Obsessive Compulsive Disorder (OCD)

Alternative Therapies

Behavioral treatments using the technique of exposure and response prevention are particularly effective in treating OCD. In this form of therapy, the patient and therapist draw up a list, or hierarchy, of the patient's obsessive and compulsive symptoms. The symptoms are arranged in order from least to most upsetting. The patient is then systematically exposed to the anxiety-producing thoughts or behaviors, beginning with the least upsetting. The patient is asked to endure the feared event or image without engaging in the compulsion normally used to lower anxiety. For example, a person with a contamination obsession might be asked to touch a series of increasingly dirty objects without washing their hands. In this way, the patient learns to tolerate the feared object, reducing both worrisome obsessions and anxiety-reducing compulsions. About 75%–80% of patients respond well to exposure and response prevention, with very significant reductions in symptoms.

Other types of psychotherapy have met with mixed results. Psychodynamic psychotherapyis helpful to some patients who are concerned about the relationships between their upbringing and the specific features of their OCD symptoms. Cognitive-behavioral psychotherapy may be valuable in helping the patient to become more comfortable with the prospect of exposure and prevention treatments, as well as helping to identify the role that the patient's particular symptoms may play in his or her own life and what effects family members may have on the maintenance and continuation of OCD symptoms. Cognitive-behavioral psychotherapy is not intended to replace exposure and response prevention, but may be a helpful addition to it.