The Obsessive Compulsive Cycle
Throughout our time together, I will often refer back to the OCD cycle for reference. This is an important resource to help us to understand how your OCD may be maintained. When someone experiences difficulties with OCD, they may struggle with those initial thoughts about harming themselves or someone else. This typically brings on distress and anxiety. What occurs usually is that there is an act to reduce the stress that comes with the thought. This could look like excessive googling or reassurance seeking. What occurs is a temporary reduction in stress, but with that reduction is a single to the brain to further be anxious about harm thoughts in the future (Hershfield 2018).
For instance, if you begin to have an intrusive thought around harm and you try to reduce your anxiety by hiding all the knives or refraining from watching anything with violence in it you are only further reinforcing that you are to be anxious about harm thoughts and ideation. This will further increase your anxiety in the future.
Why is CBT Not Working?
Some therapists need to be trained specifically to work with OCD. At times, some of the therapeutic modalities within CBT, can only further reinforce the OCD. This will contribute to an increase in symptoms and difficulties with treatment. For instance, If you challenge thoughts through CBT focused tools what could occur is a reduction in your anxiety, which will only increase your anxiety later on. This would serve little difference as you googling your symptoms or seeking reassurance. Essentially, basic CBT treatment may serve to neutralize the thought and become a compulsion in itself.
Important points from this article:
The more you avoid your thoughts, the worse it will get.
Compulsions are anything you do to reduce the anxiety (avoidance, behaviours, and self-talk). Compulsions contribute to increasing your anxiety later on.
What maintains your OCD is anything you do to reduce your anxiety.
Compulsions will only lead to temporary anxiety decreases.