CBT Treatment for OCD - London & Sevenoaks

We provide CBT treatment for Obsessive Compulsive Disorder from our clinics in Sevenoaks  and London Bridge. You can also organise Cognitive Behavioural Therapy for OCD with one of our forty therapists operating across London, Kent, Surrey and Sussex. CBT is the recommended treatment for OCD and the research evidence shows that it is highly effective. To talk to one of our CBT experts about treatment for Obsessive Compulsive Disorder, call 01732 808626 or email info@thinkcbt.com

 

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 usually involves three reciprocal processes. Firstly, intrusive and recurrent negative thoughts, urges or disturbing images, known as egodystonic intrusions. Secondly, obsessions  involving intense rumination, worry or self-doubts and thirdly, repetitive neutralising behaviours, referred to as compulsions.

SIMPLE MODEL OF OCD THINK CBT

 

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.

You can read our specialist blog on Obsessive Compulsive Disorder (OCD) and find out more about the most effective forms of CBT treatment.  

 

How Obsessive Compulsive Disorder Is Maintained

OCD is 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 provides only temporary relief and serves to strengthen the reciprocal 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.

 

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 is Treated Using Cognitive Behavioural Therapy

The evidence shows that OCD can be effectively treated using a number of CBT techniques. These techniques primarily focus on acknowledging and defusing negative intrusions, altering distressing self-appraisals, increasing tolerance of uncertainty and reducing the frequency and nature of compulsions. Modern approaches to OCD focus on the individual's resilience and tolerance of self-doubt and uncertainty.

Obsessive Compulsive Disorder is treated using Cognitive Behavioural Therapy and / or SSRI medication. Whilst SSRI medication can reduce the intensity of the symptoms, the recommended treatment of choice is CBT. In particular, specialised forms of CBT including Exposure Response Prevention (ERP), Acceptance and Commitment Therapy (ACT), and Inference Based Therapy (IBT), have been found to be highly effective in the treatment of OCD and other spectrum-related disorders. ERP, ACT and IBT are integrated into our OCD treatment protocols and can be accessed from our main offices in Sevenoaks or London.

Some of the counselling approaches from the Psychoanalytic and psychodynamic field have proven ineffective and in some cases can actually make the problem worse by encouraging increased introspection and self-doubting.

OCD sufferers are advised to follow the NICE guidance and only use Cognitive Behavioural Therapy or prescribed medication in the treatment of OCD. ERP, ACT and IBT treatments can be highly effective when integrated into a structured CBT plan.

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:

 

Take the Free Obsessive Compulsive Disorder Inventory (R)

 

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.

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The checking behaviours provide a safety / reassurance habit to control or neutralise the anxiety or worry and tend to increase in frequency over time. Common checking behaviours include:

  • Gas or electric appliance knobs, Water taps and electric light switches.
  • Door and window locks, security chains and house / car alarms.
  • Continuously rereading and checking letters, postcards and emails before sending.
  • Accident information after completing a road journey.
  • Continuously texting and calling loved ones to check safety.
  • Internet health pages to check symptoms.

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.

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This continuous checking can disrupt and interfere with daily routines and cause isolation as the sufferer attempts to strictly control the situation or their environment. Examples of Symmetry and Orderliness behaviours include:

  • Having to ensure that everything is neat, tidy and in its correct place at all times.
  • Ensuring that everything is completely spotless, hygienically clean and without any marks or smudges.
  • Hanging pictures or organising books in a completely aligned and ordered manner.
  • Organising food or crockery according to a specific formula, such as ensuring that cans of food are all facing the same way.
  • Hanging or storing items of clothing to all face the same way or follow a strict order.
  • Organising or storing items according to a strict set of rules.

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.

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Covert internal rituals or routines are often used to reverse or neutralise bad words or ideas. Contamination avoidance behaviours include:

  • Contact with cleaning chemicals.
  • Visiting GP waiting rooms, hospitals or other public waiting areas.
  • Shaking hands or touching door knobs / handles.
  • Eating in cafes or restaurants.
  • Touching red objects or stains.
  • Avoiding disabled or sick people.
  • Showering after talking to unpleasant people.
  • Having special words or internal routines to neutralise mental contamination.

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.

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There are three main anxiety factors that maintain hoarding habits. These are prevention of harm to others, depravation worries and increased emotional attachment to the objects. Hoarding behaviours include:

  • Storing old clothing, newspapers, tinned food, packaging and broken items.
  • Retrieving items from the waste or dustbins.
  • Buying or accumulating stocks of items and food stuffs.
  • Hiding hoarded items and avoiding house visits from friends and family.
  • Collecting or retaining discarded items.

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.

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Attempts to neutralise the extreme anxiety brought on by the intrusion, creates a vicious cycle as the sufferer becomes preoccupied by their attempts to suppress or control their thinking, continuous self doubting and constant self questioning. In it's pure form, Obsessional OCD is terrifying and profoundly undermines the sufferer's sense of personal integrity, morality and sanity. Intrusions can cover:

  • Perverse or unacceptable sexual thoughts.
  • Doubting own sexuality or identity.
  • Testing or challenging The stability or fidelity of relationships.
  • Violent or aggressive acts.
  • Magical, superstitious or irrational occurrences.
  • Irreligious or immoral acts.
  • Doubting own identity, self questioning and assumptions of dark or evil intent.

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. You can also find out more about our services by clicking this link.

  

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