Cognitive Behavioural Therapy
CBT is a psychotherapeutic approach to treating a wide range of psychological difficulties.. It is broad term incorporating a number of treatment approaches—some focusing on specific problem areas (e.g., OCD, PTSD). CBT is short-term, goal-directed, problem-focused, structured and active, oriented in the "here-and-now", skill-building and research based.
CBT is based on the observation that psychological problems are often fuelled by unhelpful and unrealistic patterns of thinking which, in turn, may be reinforced by counterproductive behavioural patterns.
Cognitive restructuring, or cognitive reframing, is a therapeutic process that helps the client discover, challenge, and modify or replace their negative, irrational thoughts (and/or cognitive distortions). It is important to understand and realize that OCD thoughts are irrational prior to proceeding with Exposure Response and Prevention.
First Line Treatment for OCD
Exposure & Response Prevention And/Or Medication
The most effective treatments for OCD are Cognitive Behavior Therapy (CBT) and/or medication. More specifically, the most effective treatments are a type of CBT called Exposure Response and Prevention, which has the strongest evidence supporting its use in the treatment of OCD, and/or a class of medications called serotonin reuptake inhibitors, or SRIs.
Exposure and Response Prevention is typically done by a licensed mental health professional (such as a psychologist, social worker, or mental health counselor) in an outpatient setting. This means you visit your therapist’s office at a set appointment time once or a few times a week.
Medications can only be prescribed by a licensed medical professionals (such as your physician or a psychiatrist), who would ideally work together with your therapist to develop a treatment plan. Taken together, ERP and medication are considered the “first-line" or "Gold Standard" treatment for OCD.
Exposure & Response Prevention
The most important strategy in CBT for OCD is called “Exposure and Response Prevention” (ERP). Exposure refers to confronting the thoughts, images, objects and situations that make you anxious. At first glance, this doesn’t sound right. You have probably confronted these things many times only to feel anxious over and over again. It is important to keep in mind that you have to do the second part of the treatment as well – Response Prevention. Once you have come in contact with the things that make you anxious, you make a choice to not do the compulsive behavior. Again, this might not seem correct to you. You may have tried many times to stop compulsive behavior only to see your anxiety skyrocket. The last point is key – you have to continue to make the commitment to not give in and do the compulsive behavior until you notice a drop in your anxiety. In fact, it is best if you stay committed to not doing the compulsive behavior at all. The drop in your anxiety that happens when you stay “exposed” and “prevent” the compulsive “response” is called habituation. This might be a new idea for someone with OCD – that your anxiety will start to decrease if you stay in contact with the things you fear and don’t do the compulsive behavior.
Finding your True Values - Life Values Inventory
Your values are the lenses through which you view yourself and your world.
Why find your true values? OCD goes after what you value. It goes after what is important to you, threatening to cause harm in your life unless you do a compulsion to prevent 'bad things from happening' or to 'protecting the safety of others.' etc.
Example, If you value a sense of belonging, OCD will threaten to alienate you from friends, family and lovers. OCD may create 'harming OCD' or ''relationship OCD' where you fear you may hurt someone or your partner doesn't love you, or you don't love your partner.
Example: If you value your health, you may develop "Health OCD" in where OCD will create thoughts that you are sick with an illness, or could become sick with an illness.
After completing the (free) values inventory, it will highlight your 'core values' or 'true values' or 'personal truth' from which self-esteem, fulfillment, and resilience develop. This way, when OCD is flaring up - REMEMBER YOUR VALUES! Remember that OCD attacks your values to scare you! You will receive a report of your values in a .PDF that you can save.
For instance, knowing that you value the wellbeing of others, you value your health or you value belonging. - it will help you identify that OCD is at work when it is attacking the safety of others, telling you that you have a disease, or attacking your relationships. Knowing your values is another tool to help get awareness over your obsessions (thoughts) and power over compulsions.
Obsessive Compulsive Disorder is always negative!
Use the worksheets to practice building thought (obsession) and compulsion awareness and create exposures.
Page 1 - Working on identifying Unhelpful Thinking (Irrational OCD thoughts and/or Cognitive Distortions)
Page 2 - Track your Obsessions and Compulsions to create awareness
Page 3 - Understanding the OCD Cycle with Exposure Response Prevention (With Example)
Page 4 - Make your own OCD Cycle with Exposure Response Prevention
Page 5 - Use the Fear Ladder to break down a fear into smaller fears
You don't have to learn how to control your thoughts; you just have to stop letting them control you.
Anxiety Canada has a great "Self-Help: Managing your OCD at home" tool which includes OCD worksheets.
If planning to delve into OCD treatment, one must commit. Make sure you are ready. It is not easy, but it is worth it.
If possible, find a psychologist while recovering from OCD. A psychologist is someone you can trust and tell all your thoughts. Yes ALL the thoughts! A psychologist can coach you to become your own therapist so you can learn to manage OCD on your own. Be sure to interview your psychologist. They must be professionally trained in ERP. It's also important to have a good relationship and connection. The aocdf has a list of therapists who are trained with ERP.
Join a support group to meet others going through the same journey. There are several people who live with OCD. Sharing experiences reduces shame that accompanies OCD. Depending on your age, find the right group for you.