Cognitive Behavioral Therapy for OCD


Obsessive compulsive disorder (OCD) is one of the most debilitating forms of anxiety. People with this condition experience intrusive thoughts that can be highly disturbing in nature, ranging from violent thoughts about harming others to sexual images that might be frightening or inappropriate. To ease their distress, people with OCD develop psychological or physical coping mechanisms. These responses, which are repetitive and must be done in a highly specific way, are called compulsions.

Some people have sub-types of OCD that involve fewer compulsions and more avoidant behaviors, like those who experience sexual OCD. Although it may feel like obsessive compulsive disorder is inescapable, it is a treatable condition that responds well to therapy with persistence and commitment.

How OCD Affects Your Life

Most people think of someone with OCD as a person who can’t stop washing their hands or is a “germaphobe.” While there are many people who do experience a fear of contamination, there is no limit on what types of thoughts constitute OCD. Any thought that shows up repeatedly and is unwanted is called an intrusive thought; these types of thoughts are the cornerstone of OCD, and they make it difficult for people to function in their daily lives.

OCD can occur in many ways, including:

  • Always washing your hands or cleaning.
  • Checking things constantly to avoid danger.
  • Fearing that if something isn’t done right, you will be punished.
  • Arranging things or experiencing anxiety from certain numbers, colors, or arrangements.
  • Hoarding things because you are too afraid of what might happen if you throw them away.

Not everyone with OCD develops compulsions, but everyone with the disorder has some type of behaviors that they adopt because of their intrusive thoughts. Those with inappropriate obsessions might start to avoid people because they are afraid they’re going to hurt them or sexually assault them. They do not willingly think of these thoughts or even have the desire to act on any of them, but the images persist nonetheless.

What’s worse is that avoiding triggers only causes the individual to affirm the fear their thoughts create. This leads to a harmful cycle of thinking about obsessions and feeling horrible for having them. In psychology, the act of fixating on negative thoughts, feelings, and beliefs is called rumination.

Rumination not only obscures our ability to see things clearly; it also prevents us from believing in our ability to get better. One of the ways people learn to stop ruminating is through cognitive behavioral therapy (CBT).

What is cognitive behavioral therapy?

CBT is one of the most popular forms of therapy for depression and anxiety disorders like OCD. It involves addressing unhelpful beliefs, called “cognitive distortions”, and replacing them through a process called reframing.

Let’s take a look at some of the most common cognitive distortions.

All-or-Nothing Thinking

One of the greatest struggles people with OCD compulsions face is having to do things in an exact manner. If they feel like they’ve messed up in any way, they have failed completely and have to do it all over again. This is the type of thinking that can keep someone with OCD washing their hands until their skin is raw or touching a doorknob 50 times before they can leave the house.


Assuming that things “always” go wrong or can “never” get better is an example of overgeneralization. Such extreme beliefs prevent people from seeing opportunity and making positive changes.

Discounting the Positive

Ignoring the good elements of things in life reinforces negativity and fuels depression and anxiety. People who use this cognitive distortion will reject examples of their strengths or success but have no problem believing in their perceived faults or failures.

ADHD and Addiction


Magnifying causes people to see events as having a greater impact than they actually do. Focusing on a small consequence so intently that it becomes a distressing, persistent worry is the result of magnification. Ruminating on intrusive thoughts magnifies anxiety, making you more likely to engage in unhealthy coping strategies.

The Benefits of Reframing

When we reframe thoughts, we also change how we respond to them. The connection between thoughts and behavior is the hallmark of OCD, and learning how to respond differently to obsessive thoughts is how people can begin to liberate themselves from their anxiety.

CBT for OCD is a skills-based therapy, which means you will develop coping mechanisms that stick with you. In cognitive-behavioral therapy, clients play an active role in their treatment by engaging with the therapist in a variety of exercises.

What is CBT for OCD like?

There is a special type of cognitive behavioral therapy for OCD called exposure and ritual prevention therapy. This unique form of cognitive-behavioral therapy helps people break the connection between their obsessions and compulsive behaviors. Ritualistic coping strategies like handwashing, binge-eating, or hoarding can be addressed through this therapy. Obsessions may be treated through imaginary exposure where you are asked to envision exactly what you fear and work your way through it.

Exposure is the process of introducing yourself to triggering stimuli in gradual amounts. Over time, triggers lose their effect, and anxiety decreases. A therapist will encourage you to challenge your anxiety directly. This is done while discussing your symptoms throughout the process, learning how to stay calm, focused, and in tune with your body. Getting used to OCD triggers through exposure is a process called “habituation.”

Through OCT treatment, you can realize that you control your actions, not your thoughts. Changing how you respond to them will gradually reduce anxiety over time, and many intrusive thoughts fade with time.

CBT for OCD and Addiction

Nearly half of all people with an anxiety disorder also struggle with substance abuse. Turning to drugs and alcohol in an effort to escape intrusive thoughts and unease is not a real solution. In fact, even if being intoxicated makes OCD a little less intense, it is really only a distraction, not a lasting solution.

By working on changing the relationship between you, your thoughts, and your responses, it can become easier to live with anxiety. Cognitive behavioral therapy for OCD can reduce your intrusive thoughts and help you develop healthier ways to cope.

Dual diagnosis treatment for OCD and substance abuse is a personalized form of care that offers one-on-one treatment, group support, and long-term resources to promote a lasting recovery.

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How Cognitive Behavioral Therapy Handles Exposure and Ritual Prevention for Obsessive-Compulsive Disorder

Those with OCD have rituals that can range from a particular oddity to a repeated act being harmful to oneself. Two types of association that happen with OCD – the first being an association between thoughts/situations/objects that cause distress and the feeling of despair itself. The second association that occurs is decreasing the grief, and the rituals performed to gain alleviation. These two associations are inextricably intertwined, creating cyclical patterns that can be hard to break regardless of which type of OCD you have.

OCD symptoms are challenging to live with and can control how you live your life. With CBT, it is possible to use exposure and ritual prevention to break this cycle. There are three approaches that CBT therapists can do to help prevent ritualistic behaviors:

  • In vivo exposure
  • Imaginal exposure
  • Ritual prevention

The first approach is in vivo exposure, which is practically staying in contact with the trigger object for a more extended period. The second is imaginal exposure, which has the individual visualizing themselves in a feared situation or the consequences of that situation. The third is ritual prevention, which stops the person from committing the ritual behavior.

Why Exposure via CBT Can Be Successful

You might be wondering why this type of OCD treatment might be useful. Why would you want to expose yourself to the thoughts, objects, or scenarios that cause you to carry out your rituals? The reality is, you will encounter stressful situations throughout your life, and CBT for OCD can give you the tools to cope with it – something you will learn if you stay in a Southern California mental health treatment center.

When triggers are exposed, your instincts will coach you not to engage in the rituals. The better you can resist the compulsions, the more effectively you can handle these undesirable situations. You do not have to avoid stressful situations, and you do not need to feel as though you will lose your mind if you do not engage your compulsions.

Getting the Most Out of CBT for OCD

To get the most out of your OCD treatment, you need to work with your counselor to cultivate your coping tools. Prepare to become uncomfortable should you choose to do exposure therapy. Your counselor will guide you through well-crafted, personalized scenarios that conform to your habits.

The goal is not to “cure” OCD. Instead, the goal is to weaken the strength of your obsessions and compulsions. CBT does not focus on the past so much as it does on making changes in the present.

Making changes to how you respond to stressful triggers is not easy. However, when you get the proper guidance from a specialist at a Southern California mental health treatment center, you can learn CBT techniques for coping with OCD and any co-occurring disorders. Breaking the cycle starts with reaching out and asking for professional assistance. If you or your adolescent child need help, CBT for OCD can give you or your teen power over OCD symptoms.

The facilities at Mission Harbor are staffed with trained experts to best assist patients with their mental health issues. We are capable of dealing with any and all cases with a licensed staff, equipment, and approved techniques. Our mission is to help those who want to help themselves, and we support your decision in seeking help.

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