Can Obsessive-Compulsive Disorder (OCD) Be Treated?

Can Obsessive-Compulsive Disorder (OCD) be cured? According to research, the symptoms of OCD can be brought under control through different kinds of treatment procedures. Exposure and response prevention therapy, cognitive behavioural therapy, and acceptance and commitment therapy are the best type of therapy for OCD. All these therapy modalities follow a different rationale for treating obsessive compulsive disorder. 

Best Type of Therapy For OCD?

Exposure and response prevention therapy (ERP)

ERP is founded on the premise that gradually exposing the client to the stimuli that trigger them and suppressing the anxiety response can help them manage their compulsive behaviour.  

To illustrate with an example: a person who has thoughts of harming their family members is anxious and therefore ignores their family members altogether. To cope with this anxiety, they compulsively chant mantras.  

If ERP is used to treat them, a hierarchy of events that trigger their anxiety would be developed in collaboration with the therapist, after which they would be exposed to them progressively. As a result, the person would be prevented from engaging in chanting, allowing anxiety to be addressed directly.

ERP enables patients to master their fear, thereby giving a boost to their self-efficacy. It is strongly reliant on details, many of which are delegated by the therapist to regulate the strength of the stimulus.

The Shwartz Model of Self-Help

While self-help may appear to be too simple for something as complex as OCD symptoms, the Shwartz model has been shown to benefit many people who struggle with Obsessive-Compulsive Disorder. It is built on a very simple idea that by better understanding one's thoughts and desires, one may better regulate them. There are four simple steps to follow in this approach:

1. Relabel: This is where the person with OCD tells themselves that they have an “obsessive” thought. It is essentially calling out the obsessive thought.

"I don’t have the thought of harming my child, I have an obsession that I could harm my child."

2. Reattribute: This phase involves the person with OCD assigning a cause to their idea, which is most commonly the chemical imbalance in the brain that is causing this symptom.

"I have an obsession with harming my child because I have OCD."

3. Refocus: The individual with OCD either diverts their focus away from their obsessive behaviour or engages in different behaviour.

"Let me put on some music and dance for 5 minutes instead of washing my hands."

4. Revalue: The person with OCD feels empowered by controlling the value these thoughts have in their life.

"These thoughts are not worth giving attention to."

This self-help approach in OCD is a continual effort to pull oneself out of the limbo of obsessive thoughts, but it goes a long way toward reconstructing one's mental state by giving them more control over not just their thoughts but also their behaviour.

Cognitive-Behaviour Therapy for Obsessive Compulsive Disorder

Cognitive-behavioural therapy (CBT), which focuses on ideas, patterns, beliefs, and behaviours, is the most academically supported for treating obsessive compulsive disorder. 

CBT hypothesises that people with OCD have intrusive, obsessive thoughts because they develop rigid underlying beliefs. Building on this, it targets these beliefs, which eventually bring about a change in the thought patterns and behaviour. Sounds too vague? Let’s take an example.

Angel has thoughts of harming her child. A CBT therapist would begin by targeting her thoughts and getting to the bottom of them. They will work towards increasing Angel’s awareness of the irrationality of that thought by weighing it against evidence. They will investigate the possibility of this thought coming true and gradually move towards helping Angel develop an insight that these thoughts are merely obsessions that could be replaced.

It goes without saying that CBT significantly relies on the client's psychoeducation concerning their thoughts and their condition for treating obsessive compulsive disorder. This is the medium through which they gain insight.

Acceptance and Commitment Therapy (ACT)

Acceptance and commitment therapy OCD postulate that by helping the client with OCD gain psychological flexibility, i.e the ability to copy, accept and adjust to difficult situations, they will be able to gain control of their thoughts and behaviour.

The main premise is to assist the client in experiencing anxiety without having to fight it. As perplexing as it may sound, Acceptance and commitment therapy for OCD aims to help patients embrace their thoughts rather than run away from them. It views a thought more than a thought and emphasises interacting with them better. In addition, the treatment highlights the importance of the self as a background and analyses these events in that light. Moving away from indulging in avoidance behaviour, Acceptance, and commitment therapy OCD requires clients to identify and establish their values in different domains of life.

OCD can also be treated through medication, the most effective of which are the Selective Serotonin Reuptake Inhibitors (SSRIs), among others. In addition to that, other treatment modalities include meditation, relaxation, music therapy, and distraction techniques.

While the research on the treatment of OCD is ongoing, one must note that OCD is a culmination of cultural, personal, and environmental factors. The best way to treat OCD is determined after a thorough examination of the client's personality, history, the nature of their obsessions and compulsive behaviours, and the resources available. 

References:

Foa, E., Steketee, G., Turner, R., & Fischer, S. (1980). Effects of imaginal exposure to feared disaster in obsessive-compulsive checkers. Behaviour Research and Therapy, 449-455.

Hayes, S., Luoma, J., Bond, F., Masuda, A., & Lillis, J. (2006). Acceptance and commitment mtherapy: model, processes and outcomes. Behaviour Research therapy, 1-25.

Janarthan Reddy, Y., Sudhir, P., Manjula, M., Arumugham, S., & Narayanaswamy, J. (2020). Clinical Practice Guidelines for Cognitive-Behavioral Therapies in Anxiety Disorders and Obsessive-Compulsive and Related Disorders. Indian Journal of Psychiatry, 230-250.

National Institute for Health and Clinical Excellence. (2005). Treating obsessive-compulsive disorder (OCD) and body dysmorphic disorder (BDD) in adults, children and young people. London: NHS.

Rosa-Alcazar, A., Sanchez-Meca, J., Gomez-Conesa, A., & Marin-Martinez, F. (2008). Psychological treatment of obsessive-compulsive disorder: A meta-analysis. Clinical Psychology Review, 1310-1325.

Schwartz, J. (1997). Brain Lock: Free Yourself from Obsessive- Compulsive Behaviour. Regan Books.