Cognitive Therapy for Obsessive Compulsive Disorder

At my therapy practice in Edinburgh, people with varying forms of OCD usually account for about 50% of my caseload of clients. Some of my clients also have support from NHS Community Mental Health Teams. However, often people come to see me who have been struggling for many years with OCD, with little or no support. I find cognitive therapy to be effective at helping people with mild to moderate OCD manage and overcome the effect it has on their lives.

What is OCD?

Obsessive-Compulsive Disorder (OCD) is an anxiety related disorder that can have severe impacts on the everyday functioning of those with this disorder, affecting life areas such as self-care, leisure and work. OCD is a fairly common disorder that effects people from various cultural and social backgrounds. It also affects people of all ages from children to adults.

Most people, especially in times of stress, may have experienced OCD-type symptoms such as doubting you have turned off the oven or locked the door. However, for those with OCD, persistent doubts, urges or images are much more frequent, intrusive and distressing and can really lead to a reduced quality of life and disruption in occupational performance. For some the distress of living with OCD can also lead to feelings of shame, guilt, frustration and eventually depression.

 How Can Therapy Help?

Cognitive Behavioural Therapy (CBT) is considered to be the therapy of choice for OCD, with research studies backing its effectiveness. CBT is a short term and structured psychological therapy that looks at the relationship between what we think, what we feel and how we respond. CBT is a combination of cognitive therapy, which examines cognitive processes such as unwanted thoughts, attitudes, and beliefs and behavioural therapy, which focuses on behaviour in response to those thoughts.

For example, people with OCD sometimes experience unpleasant intrusive thoughts. Sometimes, although not always, the person with OCD may feel compelled to engage in a less than rational, compulsive behavior or mental ritual in a bid to reduce the anxiety associated with the thought. For example, excessive checking of door locks, washing of hands to avoid contamination or mental ritual of some kind. These very acts, which the person with OCD uses to cope with or reduce their OCD anxiety, in fact keeps OCD going.  CBT helps the person with OCD understand and learn behavioural responses to combat OCD.

 As an occupational therapist, my aim is to support the person with OCD in regaining engagement in important life roles and activities that have become disrupted by OCD.  This begins by helping the person with OCD understand that by resisting the compulsive urge to check the locks, wash hands or mentally ritualize, they can eventually "sit out" their anxiety, until the anxiety level naturally diminishes and fades over time. This is a technique known in CBT as exposure and response prevention. This technique helps OCD get better.

 The treatment of OCD at my therapy practice in Berkhamsted, Edinburgh, also involves other techniques and methods such as equipping the person with relaxation and mindfulness skills, which are both very useful in managing OCD. Time and practical support is also given to helping the person set goals to begin re-engaging in life activities, which are important to them.

 If you feel you may have OCD, you should visit your GP for further information and advice.  If you would like to talk to me about your OCD or book a consultation session please go to the Contact Me page for details of how to get on touch.