Treating OCD with CBT: The effectiveness of tracing one’s thoughts
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06-22-15 Category: Mental Health, Therapy


It is an empowering experience to learn about some of psychology’s greatest achievements. For centuries dating back to Medieval Europe, many deviations of mental health were explained by demonic possession. Treatments were based on religion and typically involved exorcising a greater evil of some kind from the body. One of these afflictions was the ancient predecessor to modern day obsessive compulsive disorder or OCD.

Learning to understand OCD

OCD is a mental disorder that is characterized by the onset of obsessive thoughts and compulsive behavior. Obsessions can cause excessive stress through persistent, undesired urges or images. This strict and unmanageable direction of thinking will lead to a need to fulfill some specific action. As a result, these compulsions or rituals are performed in a frequent and habitual manner. For example, if a person is preoccupied with contamination and getting germs on his or her body, handwashing will become a repeated compulsion as a result. In-depth interviews of affected individuals show that these thoughts may be fueled by illogical reasoning.

Even after the schools of psychiatry and psychology were established, obsessive and compulsive behaviors were not successfully treated and not fully understood due to the limited treatment models at the time. Under Sigmund Freud and psychotherapy, OCD was thought to be expressed by unconscious conflicts. And although some initial strategies aimed to suppress these habitual actions, Freud stated that prohibiting the behavior was a temporary solution, as the desire behind the habits and rituals are not addressed and still exist within the unconscious.

Dr. Michael Jenike is the founder of the Obsessive-Compulsive Disorder Institute at McLean Hospital and the Obsessive-Compulsive Disorders Clinic and Research Unit at Massachusetts General Hospital. In 1983, he stated, “OCD is generally easy to diagnose, but extremely difficult to treat successfully. The abundance of therapeutic approaches available suggests that none is clearly effective in the majority of cases. Psychotherapy and electroconvulsive therapy are ineffective treatments for pure OCD.”

It was not until the 1960s that therapeutic methods became effective in managing OCD. The most notable step forward occurred with the introduction of exposure therapy and ritual prevention strategies. Before then, strict behavioral therapy proved equally ineffective as psychotherapy for alleviating symptoms. Like many other clinical procedures, recovery focused on addressing the behaviors at-hand instead of the thoughts driving and steering that behavior. After the first successful cases of exposure and ritual prevention became known, the doors to further exploration of a person’s inner thoughts opened.

Soon after, cognitive therapy (CT) and cognitive behavioral therapy (CBT) were also implemented into various forms of mental health treatment and showed similar benefits for those with OCD. These comprehensive methodologies have many techniques in common with exposure and ritual prevention and various sources cite the shared focus on internal thought processing and exposure to obsession-provoking circumstances are the primary contributors to therapeutic progress.


A brief overview of cognitive therapy and cognitive behavioral elements can actually modify one’s thoughts that initiate OCD:

  • Cognitive therapy begins by recording the client’s daily episodes of obsession in a thought journal. During a rush of obsessive thoughts, the person will log specific details of the present moment and the moments leading up to it. By committing to this constant recording procedure, a person will become more aware of his or her triggers.
  • After a substantial log has been collected, a therapist will assess the information and decipher triggering objects or situations as well. Then together, the therapist and client will address each recorded obsession and dismantle it through its faulty reasoning.
  • Lastly, the client will take the lessons learned about illogical obsessions and start applying them in real situations. To cement a greater understanding, the therapist will run the client through a scenario and note how obsessive thoughts are incorrect and how compulsive actions can be avoided.
  • Exposure therapy and ritual prevention share many CT and CBT elements. A client will gradually confront imaginary or real stressors while assessing similar thought processes in between sessions.

Sovereign Health of California offers special services to those suffering from various types of mental disorders. If you or a loved one has been diagnosed with obsessive-compulsive disorder, comprehensive, evidence-based treatment exists. Learn more about Sovereign’s range of therapeutic options for the treatment of mental health disorders, addiction and co-occurring conditions and get the needed attention you deserve. Contact a Sovereign representative online or call (866) 819-0427.

Written by Lee Yates, Sovereign Health Group writer

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