If you’re managing Obsessive-Compulsive Disorder (OCD), you may feel like your thoughts and behaviors are beyond your control. However, there is hope! Over the last several decades, there have been advances in clinical research. Currently, we have multiple, effective approaches to consider when building a treatment plan. In this post, I will be sharing information on three effective approaches to OCD treatment that may help you to better manage your symptoms and live a more fulfilling life.
Acceptance and Commitment Therapy (ACT) is a therapeutic approach that emphasizes the importance of accepting difficult thoughts and emotions rather than trying to avoid or control them (such as by using compulsions). By learning mindfulness and acceptance techniques, you can develop the skills to observe your thoughts without getting caught up in them. You might begin to notice that your OCD sends you “notifications” that you don’t need to “click into” and figure out, and that doing so actually takes you away from your living as full and intentional a life as you’re seeking.
Exposure and Response Prevention (ERP) is a form of therapy that involves growing your willingness to expose yourself to feared situations while preventing yourself from engaging in compulsive behaviors. I often think of compulsions as “shortcuts back to comfort” that backfire in the long run. ERP helps you build confidence, and can be a very creative, fun, and rewarding process. Through ERP, you may learn that:
- Tough situations are not as uncomfortable or dangerous as you once thought
- You have more skill and capacity than you know for managing difficult experiences, thoughts, and feelings
- The “shortcuts” to comfort you’ve been taking are time-consuming and emotionally draining, and difficult thoughts and feelings go away on their own
Inference-based CBT (I-CBT) is a newer form of OCD therapy that does not involve exposure. It focuses on examining the ways you think (and then behave) when OCD shows up. I-CBT helps you to understand the reasoning you have used to build and maintain your OCD thinking. When you’ve learned the distinctions between your OCD thinking and your other thinking, you can better spot when OCD is present and begin to move out of your “OCD story” and back into your life.
Important takeaways: Each of these therapies has been shown to be effective in reducing OCD symptoms, and you may benefit from more than one approach. A therapist can help you explore your treatment options and decide how to best sequence or combine multiple approaches. And while treatment requires effort and commitment, with the guidance of a skilled therapist and your own determination, you can learn to manage your symptoms and live a more fulfilling life.
If you’re considering therapy for OCD, it’s important to find a therapist who specializes in evidence-based treatments like ACT, ERP, or I-CBT. Be sure to ask about their training and experience in treating OCD specifically, and to work with someone prepared to individualize treatment based on your specific symptoms and preferences.
Remember, seeking help for OCD is a courageous step. You don’t have to figure it out alone. With the right support, you can learn to better manage your symptoms and spend less time wrestling with your OCD.
For further reading
- Craske, M. G., Treanor, M., Conway, C. C., Zbozinek, T., & Vervliet, B. (2014). Maximizing exposure therapy: An inhibitory learning approach. Behaviour Research and Therapy, 58, 10-23. doi: 10.1016/j.brat.2014.04.006
- Hershfield, J. (2023, January 16). An update on the poetry of evidence-based psychotherapy for OCD. Sheppard Pratt’s News & Views Blog. https://www.sheppardpratt.org/news-views/story/an-update-on-the-poetry-of-evidence-based-psychotherapy-for-ocd/
- O’Connor, K., & Aardema, F. (2012). Clinician’s handbook for obsessive compulsive disorder: Inference-based therapy. Wiley Blackwell.
- Twohig, M. P., et al. (2015). Exposure therapy for OCD from an acceptance and commitment therapy (ACT) framework. Journal of Obsessive-Compulsive and Related Disorders, 6, 167-173. doi:10.1016/j.jcbs.2012.09.003
