The “BT” in CBT stands for behavior therapy. Behavior therapy helps people learn to change their thoughts and feelings by first changing their behavior. Behavior therapy for OCD involves exposure and response prevention (E/RP). CBT therapy Mohali includes this effective technique to support patients in facing and managing their fears.
Exposure is based on the fact that anxiety usually goes down after long enough contact with something feared. Thus people with obsessions about germs are told to stay in contact with “germs” (e.g., touching “contaminated” objects) until their anxiety is extinguished. The person’s anxiety tends to decrease after repeated exposure until they no longer fear the contact. For exposure to be of the most help, it needs to be combined with response prevention (also called ritual prevention), in which the person’s rituals or avoidance behaviors (e.g., washing their hands) are blocked.
Exposure is generally more helpful in decreasing anxiety and obsessions, while response prevention is more helpful in decreasing compulsive behaviors. Despite years of struggling with OCD symptoms, many people have surprisingly little difficulty tolerating E/RP once they get started.
Cognitive therapy (CT) is the other component in CBT. CT is often added to E/RP to help reduce the catastrophic thinking and exaggerated sense of responsibility often seen in those with OCD. For example, a teenager with OCD may believe that his failure to remind his mother to wear a seat belt will cause her to die in a car accident that day. CT helps him challenge the faulty assumptions in this obsession. Engaged in this challenge, he can take steps to stop neutralizing the obsession by performing a compulsion (calling his mother six times to check on her). Other techniques, such as thought stopping and distraction (suppressing or “switching off” OCD symptoms), are more unhelpful than helpful, and rarely used by CBT therapists.
