How CBT can help with different mental health problems

Obsessive Compulsive Disorder

What is Obsessive Compulsive Disorder (OCD).

OCD is a mental health condition which is characterised by unwanted, intrusive thoughts (obsessions) and repetitive behaviours or mental acts (compulsions) that a person feels compelled to perform. These compulsions are a temporary way to relieve the anxiety and distress caused by the obsessions, but this sense of relief does not last and it doesn’t take long for the vicious cycle to begin again.

OCD is made up of two elements:-

Obsessions:

These are persistent unwanted intrusive and uncontrollable thoughts, images or urges.

These obsessions cause the person significant anxiety and distress and can result in other additional emotions such as fear, disgust, doubt, shame.

Common examples include fear of germs or contamination, fear of harming oneself or others, unwanted sexual or religious thoughts, a need for things to be just right, fear that thoughts can directly influence whether something will happen or not.

Compulsions:

These are the repetitive behaviours or mental acts a person feels compelled to perform to reduce the anxiety and distress caused by their obsessions, or prevent the feared event/outcome from happening.

Common examples include excessive hand washing or cleaning, checking locks or appliances repeatedly, arranging/doing things in a specific order, counting in specific patterns, seeking constant reassurance.

People with OCD tend to experience both of these elements but it is possible to have only obsessive symptoms or compulsive symptoms.

OCD can have a significant impact on daily functioning and cause distress and disruption to everyday life in areas such as work, relationships, family and home life.

OCD and the rituals this brings can consume a lot of time and be exhausting. Its impact can be detrimental to concentration, mood, self-esteem, physical health and sleep.

NICE guidelines recommend 10-20 sessions.

How CBT helps

CBT helps people understand the Vicious Cycle that keeps OCD going. CBT for OCD uses a combination approach to help people learn to break this cycle by targeting both their unhelpful thought patterns/obsessions (cognitive techniques) and their behavioural responses (ERP).

Exposure and Response Prevention (ERP):

Helps people break the cycle of obsession, anxiety, and compulsion by facing their fears without performing compulsions.

Its step by step approach helps people slowly and intentionally confront situations or objects that trigger obsessions, starting with those that cause the least anxiety.

This technique helps people

by gradually teaching the brain that it can tolerate anxiety and that the feared outcomes do not happen when rituals are withheld.

Cognitive techniques:

CBT helps people to challenge and change unhelpful thought patterns. It helps people test out specific predictions, identify and question the cognitive processes that maintain their OCD symptoms, as well as the meaning they attach to these. It helps people to

explore alternative meanings or beliefs about their intrusive thoughts and rituals. It helps people reframe negative thoughts.

CBT for OCD helps people to develop a new relationship with, and a more effective way of responding to obsessions and compulsions, that doesn’t maintain their anxiety and dysfunction in the long-term. It helps people develop effective tools for managing their OCD symptoms. It helps reduce the severity of OCD symptoms and improve overall quality of life.