The necessity of finding the "root of the problem"

[Rarity]

Hello out there!

Well, I guess I have a question and a concern which is bothering me. And I would love to hear your opinion about it 

I have been suffering from OCD since 2007. It evolved gradually in the 2000s and I believe it peaked around 2017. That was the time I decided to really do something about it as it was completely ruining my life and career at that time. With the help of my psychologist and by using methods from ERP (Exposure and Response Prevention) and ACT (Acceptance and Commitment Therapy) I succeded in treating it and claiming my life back (to a certain degree at least!). I believe ERP and ACT are the solutions for me personally because I experience very positive outcomes from those treatments. Something ten years of medication was unable to do for me. That said, I still experience some fallbacks and serious challenges.

Today I am functioning quite well and I am back at university finishing my masters degree and I even manage to maintain my job at the department of science along with my studies there. However, I am still bothered a lot by OCD, mostly in relation to shame and perfectionism. Then, yesterday, I watched a video about recovering from anxiety. In this video, it was stressed that in order to reach full recovery, one must uncover the true reason for ones anxiety. This was described as "the root of the problem" and that it had to be solved in order to get any further. This concerns me because I have tried everything to search for a potential issue, without any luck. I even tried hypnotherapy  Could this really mean that I can not succeed by using ERP and ACT alone? This made me quite concerned as I practice this on a daily basis! 

I would love to hear your opinion on this matter.

Thanks in advance (and for reading my story)! 

Edited May 19, 2020 by Rarity

[Ashley]

42 minutes ago, Rarity said:

Then, yesterday, I watched a video about recovering from anxiety. In this video, it was stressed that in order to reach full recovery, one must uncover the true reason for ones anxiety.  This was described as "the root of the problem" and that it had to be solved in order to get any further.

I see this a lot, especially in 'anxiety videos'.  For OCD it's absolutely not necessary, and usually those promoting this theory are those without understanding in what CBT is and sometimes promoting their own 'treatment manual'.

The problem is, even if I understand the root cause of what made me clean for 2-4 hours each time I used the loo, it wouldn't (for most people) help me not clean for 2-4 hours each time I used the loo.

That is why Cognitive Behavioural Therapy very much focuses on the 'here and now', the problems we have today and what we want to be able to do tomorrow (i.e. not have the problem).

So to answer the thread title, no, tto overcome OCD there is no necessity to find the "root of the problem".

42 minutes ago, Rarity said:

even tried hypnotherapy  Could this really mean that I can not succeed by using ERP and ACT alone?

I personally wouldn't recommend ERP alone and I am not sure about ACT either (although no harm in that).  Whilst I don't believe in needing to find the root cause of anxiety (because every human has anxiety), good quality CBT will have two parts the C (cognitive) and the B (behavioural - i.e. doing exercises like ERP). In order to give the B part every chance to succeed and succeed in long term changes without relapses, it's my belief we first need to do some C work.

That C work in part looks at our triggers, what those thoughts mean to us, explore how those thoughts can cause emotions and body sensations, which reinforce the thoughts and perhaps most importantly, sometimes lead to misreading of the thoughts or misinterpretation about the level of threat posed.  Effectively looking at the meaning behind our thoughts, but that is very different than needing to get to the 'roof of the anxiety'.

So you might be able to get better with ERP/ACT,  but my recommendation would be to focus on truing to access CBT (which includes both the C and the B).

[Rarity]

7 hours ago, Ashley said:

I see this a lot, especially in 'anxiety videos'.  For OCD it's absolutely not necessary, and usually those promoting this theory are those without understanding in what CBT is and sometimes promoting their own 'treatment manual'.

The problem is, even if I understand the root cause of what made me clean for 2-4 hours each time I used the loo, it wouldn't (for most people) help me not clean for 2-4 hours each time I used the loo.

That is why Cognitive Behavioural Therapy very much focuses on the 'here and now', the problems we have today and what we want to be able to do tomorrow (i.e. not have the problem).

So to answer the thread title, no, tto overcome OCD there is no necessity to find the "root of the problem".

I personally wouldn't recommend ERP alone and I am not sure about ACT either (although no harm in that).  Whilst I don't believe in needing to find the root cause of anxiety (because every human has anxiety), good quality CBT will have two parts the C (cognitive) and the B (behavioural - i.e. doing exercises like ERP). In order to give the B part every chance to succeed and succeed in long term changes without relapses, it's my belief we first need to do some C work.

That C work in part looks at our triggers, what those thoughts mean to us, explore how those thoughts can cause emotions and body sensations, which reinforce the thoughts and perhaps most importantly, sometimes lead to misreading of the thoughts or misinterpretation about the level of threat posed.  Effectively looking at the meaning behind our thoughts, but that is very different than needing to get to the 'roof of the anxiety'.

So you might be able to get better with ERP/ACT,  but my recommendation would be to focus on truing to access CBT (which includes both the C and the B).

First of all, I really appreciate your insights on this matter! It is a relief to hear that I am not the only one thinking that it is not all that helpful to hear that you can't do something about your issues simply because you are unable to uncover this "root problem". And I totally agree. Even though we may find out about the origin og our sufferings, I believe it wouldn't really do much for is regarding the compulsive behavior itself. I see this as a problem that has grown on its own during the years and I think it is somehow a problem in itself! I totally believe that the solution is to face the problem here and now.

I somehow made a mistake in my description because I forgot the distinction between CBT and ERP (which is a part of CBT)  Fortunately, I did learn a lot of useful methods and insights from CBT in general. But now that I look back on my progress through therapy I actually do believe I could use a brush up on some aspects of CBT. Thanks for reminding me about the B/C ratio! 

Wow, the internet surely is confusing whenever you are searching for new methods and perspectives on OCD and anxiety treatment. I will stick with my existing methods that are working well and practice more CBT in addition to that.

Thanks again