DBT for OCD

[neurosies]

Everything I have read on here references CBT as their treatment for OCD. My therapist specializes in DBT and we're utilizing those skills for treatment (distress tolerance, radical acceptance, etc). We still do ERP.  Has anyone ever used DBT instead of CBT? 

[Ashley]

To quote our website, at this time there is no evidence that DBT is helpful in treating OCD (originally developed for BPS).  CBT remains the only treatment we can and will recommend, so if you're paying for treatment it's important you ask what benefits it can have for you. If you're not sold on those benefits, then you may need to find a therapist that does specialise in CBT.

[neurosies]

6 hours ago, Ashley said:

To quote our website, at this time there is no evidence that DBT is helpful in treating OCD (originally developed for BPS).  CBT remains the only treatment we can and will recommend, so if you're paying for treatment it's important you ask what benefits it can have for you. If you're not sold on those benefits, then you may need to find a therapist that does specialise in CBT.

Yikes! Thank you for telling me. Unfortunately, I'm receiving free services and have no option to change therapists unless I can afford one (which I can't.) Plus, I really like my therapist. But I'll look to see what's involved with CBT and ask her if we can work on those exercises. Thank you for responding!

[Ashley]

Well if it's free, I guess you don't have anything to lose (other than time), I don't think it will cause any harm. But if there is a way to access free CBT that would be the preference.

[neurosies]

26 minutes ago, Ashley said:

Well if it's free, I guess you don't have anything to lose (other than time), I don't think it will cause any harm. But if there is a way to access free CBT that would be the preference.

I will look into that in the future, but finding free services in Canada is rough D: the other thing is that I have bipolar disorder which DBT actually does work well for, so switching things up might not be helpful for that 

[Ashley]

Yes based on the bipolar then yes it could be worth giving DBT a go  

[neurosies]

16 hours ago, Ashley said:

Yes based on the bipolar then yes it could be worth giving DBT a go  

Okay, thank you!

[Em00]

I'm having a combination of CBT and DBT. I also have bpd and have found DBT hugely helpful with that in the past. Currently CBT is helping with the 'what' of coping with ocd, challenging thoughts, exposure work etc. DBT is helping with the 'how' - how do I cope with the intrusive thoughts etc - mindfulness and radical acceptance has been really helpful when just 'stop ruminating' didn't cut the mustard. Distress tolerance for coping with the extreme emotions that come up. I've also been working on self compassion with my therapist and think this mix of therapies have been more helpful to me than 'straight' CBT. Obviously I can't speak for everyone. 

Edited July 28, 2018 by Em00

[Raffles]

8 hours ago, Em00 said:

I'm having a combination of CBT and DBT. I also have bpd and have found DBT hugely helpful with that in the past. Currently CBT is helping with the 'what' of coping with ocd, challenging thoughts, exposure work etc. DBT is helping with the 'how' - how do I cope with the intrusive thoughts etc - mindfulness and radical acceptance has been really helpful when just 'stop ruminating' didn't cut the mustard. Distress tolerance for coping with the extreme emotions that come up. I've also been working on self compassion with my therapist and think this mix of therapies have been more helpful to me than 'straight' CBT. Obviously I can't speak for everyone. 

This is the thing. From what I've read about DBT (and ACT, actually) it sounds like it can be a useful addition to CBT/ERP in managing the distress intolerance and doubt that occurs in OCD. Very few people will be 'textbook' cases of OCD, and might have other issues/patterns that keep the OCD going. I think a good therapist will adapt treatments they're trained in to suit the patient, blending methods to help the patient learn strategies to cope with the symptoms as they present.

ERP is essential to managing obsessions and compulsions, and understanding the cognitive mechanisms behind OCD aids understanding the condition for what it is and helps you stop buying into it. 

Plus I think a lot of therapies share CBT principles, even if they're called something else. Mindfulness Based Cognitive Therapy (MBCT) is based around compassionately observing your emotions, whatever they are, and letting go of fighting with difficult ones -- something which can be a compulsion and keep OCD going. It's definitely helped me ride out anxiety and helped with reducing rumination.