Bad CBT

[Guest rpeders3]

Hi everybody,

In this post I want to explore a bit what Professor Salkovskis meant when he talked about 'bad CBT' in his webchat. I think it's fascinating (and in the end, upsetting) how many different approaches there are to OCD. Maybe it's part of the consumerism of the modern day - doctors all over the world trying to find the miracle 'cure' for OCD. Personally, I find Professor Salkovskis refreshing in a world run by the almighty 'pound' or 'dollar'.

So, first, I guess, it would seem that any CBT that would somehow reinforce the fear, such as 'You are afraid of hurting people? Well, first you have to get rid of all the knives in the house and try your hardest not to have those thoughts enter your head' would be absolutely dreadful. On the other hand, if one were to advise, 'You are petrified of bodily excrement? What you need to do is go to a public bathroom and ask someome to loan you their bowel movement. Then go home, or better yet, a public square, and wipe it all over yourself' - that too seems quite distasteful.

What have you guys found effective and what absolutely did not work? It would be neat to find effective strageties of CBT posted here for the benefit of those struggling. Someday, I hope (and pray), we'll all be OCD free!

Randy

[Guest Wendy]

Hi everybody,

In this post I want to explore a bit what Professor Salkovskis meant when he talked about 'bad CBT' in his webchat. I think it's fascinating (and in the end, upsetting) how many different approaches there are to OCD. Maybe it's part of the consumerism of the modern day - doctors all over the world trying to find the miracle 'cure' for OCD. Personally, I find Professor Salkovskis refreshing in a world run by the almighty 'pound' or 'dollar'.

So, first, I guess, it would seem that any CBT that would somehow reinforce the fear, such as 'You are afraid of hurting people? Well, first you have to get rid of all the knives in the house and try your hardest not to have those thoughts enter your head' would be absolutely dreadful. On the other hand, if one were to advise, 'You are petrified of bodily excrement? What you need to do is go to a public bathroom and ask someome to loan you their bowel movement. Then go home, or better yet, a public square, and wipe it all over yourself' - that too seems quite distasteful.

What have you guys found effective and what absolutely did not work? It would be neat to find effective strageties of CBT posted here for the benefit of those struggling. Someday, I hope (and pray), we'll all be OCD free!

Randy

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Hi rpeders3

I was one of the lucky ones that was selected to go into the 'OCD house' a few weeks ago ( channel 4 documentary) and received the intensive cbt treatment that was on offer from Prof. Salkovskis and his team.

It was successfully and I no longer suffer with OCD!

I am unsure what your 'demons' are but one of the participants had 'germ' contamination fears and although you say sticking your hand down a toilet is distasteful (and I have to agree...it is!) I would have thought if it is a 'means to an end' of suffering with OCD perhaps weighing up pro's and con's I would definately chose the toilet over and above OCD...wouldn't you?

You only USE the 'worse case scenario' for a short while.

Catch the ch.4 progs. in June that should show you what I mean.

Beth J

[Caramoole]

I suppose that as he said, the best thing is to have goals and that way you can work towards a strategy. CBT should be graded so that you work first on the things that cause least concern and then move up the scale.

It's a bit like training for a marathon. You wouldn't try to go and run 26 miles a day from the outset. You'd probably start with a couple of miles and gradually build up.

Reading between the lines I would guess that the Prof found the 'Cognitive' bit of the behaviour therapy lacking (my interpratation only), that the exposure side was being dealt with but not the base fear and cognition that drove it.

[Guest rpeders3]

Reading between the lines I would guess that the Prof found the 'Cognitive' bit of the behaviour therapy lacking (my interpratation only), that the exposure side was being dealt with but not the base fear and cognition that drove it.

38453[/snapback]

Yeah, I think you're right. Maybe it's because we live in a TV generation but principles of thinking and logic tend to be undervalued by many in society today. Ignorance is bliss, or so the saying goes. But for those who suffer from OCD, ignorance is torture. I thought the prof was right on track when he said that we need to deal with general thought patterns rather than endlessly chasing the obsessive trail. I wonder if he's written extensively on the subject? He's been dealing with OCD treatment for decades - one would think that he's written a book by now!

[Guest Wendy]

Me again My interpretation of the 'cognitive' side of the therapy is as follows:-

Thought processes...An intrusive thought 'pops' into the mind ...how do you interpret/process it.....is it saying 'danger'? if so you must act on it....if you 'act' on it you will reinforce the fear (danger). If you don't act on it ......all hell will break loose!?......or will it?

What do you 'think' would happen if you 'ignored' the warning? ...Something bad?

However...

...if you call the OCD's bluff by ignoring it's warning of impending doom.....?

You have to do this yourself..call it's bluff..to find out for yourself ..what would actually happen....then you will KNOW, and as the old addage goes...'knowledge is power'!

We know that many OCD sufferers have 'reasons', a lot very similar, why they have 'ended up' with this horrible disorder and that was, I'm sure, what Prof. Salkovskis was referring to as 'bad luck', but if the correct cbt was on offer by all therapists information (eg what feeds the OCD etc), how to 'not respond' to the thoughts, being guided (very carefully) to the 'let's find out what really happens',

then suffers will feel empowered and strong to fight it off.

After having several attempts of out-patient treatment I firmly believe that intense therapy is the least painful way to go...still using the short,medium and long term goals...would you like that plaster whipped off quickly or slowly and painfully eased off?

regards,

Beth J