Many of us are familiar with Exposure Therapy (ERP) for anxiety based disorders and OCD. For years, this behavioral treatment has been the gold standard for OCD treatment. In recent years, however, a newer treatment option has been gaining research support and client interest. It’s called Inference based CBT, or I-CBT. It targets a different part of the OCD process - the doubting process - as opposed to doing exposures and resisting compulsions. Many clients are interested in I-CBT because there is no exposure component. While many people make tremendous progress doing traditional exposure work, not everyone does. I-CBT is an effective alternative to ERP, and is completed in 12 modules.
OCD has been given the nickname “the doubting disease” for good reason. People with OCD engage in “what ifs” or “could bes” resulting in emotional distress and compulsions to relieve that distress. According to I-CBT, though, if people were to not get tricked by OCD’s doubting process in the first place, then the discomfort and compulsions wouldn’t follow. A typical OCD sequence is trigger → obsessional doubt → consequence → anxiety → compulsion. For example:
Seeing a knife → What if I lose control? → I could stab my partner. → I would be a negligent person. → Leave the room to get away from the knife.
I-CBT targets what is called inferential confusion, which is understood to be the biggest predictor of OCD. In the above example, the confusion was about losing control. You can see if that were resolved, the rest of the sequence would not occur. An inference is something that we conclude based on reasoning. Inferential confusion, therefore, is when people conclude something based on a distorted narrative that OCD has created. Perhaps this person would say “Well, I saw a documentary about a person once that did lose control!”. I-CBT teaches people that that logic is not relevant to the here and now.
Someone with OCD might wonder: “What if I left my faucet running?” based on the logic that it’s possible. While it’s possible (because anything is possible!), does this person have any evidence in the here and now that the faucet was left running? Did they see the stream of water? Did they hear the water hitting the sink?
I-CBT helps people identify their OCD sequence, the logic that OCD is using to trick them, their feared self theme, and create a new story around these triggering events. I-CBT allows people with OCD to trust themselves and their senses in order to stay out of their imaginations and be present in the here and now. Once obsessional doubt is resolved, OCD no longer has the ability to induce anxiety and urges to engage in compulsions.
Modern Anxiety Solutions is currently offering I-CBT in addition to ERP for OCD. Please reach out to discuss getting started with treatment.
Comentarios