Cognitive Behavioral Therapy for OCD
Obsessive compulsive disorder is characterized by uncontrollable, disturbing thoughts and repetitive behaviors or rituals that can severely interfere with daily life. One of the most effective treatments for obsessive compulsive personality disorder is cognitive behavioral therapy. This therapy involves retraining the brain to eliminate habitual compulsive responses to situations that create anxiety. Cognitive behavioral therapy is composed of two parts: exposure and response prevention, and cognitive therapy.
Exposure and Response Prevention Therapy for OCD
Exposure and response (or ritual) prevention is a behavioral therapy. It involves exposing patients with OCD to the thing that they fear so they can become accustomed to it and it no longer causes them to feel the necessity to respond with rituals or other compulsive behavior to deal with their anxiety.
For example, if the patient compulsively washes his or her hands after touching a public doorknob, they will be asked to touch the doorknob and then resist the compulsion to wash. If they resist the urge for a long enough time, the anxiety and desire to wash will eventually fade.
Exposure to the feared object or situation must be repeated many times, and the length of time must be gradually prolonged in order for this type of therapy to be effective. According to a report in Psychiatric Times, most patients must repeat the exposure between 8 and 12 times before the anxiety is diminished to a point where it no longer bothers them.
Cognitive Therapy for OCD
Cognitive therapy is a method of self-treatment that people with OCD can learn, enabling them to be their own behavioral therapists. This approach concentrates on helping people deal with the uncontrollable, troublesome thoughts that cause anxiety by training the patient to recognize these thoughts and urges as symptoms of a disorder. They will then make conscious, self-directed choices to resist the compulsive urges. This method has four steps:
1. Relabel- In this first step, individuals learn to consciously name their thoughts as obsessive thoughts or compulsive urges that have a biological cause. This relabeling will not eliminate the thoughts or urges, but it is the first step toward the goal of resisting them.
2. Reattribute- In the second step, the cause of the thoughts and urges is attributed to the OCD, a medical condition. When a thought arises, the person realizes, “It’s not me, it’s the OCD.” This helps the person to understand that these thoughts are not meaningful. Instead, they are false ideas caused by a chemical imbalance in the brain, and as such, they do not require the person to respond to them. The Relabel and Reattribute steps are usually done at the same time.
3. Refocus- This step is the most difficult. It requires shifting the attention away from the obessive thought by doing another behavior. At first, the person will experience anxiety during this step. It is important to delay doing the compulsive behavior for several minutes, ideally fifteen minutes or more. During this wait time, the compulsive urge will change, and eventually the wait time can be increased.
4. Revalue- This step involves learning not to take the obsessive thoughts at face value, because they are not significant.
Cognitive behavioral therapy is one of the most effective treatments for obsessive compulsive personality disorder, and will help to lesson or eventually eliminate the symptoms.