Use of CBD for OCD?

[Loftylady]

Hi,

I have been reading about the use of CBD (Cannabis Oil) for anxiety and there are many articles that suggest it may help with reducing anxious/intrusive thoughts. Does anyone have any personal experience of using it ? I should add that CBD is not illegal, as it does not contain  / contains extremely  low doses of THC which is the element that makes people "high". It is sold as a food stuff and not medication. I am aware that it has not been trialled for use as a drug in the UK, or at least that's my understanding.

 

Interested in people's thoughts, experiences please?

 

xx

[daja]

I tried it. Was expensive and didn’t do much.

[snowbear]

Hi Loftylady,

This topic comes up quite regularly on the main forum. If you put 'cannabis' in the search box (at the very top, RHS of the screen) it will bring up a long list of threads discussing the pros and cons.

This was my personal comment on a recent discussion: CBD oil for anxiety  My opinion can probably be summarised by the phrase: Caution - user takes this 'food substance' at own risk. 

But some on the forum have tried it and have personal good and bad experiences to share. Perhaps search out their opinions too before making up your own mind.  

[Wonderer]

Hi, out of desperation I decided to buy my son the CBD gummies but didn’t give them until I got the advice of his psychiatrist, she advised me not to go there, she said her reasoning is, although it is “safe and legal” there’s not enough research into how it would react with other medications, my son is on melatonin for sleep but she said even over the counter prescription drugs could interact with it and frankly, they just don’t know yet and said that she would suggest waiting for a good while yet and seeing how it goes in the long term for people, both medically and therapeutically.xx

[Loftylady]

Thanks for your replies.

I wouldnt expect any clincian to give the go ahead to use CBD, as it is not licensed as a medicine, so ethically they cant recommend it.

My son refuses to take medication, and is now on his second course of CBT, the first was mostly ineffective, after a wait of 6 months following his second referrral. NICE guidance says that anyone for whom CBT doesnt work should not have to be re referred. Shows exactly how much our local MH team know. It also says that each Trust should have specialist OCD team. The fact that my son is being given tasks that he doesnt understand the rationale for, again suggests his treatment is not from anyone who has clue. I am hoping to go with him to his next session, but as hes an adult, I have no control over that. We have had no contact from his therapist to advise us/involve us in any goal setting or plan he has made with my son, and quite frankly I have very little faith in the NHS OCD treatments. Whilst I appreciate the CBT /ERP may well be the "gold standard", I am very sceptical, especially since funding is a massive problem and CBT seems to be the gold standard for lots of things that the NHS know little about. Relatively short term and cheap seems to be the order of the day, and if NICE recommend it, well.....you bet it must be the right thing, eh? Very convenient. If I sound angry, its because I am......

What I do know is my son is deteriorating despite being intreatment, which is obviously a ridiculous situation. A private therapist  claiming to have OCD knowledge locally wants to charge £185 for an assessment and £125 per session after that. I have no problem paying anyone for their hard earned knowledge, but frankly those sums are just diabolical, and I cant afford £125 per session in the long term.

Any specialist teams seem to be in London only and Im in the North. The situation is dire. I am at a loss what to do next. The process for applying for Specialist help seems so long winded with no guarantee of success. How can people be left in this state?? 

Can anyone recommend anyone in the North West who may have some specialist knowleddge of OCD, Please??

 

Thank You

 

x

 

 

 

 

[snowbear]

Hi Loftylady,

49 minutes ago, Loftylady said:

Whilst I appreciate the CBT /ERP may well be the "gold standard", I am very sceptical, especially since funding is a massive problem and CBT seems to be the gold standard for lots of things that the NHS know little about. Relatively short term and cheap seems to be the order of the day, and if NICE recommend it, well.....you bet it must be the right thing, eh? Very convenient. If I sound angry, its because I am......

I sympathise with your anger and your situation, but please don't ''throw the baby out with the bath water'', as they say. 

CBT from a therapist experienced in OCD is hard to come by because it's a much more expensive option that simply putting somebody on pills and giving them 'counselling'. There aren't enough trained specialists in the country to meet demand and even with improved government investment, training them takes time. 

The NICE guidelines are what every NHS district ought to be aiming for (sadly many are still a long way off providing it.) But where an NHS body fails to live up to the NICE recommendation we can take them to task on it and point out their obligation to provide what the guidelines state. 

CBT is the best treatment for OCD and it does work. Full stop.

But applying CBT isn't always easy for sufferers, and how CBT is applied by therapists can vary enormously too. It can take several rounds of 'failed' CBT before you find a therapist who understands what they're teaching sufficiently to get the message across clearly, a while for the message to sink in, and months of diligently applying the CBT you've learned before results appear. Nobody ever promised a quick fix.  

Also, there's a difference between deteriorating (OCD getting worse because it's not being tackled) and 'feeling worse' or 'symptoms being more troublesome' because the OCD is being challenged and the realisation changes must be made is uncomfortable. Sometimes, especially if a person isn't ready to face change, there's a kick-back worsening of symptoms  - almost as if the person was (unconsciously) saying 'See! I told you not to interfere, now look what you've done by forcing this therapy on me.' 

Try to stick with the NHS therapy, with its imperfections and all. If you can comfortably afford to go private then fine, but the prices you quoted are pretty average and likely to apply wherever you go in the private sector. I'm afraid I don't know of a private specialist in the North West and the charity's experience is mostly with specialists further south. You might find the advice on this page helpful. Finding a Therapist

Meanwhile if you need to vent we've heard it all before, so here's a good place to let off steam!  

[Loftylady]

Hi again

Thank you for your reply.

I have to just reply to a couple of points, as a matter of debate. 

Firstly, your reasons for detiorating symptoms whilst in therapy, I can understand. It makes sense and I see that in my family member. 

I dont  agree that CBT is more a expensive option. A course of 6/8 sessions of it is much cheaper than medication and Counselling. Skilled Counselling from a trained Counsellor is usually longer term and in my opinion hugely beneficial for those that engage with it. The process clients go through is life changing, its effects should not be underestimated. Im a counselling student so may be a little biased but  I absolutely believe that counselling alongside another therapy is essential for a client to understand themselves. The fact that this can take time makes it more expensive and of course results are measured much more subjectively , which doesnt fit NHS requirements .Why measure the physical, emotional effects on people when numbers will do, eh? There are also thousands of trained and skilled Counsellors across the UK who cannot find work because NICE guidelines recommend CBT only, not just for OCD but for a wide range of disorders. And we wonder why the mental health of our nation is dire. CBT ignores the holistic. People are simply being given a “ quick fix” which doesnt fix. Training these highly skilled professionals, many of whom also hold CBT qualifications, in OCD and other disorders would be better than the money being spent on short training courses training people who then deliver watered down services like PWP’s.. (this is not an attack on them) Then, sufferers could gain counselling and CBT from one skilled professional.

Ive been reading and watching videos about Inference Based Therapy, which was brought about because of the relapse rate, inefficiency of CBT /ERP for OCD, which I feel makes much more sense than simply “ stop doing it”.

The fact that you state it takes “ several rounds of failed CBT before finding a therapist who can apply it properly” is simply mindblowingly ridiculous! This increases costs, damages people further and makes waiting lists longer because people have to suffer for inadequate therapy. The acceptance of poor care in that statement is beyond belief ( again not an attack on you) but an attack on how people simply accept care that is disgustingly poor and imply its “ normal”. 

CBT/ERP in my opinion is touted as the gold standard because its all we've got. There are many research articles which agree that CBT isnt all its cracked up to be. NICE will go along with it because to not would mean the Govt would have to spend money, and that isnt going to happen. 

I’ll be watching the advance of IBT closely, and believe NICE will be proved wrong. Im not against CBT /ERP completely. It helps many people undoubtedly and for those, of course thats great.  But it fails many many others.

If we always do the same thing we’ll always get the same results.

 

xxx

 

 

 

[Wonderer]

Hey, I just wanted to say that I had counselling, it was wonderful to be able to go and talk to someone, figure out things from my past etc, I loved my counsellor, she was fantastic! However, it did not do a single thing for my OCD, not one thing. I have had CBT and it did wonders for my OCD, so it’s definitely in my opinion the way to go in terms of treatment. I am a huge advocate of talking therapies, I loved counselling, I hated CBT at first, it was painful and embarrassing and such hard work, but once I committed to the hard work, it’s been the best thing for my OCD and also helps with general anxiety and panic disorder.xx

[Loftylady]

Hi Wonderer,

Thats good to hear

However, there are different modalities of talking therapies and some are not concerned with events of the past.

Person Centred counselling  is concerned with the here and now, not the past. There may be influences from the past in how we view ourselves, but it deals with how our thoughts, feelings and emotions affect us now. The therapeutic relationship that develops allows the counsellor to see the world as the client sees it, helping them to understand themselves in relation to it. The client, through this safe, therapeutic relationship and environment of empathy and positive regard,  is more able to explore negative thoughts and feelings and deeply explore his anxiety, and move towards growth and change. 

This is the counselling I feel will compliment IBT or CBT

xxx

[Wonderer]

3 hours ago, Loftylady said:

Hi Wonderer,

Thats good to hear

However, there are different modalities of talking therapies and some are not concerned with events of the past.

Person Centred counselling  is concerned with the here and now, not the past. There may be influences from the past in how we view ourselves, but it deals with how our thoughts, feelings and emotions affect us now. The therapeutic relationship that develops allows the counsellor to see the world as the client sees it, helping them to understand themselves in relation to it. The client, through this safe, therapeutic relationship and environment of empathy and positive regard,  is more able to explore negative thoughts and feelings and deeply explore his anxiety, and move towards growth and change. 

This is the counselling I feel will compliment IBT or CBT

xxx

Yes I had person centred therapy as well, it helped me to understand myself a bit better and how the way I think shapes my experiences, which was quite helpful in that it taught me how to switch from negative to positive etc, this was quite effective with generalised anxiety and social anxiety, I had gave myself some homework and set goals in between sessions, I decided I needed to build up my self esteem by using affirmations, Still, it did nothing for my OCD, I am quite severe though when at my worst...I just feel that CBT is what works because honestly I have been through a lot of therapies and meds and nothing else did the trick, I think cbt is extremely difficult and if it’s not working it’s probably a lot to do with ther person being afraid to do what they have to do to get better, it’s very scary at first and takes a lot of strength to implement when OCD is at its worst. That’s not to say there aren’t people who don’t respond, I suppose like anything in life there will be people who are unable to get well through cbt, but there’s probably a myriad of reasons for this, thing is, it’s the gold standard treatment for OCD because for MOST people who engage with their therapy it will make them better. There’s also other issues, if CBT is not working for someone then they maybe want to change therapists because I’d been to one before who was absolutely useless and hadn’t a clue what she was doing, it put me off for a while but then I found my last therapist and he was amazing, he took no rubbish from me and put me to work and it was the best thing that ever happened to me.xx

Edited April 7, 2018 by Wonderer

[snowbear]

5 hours ago, Loftylady said:

it deals with how our thoughts, feelings and emotions affect us now.

So does CBT. 

5 hours ago, Loftylady said:

The therapeutic relationship that develops allows the counsellor to see the world as the client sees it, helping them to understand themselves in relation to it. The client, through this safe, therapeutic relationship and environment of empathy and positive regard,  is more able to explore negative thoughts and feelings and deeply explore his anxiety, and move towards growth and change. 

That's true for any form of counselling/therapy. It doesn't just apply to one type of cognitive therapy. Ant therapist who doesn't incorporate these aims automatically as part of their practice ( regardless of the type of therapy chosen for an individual client)  is failing in their job. 

11 hours ago, Loftylady said:

CBT ignores the holistic. 

I can see why you might conclude this, but I think perhaps we're talking at cross purposes, or at least viewing this from different angles.  

CBT is a holistic term which can include all these other variations in therapy. IBT, PCT and many more are all adaptations of cognitive therapy and so come under the cognitive umbrella. The 'C' of CBT allows a therapist to introduce any form of cognitive therapy, or to focus on one type more than others, according to what is appropriate for the individual person's needs. 

But this flexibility is also one reason why it's possible to come across a therapist who 'isn't right for you.' Some therapists are only trained in a stylised/basic delivery of CBT and although this means the majority of therapists treating the majority of patients will be effective for minimum training costs, it also reduces the flexibility of what kinds of cognitive therapy they are able to apply. A person may receive a 'basic' course of CBT and not respond, but that doesn't make it an ineffective therapy or the wrong choice for first line therapy, because the majority will benefit. 

Those who don't benefit from their first introduction to CBT can then be referred on for a second course with a more experienced therapist who is able to introduce one or more of the other forms of cognitive therapy alongside the behavioural aspect of ERP. A lucky few will come across a therapist with a range of cognitive therapy approaches in their repertoire for their first course of treatment. This would of course be the ideal for everybody, but it isn't what's available presently and we have to work within the system we've got even while fighting for improvement and change.

I certainly don't accept poor quality of care and neither does our charity. We campaign for, negotiate, and achieve better care for all sufferers as an ongoing process. I, alongside OCD-UK, am passionate (!) about getting the right form of therapy to every person suffering OCD. Part of that battle is getting the cognitive therapy part of CBT accepted as essential alongside the more widely used behavioural part. It also requires ensuring the cognitive approach taken is suitable for OCD. Many forms of cognitive therapy will benefit a person holistically (as you put it), but won't treat their OCD. What's needed is a balance between actively tackling the OCD and supporting individuals with other aspects of their cognitive function as needed to maximise each person's well-being overall.

In short, I believe you and I are fighting for the same thing, but just referring to it by different names.  

[carolj]

I was just looking back at your posts from last year and I wondered if your son has now officially been diagnosed with OCD and whether he made it to uni and how he is doing?

 

 

[Loftylady]

Snow bear... maybe we are. Xx

Yes carolj

He was diagnosed and did make it to Uni last September. He lasted until Christmas and then had to drop out as he couldn’t tolerate the journey by train and it’s associated intrusive thoughts. 

He has officially deferred until September. We’ll just have to wait and see what happens and how he progresses on this round of CBT.

Thank you for asking

x