Inference-based Cognitive Behavioral Therapy (ICBT), Exposure & Response Prevention (ERP) and EMDR

What is Obsessive-Compulsive Disorder?

Obsessive compulsive disorder (OCD) is a neurological disorder that causes intense anxiety/distress. It affects your thinking and behavior and threatens things you value the most. When you feel anxious, it might feel like you are in danger. To rid yourself of the perceived threat, compulsions or rituals step-in. You might recognize that the fear is excessive or doesn’t make sense, yet it still feels very real. Your brain is telling you that you are in danger when you are not.

Treatment

Several key aspects of treatment are thorough assessment, hierarchy planning, in vivo exposure, response (ritual) prevention and cognitive processing. Cognitive behavioral therapy (CBT), a type of psychotherapy, is effective for many people with OCD. Exposure and response prevention (ERP), a component of CBT therapy, involves gradually exposing you to a feared object or obsession, such as dirt, and having you learn ways to resist the urge to do your compulsive rituals. ERP takes effort and practice, but you may enjoy a better quality of life once you learn to manage your obsessions and compulsions.

Additionally, research has indicated EMDR is efficacious for OCD treatment, specifically with use of the Distancing Technique. Before processing trauma, which may be (or may not be) the root of OCD obsessions and compulsions, the distressing encounters must first be addressed. Using the Distancing Technique prior to incorporating the Standard EMDR protocol is important. Depending on the client this can be a process which is slow and determined, or quickly incorporated. The client and client experience determines the path forward.

I-CBT or Inference Based Cognitive Behavioral therapy is a relatively new and evidence-based treatment which targets the obsessional doubt (versus reasonable doubts) from which the obsessional sequence follows. By asking the “why” questions traditional OCD treatment such as ERP does not, I-CBT addresses the narrative that propagates the loop in which one becomes stuck. I-CBT involves progressing through 12 modules over the course of 12-15 sessions to help decrease obsessional doubt which is the basis for anxiety.