CBT for Obsessive Compulsive Disorder in London

CBT for Obsessive Compulsive Disorder in London: The IPC Approach

If you check if the door is locked, or if the iron is off, or anything, again and again, you are likely suffering from an obsessive-compulsive disorder. Cognitive Behavioural therapy is known to be one of the best therapies for treating OCD. Cognitive behavioural therapy is focused on the fact that our emotions, thoughts, and actions are all interconnected. The best thing about CBT is that it induces insight and awareness and make you able to deal with situations on your own in a better way.

Are you struggling with OCD in London?

OCD is the reoccurrence of intrusive thoughts combined with compulsive behaviours to reduce the anxiety experienced by such thoughts. For example, excessive hand washing due to fears of contamination. In order to meet formal diagnostic criteria for an OCD diagnosis, this preoccupation or compulsion must be present for a minimum of 2 weeks for most days. The distress must cause significant impairment in social, academic, occupational/education or other areas of functioning. Engagement in compulsions must be time consuming.

Some people may be more vulnerable than others to developing these difficulties.

How can CBT for Obsessive Compulsive Disorder Help?

CBT is the best therapy for OCD. Exposure therapy is undergone where the client is forced to fight the obsessive thoughts and not to act upon them. It requires some time but it is a process of learning. CBT teaches the client to face the fears because it forces them to face the same situation every time but with better handling.

When is the right time to seek Cognitive Behavioural Therapy for obsessive compulsive disorder?

If the person suffering from OCD is showing these symptoms frequently, it is time to go to professional help:

• Fear of harming oneself or others
• Excessive focus on moral or religion
• Fear of losing something
• The idea that everything needs to be just right
• Superstitious beliefs

How long does CBT for Obsessive Compulsive Disorder usually last for?

Different techniques are used in this plan. Concerning the intensity of the situation, the treatment might be prolonged with fewer more sessions than just 5-10.

How does a person develop OCD?

Factors that may increase the likelihood that OCD will develop may include: early exposure to stressful situations, perfectionistic traits, low self-esteem, a tendency towards over-responsibility or the experience of abuse/trauma. The experience of parents with high moral standards may also predispose some individuals to developing OCD.

Core Beliefs

Core beliefs may include the belief that thoughts are powerful and represent reality. This leads the individual to belief that they will be responsible if something happens (e.g. if they have a thought that someone gets hit by a bus, it will be their fault if this ever happens. “My thoughts are powerful. I must not think bad things”. Assumptions/Rules: If I can control my thoughts then I will be safe. If something bad happens because of my thoughts then it is my responsibility.

Precipitating factors

Factors associated with the definitive onset of OCD may include: stress or head injuries.

Maintaining factors

Factors that maintain the problem once it has become established may include: the engagement in compulsive behaviours, which reinforces the belief that this is what is neutralizing their thoughts and keeping everyone safe. Other perpetuating factors include having family members with OCD or loved ones who struggle to challenge intrusive thoughts and compulsive behaviours as this inadvertently reinforces them.

Protective factors

Factors that are strengths of the person and reduce the severity of problems, promoting healthy and adaptive functioning may include: high self-esteem, interests in engaging in activities, support from family and friends, adaptive coping strategies and insight into the likelihood that their intrusive thoughts are not representative of reality.

CBT for Obsessive Compulsive Disorder. Two case studies.

Example 1:

Rita came into contact with dirt while cleaning her house. She start to think: 'What if I fall ill or get an infection? What if I make someone else ill?'. As a result, she gets worried about getting sick or making others sick. She starts to display compulsive behaviours, which act to neutralise intrusive thoughts, such as washing her hands several times and other routines such as checking that environments are completely clean in the future.

This can be understood within a Cognitive Behavioural Therapy framework as follows:

Factors associated with the definitive onset of OCD: Dirt was the precipitating factor that led Rita to experience feelings of anxiety.

Factors that maintain the problem once it has become established: To reduce this anxiety Rita began to wash her hands repeatedly until she felt calmer. This compulsive/safety behaviour is a perpetuating factor, as Rita will continue to do this in the future, as she has learned that this is an effective way of reducing her anxiety. However, this is blocking her from learning that no-one will become sick as a result of dirt in the environment, or that if they did become ill that this would be minimal.

In these situations it would be helpful for Rita to be exposed to dirt so that she learns that these situations are manageable and that nothing awful happens as a result. Rita would also need to engage in response prevention, which means that she would not engage in her compulsive behaviour. Engagement in compulsive behaviours during exposure work is counterproductive, as this would lead Rita to believe that her rituals are keeping her safe. By preventing herself from engaging in compulsive behaviours Rita learns other ways to manage her anxiety and realizes that it is not the compulsive behaviour that is protecting her.

Example 2

Sally’s friend informs her she is going on a trip to Paris for work for a week. Sally immediately experiences intrusive images and thoughts of the plane crashing. Sally feels anxious and guilty about these images but the more she tries to block them the more frequent the images become. Sally begins to engaging in various rituals to reduce this anxiety, which she believes will keep her friend safe. Sally’s friend has a safe trip to Paris. Sally is relieved and associates this positive outcome with the compulsive behaviours/rituals she engaged in.

This can be understood within a Cognitive Behavioural Therapy framework as follows:

Factors associated with the definitive onset of OCD: Sally’s best friend has to go on a work trip to Paris for the weekend. Sally experiences an intrusive thought that the plane would crash on the way to Paris. Sally becomes anxious at this thought and cannot stop thinking about it.

Factors that maintain the problem once it has become established: Sally’s intrusive thought did not become a reality. Sally attributes this to her engagement in counting rituals. If Sally had not engaged in this ritual she would have observed that her intrusive thought was not a prediction for the future/magical thinking. This would also lessen her need to engage in counting or other rituals, as she would lessen her belief that she needs to do these to neutralize her intrusive images.

Factors that are strengths of the person and reduce the severity of problems, promoting healthy and adaptive functioning : Support from loved ones to challenge these rituals would help. If Sally were to engage in CBT this would help her to reduce her anxiety in more helpful ways.