Curing OCD

Obsessive Compulsive Disorder is a disabling condition that afflicts 1-2 % of people during their lifetime. The severity of this illness varies from mild to sever in mild cases the illness triggers anxiety while in severe cases it can be so disabling that the person is unable to leave their home.

Many people with OCD looking for a cure and are not satisfied with partial relief or living for years on medication. While a non drug cure is possible in a large percentage of cases it usually requires a effort and takes  time.

Obsessions are persistent recurrent disturbing thoughts that usually cause the person intense anxiety. The person is unable to control these thoughts.

In addition to control the anxiety these thoughts produce the person develops compulsions. Actions they carry out to reduce the anxiety and distress  that the obsessions produce.

For example the person may develop obsessions about contamination by germs and then develop the compulsion to wash their hands each time they touch something they consider contaminated (i.e. money or a book).

Some people only have obsessions (Pure O –OCD) – often the obsession could focus on a person or an activity.

Modern psychiatric medication usually rapidly reduces the persons discomfort and helps them get relief from anxiety in a few weeks with a reduction in the obsession and compulsions. A fairly large percentage of  patients do not get much relief or find the side effects such as drowsiness or weight gain difficult to deal with. Anti-obsessive medication do not cure OCD so patients often have to take their medication for years. Also there are concerns abut these drugs causing fetal defects and makes child bearing difficult while on these medication.

Despite relief many people with OCD look for alternatives to medicines some because they do not get adequate help from or have concerns about the safety of medicines. Others because want to live without feeling dependent on medicines.

In addition many of the personality traits associated with OCD such as procrastination, perfectionism and  hoarding do not respond to medication.

One effective form of therapy for OCD is Cognitive Behavioral Therapy (CBT) the corner stone of treatment in OCD is response prevention. The therapist promotes anxiety and then helps the person wait out the anxiety without doing their anxiety reducing rituals. This works well for patients who have well developed compulsions. However patients with pure obsessions find this more difficult to do this. ERP sessions need to be at least one and a half hour long so as to give enough time for the anxiety to come down during the sessions. Many patients find the idea of confronting their feared trigger (i.e germs) too traumatic and refuse this mode of therapy.

An approach called “Brain Lock” developed by Dr Jeffrey M Schwartz, M.D. of the UCLA school of medicine overcomes the difficulties with traditional CBT techniques and is equally or more effective than it. This method is based on the Buddhist Mindfulness philosophy and enables people to take an active part in overcoming their disease.

For patients who do not respond to CBT or the “Brain Lock” techniques. Hypnotherapy is a technique of last resort this approach has been developed by Dr Claire Frederick, MD, and utilizes hypnotically facilitated treatments for OCD. These will include hypnotically facilitated Cognitive-Behavioral Therapy, Hypno-ERP, Hypno-Imagery, Ego-Strengthening, and  Ego State Therapy.

While I am sympathetic to alternative therapy I have never seen any patients with established OCD responding to homeopathy, Ayurveda, Reiki, Pranic healing. Of the complimentary approaches Mindfulness Based Cognitive therapy is helpful it is based on the Buddhist Vipassana meditation and is very helpful. Older form of psychotherapy such as psychoanalysis, transactional analysis are not much use in treating OCD and are best avoided.