OCD TREATMENT

 OCD HOME

OBSESSIVE COMPULSIVE DISORDER 

 TREATMENT

 

BREAKING THE LOOP

 The most effective way to quieten any loop of brain activity is to activate another pattern of brain activity that uses a different pathway.  This might be achieved by relaxing and calming the brains alert response, or by finding a distraction that shifts brain energy to another part of the brain, resulting in a lack of available energy to fuel the OCD loop.  Relaxation techniques must be effective enough to fool the unconscious into believing that everything ‘feels okay’ and it is safe to switch off the OCD loop.  (Relaxation is currently experienced in OCD, only when a compulsive behaviour that reduces the anxiety is completed.  This basically leads the brain to believe it is safe to relax and quieten the OCD loop)  Meanwhile, any distractions used must be fully engrossing because the more brain energy that is used for the distraction the less energy is available for the OCD loop.

 

Using the above treatment approach is by no means easy, it requires a great deal of commitment and energy, certainly in the initial stages.  You will be building new associations in the brain, so that with practice, any future OCD activation will also activate pathways that lead to relaxation and/or distraction.  You will also be consciously choosing to quiet the OCD loop, the more frequently this is done the easier it becomes to distract your brain in the future.  With a reduced overall activation the frequency and intensity of any activation in the future will also be reduced. 

 

Think of this like a skill such as memorising a speech.  The more you practice recalling the speech the stronger the associated pathways in your brain become, and thankfully the easier you can pull out the memorised words, and entertain the crowd.  After delivering the speech you stop using the brain pathways associated with recalling it, and it becomes harder and harder to remember the words.  The brain pathways are more difficult to activate because they have not been used and strengthened.  Currently your OCD is strengthening the associated brain loop each time you complete the cycle of obsession and compulsion, if you practice using relaxation and distraction techniques for long enough, the pathway will become weaker and controlling the compulsion will become easier and easier.

 

OCD & ADDICTION CONNECTION

 

OCD may work like an addiction, smoking, drinking etc also involve a brain pattern and a reward system of dopamine overactivity, that can be altered by reducing and then stopping the addictive substance.  It is maybe helpful to think of the OCD obsession as an urge for the substance e.g. ‘I must clean, check etc’, and the response, washing or checking, as the addictive substance.  To stop the addiction and quieten the brain patterns that maintain the addiction we must give up the addictive substance or response.  It may take some time for the cravings to subside and you might feel some uneasiness and anxiety while you go through the withdrawal period.  With the commitment and strength to beat your addiction though, and some assistance with anxiety reduction techniques or state and belief changes the addiction can be beaten, the brain patterns will quieten and you will live free.

 

COGNITIVE-BEHAVIOURAL METHODS

 

EXPOSURE & PREVENTION THERAPY

 

Psychologists generally try a number of familiar treatment approaches such as exposure and response prevention therapy.  Clients are asked to gradually reduce their rituals by exposing themselves to the trigger e.g. dirt and the obsession ‘I must wash or I will spread germs’, whilst preventing the compulsive response, hand washing.  This enables the client to learn to cope with the anxiety whilst eliminating a fear that the anxiety will continue to increase, or lead to a devastating outcome.  The client instead experiences moving through the anxiety until it reduces and they become calm and feel safe despite not having complied with their OCD urges. 

 

Basically if you refuse to cater to the urge to do something for long enough e.g. wash your hands, the related brain area will eventually stop firing.  The feeling that something is wrong and general unease will dissipate as the loop of brain activity subsides, and your attention will then switch to something else.  The more you REPEAT this cycle of exposure to the OCD trigger whilst refusing to respond in your normal way that reduces your anxiety, the more effective the brain will become at linking a state of calm relaxation to the OCD trigger.  Eventually the OCD trigger you previously had will fail to spark off the brain activity it used to. 

 

This treatment can be extremely effective for those that can cope with the high levels of anxiety they will face.  It is though a needlessly harsh treatment.  Two OCD specialists, Dr Schwartz and Dr Iver Hand have demonstrated that relaxation and distraction techniques to relieve the anxiety induced in response prevention are very effective.  These techniques allow rituals to be reduced more easily and this just seems to make more sense to me.  I use similar techniques for phobia elimination, where rather than exposing a client to the stimulus (e.g. a spider) over and over until they hopefully begin to feel relaxed, I relax them before exposure, so that exposure to the feared stimulus is easier.  In fact, by the time we have finished clients usually can’t wait to confront their previously feared stimulus, just to experience the accomplishment of overcoming their fears.  Rather than dragging my clients kicking and screaming they are asking me for more, a far more humane treatment don’t you think?

 

Another technique is to use cognitive-behavioural therapy (CBT) where psychologists tell us what we should be thinking, and argue logically with us that our behaviour is illogical. People with OCD already know that their behaviour is illogical, that is one of the key features of OCD, their main problem is that their brain will not accept the logic of the situation.  To get anywhere we need to tackle that aspect with far more direct techniques that appreciate the sub-conscious and unconscious aspects of OCD.

 

NLP

The field of Neuro-Linguistic Programming offers us a wealth of effective techniques to calm the OCD loop.  You will find easy, quick and extremely effective ways to change emotional states, reduce anxiety and heighten relaxation so that response prevention is easier and, smart ways to distract the sub-conscious and unconscious brain areas, the areas that actually maintain the OCD cycle.  NLP also offers some superb techniques to quieten internal dialogue and obsessive thoughts, see my article HERE for further details.  Using NLP technology we can also train our brains to activate the relaxation cue earlier in the response prevention process making the whole process easier.

MINDFULLNESS

 

Working with mindfulness is also very useful.  Firstly to become aware of how your thoughts are running the OCD, and how the OCD feels when you experience it directly without trying to run from your feelings.  Secondly to be able to observe your OCD from a detached perspective.  It’s not me it’s my OCD, I don’t have to obey it as its just a false message from my brain that has no true meaning at all.

 

SELF-ESTEEM TRAINING

 

This treatment assists clients in learning to accept themselves and their OCD.  The pressure to hide symptoms and adopt an act of perfection begins to lessen.  People with OCD are usually very good at criticising and beating themselves up, particularly if they become overwhelmed with the OCD and succumb to the urges during treatment.  It is extremely important to maintain a high awareness of your accomplishments, by keeping a journal that lists only the times you have overcome the OCD urge.  There will undoubtedly be times when you will feel the need to give in to the OCD, particularly when you are under stress in other areas of your life.  At these times read over your accomplishments journal, take good care of yourself by treating yourself with the utmost kindness and get straight back to the therapy as soon as you are ready.

 

STRESS REDUCTION TRAINING

 

Stress reduction training will assist clients in keeping up the strength and courage required to begin and maintain this treatment in the short term, in the long term it will get easier to maintain anyway.  When stress is apparent in other life areas most people with OCD report an increase in symptoms, and this makes sense from a neurological perspective, the stress hormones will heighten the activity in the OCD loop, and make it more difficult to inhibit a compulsive behaviour.  De-stress and OCD treatment becomes easier simple as that.

 

BRAIN LOCK 4 STEP PROGRAMME – DR JEFFREY SCHWARTZ

 

Dr Schwartz offers a very effective treatment in four steps that compliment the above treatments very well indeed.  I have provided an adapted version below and full details of this therapy can be found in Dr Schwartz book Brain Lock.

 

Step 1 – Relabel

Learn to recognise your obsessive thoughts and compulsive urges for what they are.  Increase your mental awareness each time you experience either, repeat to yourself that this is an obsessive thought or compulsive urge that is caused by your OCD, an underlying overactivity in your brain that you are unable to control yet.  Say something like, ‘I don’t think or feel that my hands are dirty’.  ‘I’m having an obsession that my hands are dirty’.  ‘I don’t feel a need to wash my hands.  I’m having a compulsive urge to perform the action of washing my hands.

 

Step 2 – Reattribute

With an awareness of the underlying biological factors, learn to reattribute the obsessions and compulsions as being false messages from the brain that have no true meaning to you.  Do not try to stop the thoughts as initially this is fruitless, it is your action or compulsion to stop the anxiety that is produced by the obsessive thought that is the area you can work on. 

Step 3 – Refocus

 

Distract yourself so that instead of completing your compulsive ritual such as, counting, washing or checking, you do something else.  This can be anything that distracts you enough to maintain your attention, go for a walk, pursue a hobby, clean the house (as long as that is not your compulsion!), cook an elaborate meal, anything you can think of to delay or stop the compulsion.  Schwartz asks clients to wait at least 15 minutes before they decide whether to satisfy the compulsion, during this period distract yourself however necessary.

 

Step 4 – Revalue.

 

This involves learning to revalue the thoughts and urges you experience as OCD as distinct from yourself.  Using the above three steps you learn to observe the OCD as something that is at work within you due to the overactivity in your brain, but that it is not in control of you.  You are the driver of your own mind, you choose what thoughts or obsessions are meaningful or not, and you determine whether you should act on any of them or not.  You become in essence an ‘impartial spectator’ of the OCD.

 

'As you read this page, turn your attention to the one who is doing the reading.  Or while listening to music, turn to the one who is hearing.  Or if you happen to see a rainbow, catch sight of the one who is seeing.  In all these cases you will immediately sense an awareness that is alert, awake, uninvolved, silent, yet intensely alive.  What have you actually done?  You have interrupted the act of observation to catch a glimpse of the (impartial) observer.  This trick gives insight in to an absolute certainty of your existence, for beyond all observation lies the unchanging observer.  This seer is the timeless factor in every time-bound experience, and this seer is you.’

 

The Way of the Wizard – Deepak Chopra

 

Sasha offers a combination of all the treatments discussed above to those with OCD, contact me now for a free initial consultation.

 

Sasha also provides talks on the treatment of OCD and other mental health issues to mental health staff, therapists and NLP practitioners.  Contact us HERE for further details.