn more about your OCD and find out how to treat it.

Start the test here.

Author: Micah Abraham, BSc Psychology, last updated Sep 28, 2017.

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