OCD is characterised by obsessions and compulsions. An obsession is a persistent thought, image or urge that comes into your mind and sets off feelings of anxiety and distress. These obsessions occur frequently, are intrusive and not easy to get rid of. For example, common obsessions in OCD include, thoughts or images of violence, blasphemous thoughts, fear of contamination, sexual thoughts or images and excessive concern with health. In OCD a compulsion is an act or ritual that is repeated and repeated in reaction to an obsessive thought. A compulsion may be an behavioural act such as repeatedly checking the door is locked or a mental act such as saying something or picturing something to make the distressing feeling, associated with the obsessive thought feel better.



Usually when I treat people for OCD at my CBT therapy practice in Edinburgh, I find that the method that the person with OCD uses to cope with or solve their OCD, is the very factor keeping their OCD going. This is because people with OCD commonly give a special meaning or powerfulness to their obsessive thoughts, usually that having the thought will lead to something bad happening to themselves or others. As a consequence, the person will usually mistakenly believe that the way to solve the obsessive thought is to try to block it or carry out a compulsion to "undo" the thought. What we know is that our brains work in such a way that trying to block a thought will only make it more frequent and whilst carrying out a compulsion will make the person feel better initially, it will actually feed the OCD so that the problem keeps going.

This can be likened to having "just one puff" to get rid of a craving for nicotine when trying to give up smoking. Whilst for a short period the craving is dealt with (distressing feeling in OCD), it actually leads to stronger and increased cravings.

When working with clients at my CBT therapy practice, Edinburgh who have OCD a lot of time is spent identifying the persons OCD maintaining factors. Typical factors that keep OCD going include: giving thoughts more meaning then they deserve, misunderstanding about why you have the particular obsessions you have, avoidance and safety seeking behaviour (avoiding anxiety triggered by the thought by blocking or undoing the thought with a compulsion, avoiding situations that you associate with the obsessive thought, asking others for reassurance), giving too much time and attention to your obsessions, trying to control your thoughts and thinking biases.

CBT therapy, Edinburgh, works by helping the person unravel the factors that maintain their OCD in order to build a different solution to overcome it. Treatment will then involve exposure and without responding, with the support of your therapist. This basically involves accepting your obsessive thoughts in such a way that you learn to tolerate the anxiety which accompanies them without carrying out any compulsions. Eventually the anxiety naturally fades so that you will be able to experience the thought without finding it distressing. This is called habituation.