CBT, ERP, and I-CBT (Oh my!) to help with OCD?
***Disclaimer: I am not a health care professional, just a member sharing what they have learned in their journey to understand and combat OCD. Please seek a professional for diagnosis and treatment.
Typically, most people I have talked to have used CBT and ERP as first-line therapy for OCD. But are there other options?
There is a great site that explains the difference between CBT, ERP, and I-CBT treatments and how they relate to the OCD. Let's go through some definitions provided by this source: https://icbt.online/what-is-icbt/
Standard Cognitive Behavioral Therapy (CBT) is based on the idea that intrusive cognitions and doubts are normal. It holds that these thoughts develop into obsessions depending on how the person interprets them. For example, a person with thoughts about harming someone will develop obsessions if these thoughts are given importance or negatively interpreted. Consequently, standard CBT focuses on helping the person to no longer misappraise these thoughts, so that they will no longer provoke distress and cause compulsions.
Exposure and Response Therapy (ERP) is usually an important part of standard CBT. This behavioral technique consists of exposing oneself to feared objects and situations without engaging in any rituals or compulsions to overcome OCD. These can be repeated and prolonged exposures to feared objects to habituate to it, or learn to tolerate this distress.
Inference-based Cognitive-Behavior Therapy (I-CBT) is an evidence-based treatment specifically designed for OCD based on the central idea that obsessions are abnormal doubts or inferences about what “could be”, or “might be” (e.g. “I might have left the stove on”; “I might be contaminated”; “I might be a deviant”). While it is true that intrusive thoughts are normal, and they occasionally occur to everyone, something very different is happening when a person has OCD. In fact, according to I-CBT, there is no such thing as an “intrusion”, or thoughts that arise randomly without a reason behind them, at least not in the case of OCD. Instead, I-CBT views obsessions are as inferences or doubts that come about due to prior reasoning. It focuses on learning how to trust reality in OCD triggering situations, not by repeated and prolonged exposure to feared objects to habituate to it, or learn to tolerate this distress.
The take home message is that I-CBT claims that obsessions do not arise in the same way as normal intrusions. They come about through a distorted reasoning narrative. Moreover, in the case of OCD, these inferences or doubts are the result of specific reasoning errors which makes these thoughts feel real even though they are false and incorrect.
I-CBT focuses on how obsessions arise due to reasoning.
Standard CBT focuses on the consequences of the intrusion or obsession.
So what do you think? Have you treated with ERP before? Have you tried I-CBT? Were they successful? What were your experiences like?
OCD Support Sessions are Wednesday 8pm ET listed here
Join the OCD taglist here for more updates!!!
@AmintaBlack @Dannc7c @thoughtfulGrapes1163
@AmintaBlack I have tried so many different things for my OCD. I think ERP is the best method, but it can be so scary to face your fears head on. Talk therapy is something I really enjoy and CBT can be helpful too! I think everyone is a little different, but there are so many great options to treat OCD. It's so important to remember that you will get through this! Thank you for sharing this!
@fruityPond7887 Thank you for sharing your experiences! Appreciate the support as well ❤️
I agree that ERP has been the best thing so far (like night and day compared to before starting it). Personally, it helped me a lot with making sure I resist compulsions, deal with uncertainty better, and not seek reassurance. I still struggling with "intrusive thoughts" which I was told ERP doesn't necessarily stop, so that is what got me curious about I-CBT 😊 Let's see though.
@AmintaBlack I agree that while ERP is really effective, it may not fix everything and that's why there are other therapies! Seeking reassurance is definitely something I struggle with too, so you're not alone! You're very strong and I appreciate you sharing your experience with others! ❤️
Thanks for tagging me along, Aminta!! I appreciate it 😄. I’m still in wonder, though. How did you know about my OCD? I never mentioned it.
In my opinion, and for me personally, I feel that a combination of talk therapy and I-CBT would definitely be better, in managing the feelings related to OCD.
For me, OCD shows itself in the form of debilitating confusion. Confusion that doesn’t make sense. Why does this happen? Why that thing? Why why why?? It’s like, for a lack of a better example, the scene in the first doctor strange movie where he first enters the different realms. It’s chaotic, it’s utterly confusing, you don’t know what or why or how or when. It’s a very wierd perspective on life
@thoughtfulGrapes1163 Hey Grapes! I just used the OCD taglist that people signed up for earlier, but I can always remove you if you'd like :) I don't want anyone to feel called out or uncomfortable.
Thank you for sharing your experiences! I think I understand about the confusion. For me it is because I can't seem to trust what my brain says, and then nothing feels real. Very scary feeling :(
I agree the talk therapy can be helpful as well!
Oh no, it’s ok, aminta. I was just curious, is all.
It can definitely be a scary feeling, yeah, because you don’t feel like you know what you’re doing. And if what you’re doing is correct, or wrong. Have you ever stayed awake for so long that the world around you starts to disconnect from you? Like you physically feel like, I’m not here. It’s a weird feeling, for sure.
@AmintaBlack Thank you very much for sharing all these therapeutic techniques with us today! I think these are the most research base and flexible therapy svhools that can be applied almost in every disorder and treat it based on solid evidence! It's really good to inform people about them!
@calmDew1576 Thank you! I agree it is important to talk about these different kinds of therapies. That way people can ask informed questions to their mental health practitioners about their treatment or seek the correct kind of help. I like how the original article breaks down the "mechanism of action" too!
@AmintaBlack Thank you for sharing this information, with us. I really enjoyed reading this and learned something new. Thanks for the free education. You are an amazing teacher, by the way. Please keep up, the good work, you are doing here at 7cups.