OCD, or obsessive-compulsive disorder, is an anxiety disorder where the patient has either obsessive thoughts or compulsive behaviors, though having both types of symptoms is possible; these symptoms are excessive and impact the patient's life. Melinda Smith, MA and Ellen Jaffe-Gill, MA, authors of the article "Obsessive-Compulsive Disorder (OCD)," state that the patient can recognize her abnormal behaviors, but the condition prevents her from disengaging from them. Psychological treatments, like therapy, can help the patient break free; the main type of therapy is cognitive behavioral therapy (CBT), which is divided into two treatment methods.
CBT: Exposure and Response Prevention
The first type of CBT used for OCD is exposure and response prevention, which the Mayo Clinic states involves exposing the patient to the trigger; afterward, the therapist tells the patient to refrain from her compulsive or obsessive behavior. For example, if the symptom is compulsive cleaning or obsessing over germs, the therapist will put dirt in front of the patient. Part of the process of exposure and response prevention is to teach the patient that he has the ability to control his behavior, compared to feeling powerless to his disorder. Smith and Jaffe-Gill note that this type of psychological treatment can "retrain the brain," which can lead to an elimination of symptoms.
CBT: Cognitive Therapy
The other part of CBT for OCD is cognitive therapy, which targets the underlying cause of the anxiety disorder and how it is impacting the patient's behaviors. Smith and Jaffe-Gill reference Jeffrey Schwartz, MD, and his four-step program to treat OCD with cognitive therapy. The first step, according to Schwartz, is to help the patient reorganize thoughts and behaviors; the purpose is to help the patient identify his obsessions and compulsions. The next step teaches the patient to move from identification of symptoms to realization that they are caused by OCD. The third step is for the patient to refocus his attention, moving away from the symptoms that have controlled his life. In Schwartz's fourth step, the patient "revalues" his OCD symptoms. At the end of the cognitive therapy, the OCD symptoms no longer have the same influence on the patient's daily functioning.
Variations of Psychological Treatments
While exposure and response prevention and cognitive therapy are the two main psychological treatments, the therapist may use variations based on the patient's symptoms. The Mayo Clinic notes that psychotherapy with medication is an effective treatment; examples of medications for OCD are clomipramine, fluvoxamine, fluoxetine, paroxetine and sertraline. The therapy session may be individual or group, where other OCD patients will be in the session. Family therapy is another option, which helps educate family members about OCD and how to help the patient.
