How Counselling can help with OCD

Hi Guys! In Today’s post I am talking about Obsessive Compulsive Disorder (OCD). I will explain what OCD is and give a detailed description of a treatment plan using Cognitive Behavioural Therapy (CBT).

This is one example of a treatment plan that would be used in a counselling session. CBT has become hugely popular in recent years and its results in treating OCD has been very positive.

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What is OCD

OCD fills your mind with unwanted thoughts and threatens you with doom if you do not perform repetitive rituals. OCD is characterised by obsessions and/or compulsions that are time consuming, distressing, and can interfere with everyday life.

Obsessions are persistent, unwanted thoughts, images or urges that intrude into a person’s thinking and cause excessive worry and anxiety. While compulsions are mental acts or behaviours performed repetitively to relieve or prevent the anxiety generated by the obsession.

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Treatment Plan used in Counselling for OCD: Exposure and Response Prevention 


The purpose of exposure and response prevention (ERP) is to reduce the anxiety and discomfort associated with OCD through the natural process of sensory habituation. Habitation is a natural process whereby the central nervous system gets used to things through repeated and prolonged contact.

One example of habituation is when you first go into the swimming pool. When you first enter the pool, the water feels very cold and it can be hard to get in.

However if you remain in the water, after a few seconds the water feels like it has warmed up.  Obviously the water doesn’t become warmer, rather your brains interpretation of the temperature of the water changes.

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That is where exposure comes in, exposure is best done in stages, taking baby steps towards the ultimate goal of reducing your OCD. With each step the person confronts the fear, experiences anxiety, and then experiences habituation gradually and naturally.

For example, if someone has a fear of dirt or germs, than that person would slowly expose themselves to their fear by touching something they believe has germs. This would be done in small steps.

It must purposefully and vividly re-enact situations that provoke fear, dread, doubt and avoidance. It must be prolonged, lasting as long as it takes for the anxious feeling to diminish through habituation.

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Response prevention

Think of response prevention as the act of voluntarily preventing the rituals you typically preform when an obsession triggers anxiety. Examples of rituals are: washing hands, doing something a certain number of times etc.

At first you may simply decrease the length and frequency of a ritual as you gradually work towards resisting the compulsion.

For example, if someone has to constantly check every window 5 times before they leave the house. Than that person would begin the response prevention process, by prolonging the time before they give into the urge, next by decreasing it to 3 time and so on.


To begin with there are many ways to start the response prevention, such as delaying them, shortening them, slowing them down, or eliminating them entirely. The decision to “feel the discomfort”, to just “be with it” or “allow it to be” without acting on it and controlling it will pay off in the progress towards breaking free from the grip of OCD.

Both the exposure and response prevention can be challenging to begin with. However your therapist will also provide you with coping skills and strategies to help you with your OCD urges.

Cognitive restructuring

Cognitive restructuring involves actively challenging and confronting the distorted thinking and faulty beliefs that drive and maintain obsessions and compulsions.

For example, these would be the thoughts that drive you to carry out the ritual of checking the windows 5 times. In counselling you will be encouraged to identify faulty beliefs and replace them with more accurate and realistic ones.

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I hope you got a better understanding of OCD and its treatment plan. If you suffer OCD, counselling can be a major support system for you. OCD is extremely challenging to have to face alone and its treatment plan is effective but also challenging.

That is why having the support system of counselling to guide you through it can be a massive help, along with the coping skills and strategies it can provide you with.

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Niamh-Psychotherapist xx

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