By Carol Edwards, Intrusive Thoughts Adviser
Carol Edwards is a former cognitive behavioural therapist by profession and a writer by passion specialising in obsessive-compulsive disorder (OCD) and related issues. She writes educational articles for therapists new to cognitive behavioural therapy for OCD and anyone interested in OCD and related problems. Her keen attention throughout this website is to talk about pure-intrusive thoughts, what they are and how to treat them. Also, to offer tutorials and courses and be a listening ear for people with OCD and their families. She talks about her book "Desire-Intrusive Thoughts: What To Do When Sexual, Religious, and Harm Obsessions Carry Unwanted Arousal" and discusses, in an interview with Sunil Punjabi, the reasons she decided to write this book. Carol writes for Thrive Global and has an article in the IOCDF.
Obsessive-Compulsive Disorder (OCD)
OCD has two essential characteristics - obsessions and compulsions. Intrusive thoughts that come into one's mind involuntary trigger obsessions. Compulsions are the behaviours people do to make the obsessions go away.
Obsessions include contamination fears, an intolerance to asymmetry, fear of harm coming to oneself or someone else. Other obsessional fears include being gay, transgender, a paedophile, or having mistaken intentions to hurt others or oneself. These are known as pure-intrusive thoughts or pure O. Also, one's attention to a specific part of the body and its functioning can cause a lot of distress. Such awareness is known as a somatic obsession. The heart beating and fearing it is irregular is another example of it; also, breathing, eye-blinking, staring and a crawling sensation on the skin.
Compulsions include checking, straightening, praying, ruminating, reassurance-seeking and washing. However, what the person doesn't know or trust yet is that such actions are not the solution to ridding themselves of the thoughts they cannot control. These actions do not make intrusive thoughts go away. Instead, compulsions reinforce that there is a real danger when there isn't. Consequently, the problem keeps going and thus strengthens the obsession, making it more challenging to manage.
Cognitive-Behavioural Therapy (CBT) and Exposure-Response Prevention (ERP)
Cognitive-behavioural therapy (CBT) helps change thoughts, feelings and behaviours for better outcomes. Exposure-response prevention (ERP) is the well-known evidence-based therapy that helps prevent the actions people do in response to intrusive thoughts. When people do ERP, they agree to face their fears in small steps - this is EXPOSURE. When facing obsessions, they further agree to resist compulsions - this is RESPONSE PREVENTION. Over time, it helps them build a tolerance for anxiety and leads to reduced symptoms or remission.
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