Obsessive-compulsive disorder was once thought to be almost untreatable. Over the last couple decades, two treatments have been proven effective in the treatment of OCD - medication and cognitive-behavior therapy (CBT). Together they are powerful tools in the struggle against OCD.
Cognitive-behavior therapy is actually the combining of two types of therapy. Behavior therapy has been used to treat OCD for over twenty years and numerous studies prove its effectiveness. It uses methods of changing behavior. Cognitive therapy has recently joined forces with behavior therapy. It involves strategies for helping to change the faulty beliefs prevalent in OCD.
The type of behavior therapy used to treat OCD is called exposure and ritual prevention (ERP) It is also called exposure and response prevention. Patients are taught to expose themselves to that which they fear. As the anxiety rises, they then work to resist the usual ritual that reduces the anxiety. For example, a person with fear of contamination would expose himself to what he considers unclean or "contaminated," then resist hand washing or showering.
Exposure and ritual prevention is best done in stages - baby steps. My biggest problem is checking. When my OCD was at its worst I checked everything, often several times. Leaving the house involved checking the lights, the stove, coffee pot, computer and any other appliances. Then checking that the back door was locked and all the cats were in the house. If I was interrupted, I'd have to start over. I started at the back of the house and worked my way to the front door. Finally, I could go out the door. Then I had to lock the door, check it, lock it again, check it. When I got to the car, I was often struck with a fearful thought that made me go back and check again:
"Maybe I accidentally turned the stove on when I was checking it." "Did I lock the door?" "Maybe I unlocked the door instead of locking it." "Did I let the cat out?"
When I determined to attack this problem with OCD, I made a plan. The first step was easy. Sounded easy anyway, but it wasn't easy to me. I changed the order and method of checking things each time I left the house. Instead of starting at the back of the house, I started with the kitchen. When I checked the stove, I didn't touch the knobs as I was accustomed to doing.
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