Using CBT to deal with Obsessional Disorders

Obsessional disorders: Obsessive-Compulsive Disorder OCD, Body Dysmorphic Disorder BDD and Health Anxiety are categorised as Anxiety Disorders, however, the CBT treatment differs substantially with that of other Anxiety Disorders.

The main reason is because the obsessional mind tends to rely on rational thinking to justify its obsessions, which in turn create compulsions. A person with obsessional tendencies often over-thinks experiences and internal processes, leading to compulsions which then reinforce the obsession and so forth. Once trapped in a thinking loop, one tries to get out of it by creating another thinking loop which leads to another thinking loop and so on. Specialised CBT treatment for obsessional tendencies seeks a clear understanding of the obsessional thinking process, learning how to get out of these thinking loops.

“You don’t have to control your thoughts, you just have to stop letting them control you”
Dan Millman

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Obsessive-Compulsive Disorder (OCD)

OCD manifests itself in recurring obsessions and compulsions. Obsessions are intrusive recurrent thoughts, images or urges that cause anxiety and disgust. Common obsessions are fear of contamination and fear of causing harm to self or others.

Compulsions are thoughts or actions that one feels compelled to do and repeat as a result of the obsessions. The aims of the compulsions are to keep them or others safe. For example, someone with a fear of contamination, will repeatedly wash, avoid contaminant, check, and try to reassure oneself that they or their loved ones are safe. They will also engage in covert compulsive behaviours, such as doubting and questioning themselves and their thoughts, rationalising, justifying, debating, checking, counting, neutralising and self-monitoring, comparing and avoidance. This problem is accompanied with high levels of anxiety, panic attacks and depression. The condition can be all consuming and can be extremely debilitating.

Body Dysmorphic Disorder (BDD)

Body Dysmorphic Disorder manifests itself as a debilitating preoccupation about one’s appearance. It could be a specific aspect of one’s appearance or many aspects. A person suffering will often describe themselves or a specific aspect of their appearance as ugly, deformed, disproportionate, not quite right or totally wrong.

This preoccupation results in similar compulsions as those described above and in addition, the person may attempt to camouflage using clothes and make-up, change the physical appearance of the perceived defect by DIY surgery or withdraw completely or only come out when there is little chance of being seen. Again, this problem is accompanied with high levels of anxiety, panic attacks and depression. It is extremely debilitating and can lead to total isolation.

Health Anxiety

Health anxiety manifests itself as an over preoccupation about one’s health. The preoccupation often takes the form of intrusive feelings, sensations and thoughts about ill health. It is accompanied with safety behaviours not dissimilar to the compulsions described above.

Furthermore, the person suffering from Health anxiety will either avoid their GP or make frequent visits to reassure themselves of the intrusive symptoms of ill health they experience and research the internet to self-diagnose. This problem is also accompanied with very high levels of anxiety, panic attacks and depression.