CBT for OCD, by Brianna Sculley, LCSW

Cognitive Behavioral Therapy (CBT) can be an effective treatment for Obsessive-Compulsive Disorder (OCD) by targeting irrational and obsessive thought patterns. At times, these distressing thought patterns lead people to engage in compulsions that provide temporary relief and temporary feelings of safety, but they are only temporary and can play tricks on us!

Exposure and Response Prevention Therapy

A therapist working with a client with OCD can provide a safe environment to expose to stress-inducing scenarios. Exposure therapy should proceed at a comfortable pace for the patient. During exposure therapy, the client will not be able to engage in compulsive behaviors for anxiety relief. Instead, they face their fear and allow the anxiety to gradually fade away. This desensitizes the client to these scenarios over time resulting in them happening less frequently.

Types of Exposure

How does a therapist expose their client to stressful scenarios? They can use a few different methods. First, they might proceed with real-life exposure and supervise the client in an anxiety-inducing scenario for a period of time. Alternatively, they might use imaginal exposure, in which the client visualizes the stimulus they are afraid of to reduce their fears and distress. In addition to these forms of exposure, a key aspect of exposure therapy is response, or in this case, ritual, prevention. It can be difficult for OCD sufferers to let go of their powerful urges. However, through exposure therapy, it is highly possible to experience long-term relief.

Grounding and Deep Breathing Exercises

In CBT for OCD, a therapist will likely work with their client on grounding and deep breathing exercises. These skills are very helpful for reducing anxiety without turning to their go-to ritual behaviors. While they are not “quick fixes” for OCD, clients can often experience relief with these coping mechanisms. Through deep breathing and grounding, clients can learn to slow their breathing and get their heart rate under control for an overall calming effect.

Progressive Muscle Relaxation

Many people who struggle with OCD also carry tension in the body. After all, stress doesn’t just affect the mind. A person with OCD may feel their muscles tense up when they are anxious. This is because the fight or flight response kicks in. Progressive muscle relaxation techniques are another aspect of CBT for people with OCD. This helps people to disengage from the automatic fight or flight response and see the situation more clearly.

Cognitive Restructuring

CBT for OCD includes a focus on cognitive restructuring. A therapist will help their client to challenge irrational thoughts that are not necessarily based on facts. Basically, CBT for OCD involves using logic to critique thought patterns that result from emotional responses rather than factual evidence.

And after a therapist guides their client through these exercises, the client will begin working to establish new thought patterns by analyzing the evidence for their new beliefs. This does not happen overnight, but it becomes easier for people who struggle with OCD to focus on more rational thought patterns over time. This makes it possible to avoid engaging in compulsive behaviors. Essentially, clients learn to become their own exposure therapists!

Are you curious about the benefits of CBT for OCD? Consider working with a therapist. Reach out to us today to discuss options for scheduling your first session - it will be so worth it.