CBT for OCD: How It Works and What to Expect

If you have obsessive-compulsive disorder (OCD), you know that the problem is primarily behavioral. So, it makes sense that the best way to curb those unwanted impulses is with a treatment that focuses on them and their underlying triggers. 

Cognitive behavioral therapy (CBT) does just that. It enables you to reclaim control of your actions and your life. 

In this blog post, Dr. Oluranti Adepoju and our Revive Holistic Psychiatry team break down what CBT is, how it works specifically for OCD, and what you can expect from treatment. We also explore key components of CBT for OCD, including exposure therapy, imaginal exposure, and ritual prevention. 

What is CBT, and how does it work for OCD?

Cognitive behavioral therapy is a type of psychotherapy that helps you change unhelpful, unwanted behaviors. It enables you to develop personal coping strategies that help you identify and solve behavioral problems. 

CBT is typically our first line of treatment for OCD because it addresses both your thoughts (obsessions) and actions (compulsions). It teaches you to question and change your distorted thoughts so you can reduce your compulsive behaviors.

During CBT, you work with Dr. Adepoju and Priya Hippolyte, our board-certified psychiatric mental health nurse practitioner, to identify negative thought patterns and behaviors. Over time, you learn to replace them with healthier ways of thinking and acting. The goal isn’t to eliminate thoughts but to change your response to them.

Why CBT for OCD?

We love CBT for people with OCD because it offers practical techniques. Unlike some forms of therapy that can take years, CBT is usually a short-term treatment. Most people see significant improvements within 12 to 20 weeks.

CBT also helps you develop a valuable skill set that helps you in other areas of life. And if your OCD symptoms reappear, you'll know how to handle them.

Exposure therapy: CBT’s secret weapon 

Exposure therapy is an integral part of CBT, where you gradually expose yourself to the thoughts, images, objects, and situations that trigger your anxiety. The idea is to do this in a controlled and safe environment and let your anxiety decrease over time.

In exposure therapy, you start with less intimidating triggers and gradually move to more challenging ones. As you expose yourself to these triggers repeatedly, they become less threatening and eventually stop causing anxiety.

During this process, we help you stay in the anxiety-provoking situation until your anxiety decreases. 

Research shows that exposure therapy not only helps reduce OCD symptoms but also addresses mental health issues that often accompany OCD, reducing depression symptoms by 44.2% and anxiety symptoms by 47.8%.

Imaginal exposure: Another OCD tactic

Imaginal exposure is another form of exposure therapy. It uses mental imagery rather than real-world exposure to help you confront the thoughts and scenarios that cause you fear and anxiety. This technique is helpful for situations that are difficult or impossible to recreate in real life.

In imaginal exposure, you imagine scenarios that trigger your OCD. For example, we might have you write a detailed description of a situation you fear and then read it repeatedly. The idea is to confront your fears mentally.

We guide you through this process, helping you create vivid images. Over time, the anxiety connected to these imagined situations should decrease.

One of the main advantages of imaginal exposure is its versatility. You can use it to address several OCD symptoms, especially those involving intrusive thoughts. It also offers a safe way to confront fears that are too risky or impractical to face in the real world.

Ritual prevention: An effective CBT add-on 

We often pair exposure therapy with another tool in the CBT toolbox: ritual prevention. This part of the therapy teaches you to actively resist the urge to perform compulsive behaviors and break the cycle of obsession and compulsion that fuels OCD.

The first step in ritual prevention is identifying your compulsive behaviors with our help. Then, we create a strategy for you to practice resisting your urges and impulses. For example, we might have you focus on delaying the behavior, doing something else instead, or not performing the ritual at all.

Over time, as you resist the urge to perform these rituals, the anxiety associated with not doing them will decrease. This process helps to weaken the power that compulsions have over you.

Don’t let OCD control your life. CBT is noninvasive, medication-free, and relatively fast. Call Revive Holistic Psychiatry in Weymouth, Massachusetts, or request an appointment online. We also offer telehealth services to treat you remotely while you stay in the comfort and privacy of your own home.