Cognitive-Behavioral Therapy (CBT)

It is most commonly accepted in the mental health profession that OCD and the other anxiety disorders are caused by a combination of biological and environmental factors such as genetics, life events, and brain chemistry. Another way of saying this is that brain chemical imbalances that create symptoms of anxiety may be caused by the presence of inherited genes that give some people a greater likelihood of developing an anxiety disorder, along with the effects of things that we experience, particularly when we are young, such as ongoing stress, traumatic experiences, or certain physical illnesses.

Numerous scientific studies have shown that a particular kind of therapy called Cognitive-Behavioral Therapy (CBT) has helped many people to reduce, if not virtually eradicate their anxiety. In plain language, we could call CBT "Think Differently - Do Differently Therapy" because in this type of therapy, we examine our thoughts (our cognitions) and our actions (our behaviors) to find more effective ways of dealing with the things that make us anxious. In time, we can learn to let anxious feelings come and go without causing major upset, and in many cases we can get to the point where they won't even arise in situations that once caused us great discomfort.

Some of the techniques that are used in CBT are: cognitive restructuring – changing the way in which we think about the things that trouble us; positive self-talk, progressive muscle relaxation, and diaphragmatic breathing – some things we can do to help ourselves get through anxiety producing situations;  exposure and response prevention (ERP) – with the guidance of a therapist, we use this technique to face our fears gradually; imaginal exposure – a similar technique, used in situations in which real-life exposure to an anxiety producing situation may not be possible; and habit reversal training and stimulus control – two techniques that are used in breaking troublesome habits. In time, most people have some degree, if not a great degree, of success in dealing with anxiety by making use of these therapeutic tools.  

How does ERP work?
Every time we think a particular thought, feel a certain feeling, or do something particular, the "wiring" in the brain for that particular thought, feeling, or action remains in place. However, when we start "ignoring" that wiring by not using it, the wires start to get "disconnected" from lack of use. For example, say we've built up a huge wiring system for feeling uncomfortable unless we check locks repeatedly. We've created this wiring by checking locks over and over and over again for a long period of time. Now, if we decide in therapy to repeatedly choose not to check, despite the fact that we feel uncomfortable, a new "wiring system" starts to develop in the brain and begins to take over. In time, the "old wires" disconnect, "new wires" replace them, and the uncomfortable feelings eventually get less intense and sometimes die away altogether! The downside of ERP is that to do it requires that we feel somewhat uncomfortable for a period of time before feeling better. The upside, however, is that Exposure and Response Prevention appears to be an effective way of treating OCD. When we are successful at applying ERP in our therapy, its effectiveness usually lasts.