Sarah - CBT for OCD

1. How would you describe CBT? How was your experience of it? What was it like?

I had 20 sessions of CBT for OCD. Before this, I had struggled with anxiety and depression for many years and had tried a number of other therapies. CBT was different, it was a lot more structured – we set an agenda at the beginning of every session. This took a bit of getting used to, but meant we used our time much more productively. CBT also felt more collaborative, which was very empowering. My therapist was the expert on CBT principles, I was the expert on how my mind worked. Sometimes she suggested I do things that were difficult, but I always understood her reasoning, the process was very transparent.

I have heard CBT described as more of a doing therapy than a talking therapy and this feels true to my experience – the approach is quite scientific. The talking bit was important though.

2. What did you find most useful?

We did a lot of what CBT refers to as behavioural experiments: activities designed to test beliefs and predictions in the real world. Before the experiment the therapist would ask what I thought would happen and how strongly I believed this would occur. Afterwards we would compare this with the outcome.

The therapist also taught me some useful cognitive techniques such as the downward arrow technique, which identifies the beliefs underlying particular thoughts (or what I call the fear beneath the fear) and also generating alternative explanations for events.

3. Was there anything you would have changed about it?

The main things was that I wish I had had CBT a lot sooner! Although the time limited nature of the treatment was helpful in many ways I wish it could have been a bit more flexible – I think I would have benefited from more sessions in “blocks” e.g. 16 sessions, then a break of a few months and then a further 8-10 sessions. It would also have been great if the therapist had the time available to come out “on location” for behavioural experiments and exposure therapy.

4. Did it make any difference to your life? If so, what was different?

CBT has made a huge difference to my life. I can do things that I could not do before, such as cook for other people. The time and energy I used to expend on checking is now free for other things. I still experience intense anxiety in certain situations, but this is less frequent and my overall anxiety levels are much better. I still feel some way from recovered or able to live a fulfilling life, but I have a much clearer sense of how to get to this point.

5. What would you say to someone considering having it?

Mainly, go for it!

I think that he transparency of CBT means that you will know relatively quickly whether it is helpful for you, which is not the case with all therapies.

The caveat would be to be prepared for it to be challenging and to be aware that you will have to do some work between sessions. Do make the the time to do this as the benefit will be much greater if you do. Tell the therapist if he or she asks you to do something which feels to difficult or which you don’t understand the reasons for. Finally, make sure you are getting “proper” CBT. OCD Action has a good checklist of what CBT for OCD should look like [LINK https://www.ocdaction.org.uk/resource/what-cognitive-behavioural-therapy-cbt]