CBT for Obsessive Compulsive Disorder (OCD)

On this page, we explain the key characteristics of Obsessive Compulsive Disorder (OCD), outline the different forms of OCD and describe how Cognitive Behavioural Therapy is used to manage this problem. If you want to talk to an expert about OCD related problems, you can call us on 01732 808 626, email info@thinkcbt.com or complete the confidential contact form on this page.

What is Obsessive Compulsive Disorder?

Obsessive Compulsive Disorder (OCD) is a highly distressing anxiety related problem affecting around 1.2% of the general population.  OCD is usually characterised by two reciprical processes. Firstly, intrusive and recurrent negative thoughts or disturbing images, known as obsessions  and secondly, repetitive behaviours, urges or impulses, referred to as compulsions.  The negative intrusive thoughts and obsessions are highly distressing and often repugnant to the individual. The repetitive behaviours or rituals are accepted as irrational but highly habit forming and incredibly difficult to break. OCD can be referred to as "Covert" where the obsessional thoughts and compulsions are internalised  as mental habits or routines, or "Overt", where the compulsions are externally observable and involve repetitive behaviours or rituals. OCD is a spectrum disorder and commonly occurs along side other anxiety or mood problems including generalised anxiety disorder, panic disorder, social anxiety and depression. 

How Obsessive Compulsive Disorder Works

OCD is usually maintained by an attempt to control, avoid or overcome worries, doubts or anxiety about the meaning of negative intrusive thoughts, impulses, sensations  or upsetting images. Responsibility for preventing, controlling or neutralising these negative thoughts or images, often involves using repetitive behaviours, internal mental checks, routines, rituals or distractions.

For a person experiencing OCD, the only way to prevent or neutralise their worry and anxiety, is to try to stop the thought or carry out the associated compulsion. This only provides temporary relief and serves to strengthen the reciprical relationship between the negative thought and the compulsive behaviour. Attempting to stop the unwanted thought actually increases the preoccupation with the thought itself and the level of associated anxiety or distress. You can use the downloadable Thought Record available here to help monitor obsessional thoughts and behaviours.

Obsessions involve:

• Recurrent and persistent thoughts, impulses or images that are experienced as intrusive or inappropriate and  which cause anxiety or distress.
• The thoughts, impulses or images are not simply excessive worries about real-life problems.
• The person attempts to ignore or suppress their thoughts, impulses or images, or to neutralize them with some other thought or action.
• The person recognizes that the obsessional thoughts, impulses, or images are a product of his or her own mind.

Compulsions involve:

• Repetitive behaviours or mental acts that the person feels driven to perform in response to an obsession or according to rules that must be applied rigidly.
• The behaviours or mental acts are aimed at preventing or reducing distress or avoiding a dreaded event or situation.
• These behaviours or mental acts are usually excessive and not connected in a realistic way to the feared situation or event.

For an OCD diagnosis to take place:

• The individual recognises that the obsessions or compulsions are excessive or unreasonable.
• The obsessions or compulsions cause marked distress, take up more than 1 hour a day, or significantly interfere with the person's normal routine, occupation or social activities.
• If another psychological disorder, substance use, or general medical condition is present, the obsessions or compulsions are not exclusively restricted to it.

How OCD Can Be Treated Using Cognitive Behavioural Therapy

The evidence demonstrates that OCD can be effectively treated using a number of established CBT techniques. These psychological techniques primarily focus on acknowledging and discharging negative intrusions, altering distressing self-appraisals, increasing the individual's tolerance of uncertainty and reducing the frequency and nature of compulsions. Modern approaches to OCD focus on the individual's resilience and uncertainty tolerance, tackling the problem at it's root cause by undermining the psychological resistance that maintains the worry and anxiety.

Some of the passive counselling approaches from the psychodynamic field have proven ineffective and in some cases can actually make the problem worse by encouraging increased introspection and self-appraisal. OCD sufferers are advised to follow the NICE guidance and only use Cognitive Behavioural Therapy or prescribed medication in the treatment of OCD.

If you want to talk to a Cognitive Behavioural Psychotherapist about OCD, you can complete the simple contact form and we will organise an initial free telephone consultation.  You can also take the confidential Obsessive Compulsive self-assessment by clicking on the following link:

The Different Forms of Obsessive Compulsive Disorder

OCD is a single term given to describe a wide range of anxiety related problems that tend to follow common cognitive and behavioural patterns. Whilst there are numerous variations on the problem, OCD will typically involve one or more of the following areas:

Checking Behaviours - Continuously checking or testing things to minimise perceived risk or threat. This could include switches on the cooker, locking doors and windows or repeatedly asking questions or asking for verbal reassurance.

Symmetry and Orderliness - This involves a compulsion to ensure that everything is lined up, in it's correct place and feeling " just right". This is done to maintain a sense of security and control, to prevent discomfort or sometimes to avoid worries about something bad happening.

Physical / Mental Contamination Fears - This involves extreme worries about real or "magical" threats such as bacteria, viruses, chemicals, bad luck, bad numbers and the names of illnesses. Sufferers become preoccupied with cleansing, avoiding possible sources of contamination and attempting to limit the potential for cross-contamination of "safe" areas.

Hoarding - This involves compulsive collecting, difficulty discarding and problems organising the saved or acquired items. This usually results in cramped living conditions as the hoarding habit takes over all available living space.

Intrusive Thinking / Rumination - This involves the continuous recurrence of personally repugnant and disturbing thoughts, images or impulses that are highly distressing and often relate to violence, sexuality, morality, danger, or acting in an unacceptable manner.

If you are experiencing problems with OCD, you can take our OCD self assessment questionnaires by clicking here.

Cognitive Behavioural Therapy for OCD brings the same rigor, structure and focus that it provides for many other psychological, emotional and behavioural problems.

Follow the evidence and take a positive step towards changing your situation.
Call us now on 01732 808 626, click here to send a message or  email us at info@thinkcbt.com.

Think CBT is committed to providing access to affordable independent Cognitive Behavioural Therapy. Our aim is to support tangible improvements in the psychological health and well being of our clients, contributing to better lives worth changing for.

There are many psychotherapists and counsellors offering cognitive behavioural therapy. Always ensure that your therapist is professionally accredited with the British Association of Behavioural and Cognitive Psychotherapy (BABCP).

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