DBT and Obsessive Compulsive Disorder
Obsessive compulsive disorder is a mental health condition where you have recurring thoughts and repetitive behaviours that you cannot control.
The main symptoms of obsessive compulsive disorder are unpleasant thoughts and repetitive behaviours that you cannot control.
Obsessive compulsive disorder is usually treated with talking therapies. Medicines may help if your symptoms are severe.
A type of cognitive behavior therapy called exposure-response prevention therapy (ERP) has been considered the gold standard for treating OCD.
Exposure and Response Prevention is a therapy that encourages you to face your fears and let obsessive thoughts occur without trying to ‘put them right’ or ‘neutralise’ them with compulsions.
Exposure therapy starts with confronting the items and situations that cause you anxiety, but at a level of anxiety that you feel able to tolerate. After the first few times, you will find your anxiety does not climb as high and does not last as long. You will then move on to more difficult exposure exercises.
For those who find that exposure-response prevention therapy does not work for them, dialectical behavior therapy may be an option.
As we have learned in previous lessons, dialectical behavior therapy (DBT) is a form of cognitive behavior therapy that focuses on mindfulness, acceptance, validation, and building trust.
Unlike CBT, where the focus is on making changes in behaviour, DBT is focused on acceptance and non-judgment – people can learn to be honest about their feelings, emotions and behaviours, without shame. And it’s about validation for your efforts – you showed up, you are working on yourself.
For people living with OCD, DBT can help reduce the anxiety and hopelessness, and can improve your self-copntol, in turn improving your quality fo life.
So how do we apply DBT skills to a condition such as OCD? Well, we use the four key aspects of DBT:
Distress tolerance – useful coping skills we can use to distract or self-soothe when our OCD symptoms are causing us anxiety, distress or causing us to have disturbing thoughts and emotions
Emotional regulation – by learning skills to manage the anxiety, panic or fear that is associated with obsessions and obsessive behaviour, you will realise that over time your anxiety will lessen. Over time, it will reduce in severity and the length of time it lasts, without having to give into the compulsion.
Interpersonal effectiveness – this set of skills helps you manage your feelings in relation to your interactions with others. People with OCD often seek reassurance from others, and interpersonal effectiveness skills can help reduce that dependence.
Mindfulness – these skills help you to be more present in the moment. This means not attaching to the distressing and compulsive thoughts, learning to be less judgemental on yourself (realise that your thoughts are neither right nor wrong), and can help you to redirect your compulsive, intrusive or repetitive thoughts when they occur.
As we have discussed previously, DBT on its own is not a directly suitable treatment for OCD, but the skills learned in DBT are useful in dealing with the anxiety associated with compulsive behaviours.