Talking in Circles: When talk therapy feeds obsessive thought
Exploring thoughts and motivation for behavior is a common practice in therapy. In CBT, there’s a technique called cognitive restructuring, which involves helping clients identify and challenge unhelpful thoughts that contribute to emotional distress and maladaptive behaviors. The goal is to increase awareness of unhelpful thinking patterns and practice more balanced, realistic, and constructive ways of thinking.
This might sound like:
“What’s the evidence for that thought?”
“Is there another way to interpret this information”
This can be a helpful strategy. But in the context of OCD, challenging or reframing negative thoughts and developing coping strategies to reduce distressing emotions can be counterproductive and can often exacerbate the symptoms.
These techniques may inadvertently reinforce the idea that obsessive thoughts must be “neutralized” or avoided, further perpetuating the cycle of avoidance and compulsions.
If you’ve had this experience in therapy, you’ve probably been left feeling stuck in a loop of anxiety and compulsion without any real reduction in symptoms.
We cannot reason our way out of OCD. When therapists try, we can find ourselves unintentionally joining and reinforcing the OCD loop.
Exposure and Response Prevention (ERP): The Gold Standard for OCD Treatment
Exposure and Response Prevention (ERP) is the gold standard for treating OCD. ERP is a form of CBT specifically tailored to OCD that directly targets the behaviors and thought patterns contributing to the disorder. ERP involves two key components: exposure and response prevention.
Exposure: This involves exposing the person to the feared thoughts, images, or situations (the obsessions).
Response Prevention: The second part of ERP involves preventing the individual from performing the compulsive behavior they usually engage in to reduce anxiety. Allowing for new learning to take place.
Despite being on of the most common mental health disorders, OCD is often misdiagnosed and misunderstood, resulting in inappropriate treatment.
If you’d like to discuss treatment for OCD, please schedule a consultation below: