Recovery Overview

When it comes to OCD, the word recovery has two meanings.

The first meaning is a short term fix. This is about reducing the anxiety you experience from your current set of OCD thoughts so that you can function in daily life. Cognitive Behavioural Therapy (CBT) is the main approach used for this short term fix, and it is the primary treatment the NHS offers for OCD, with many private therapists offering it as well.

For some people, CBT can start to reduce anxiety from the current set of OCD thoughts in as little as a few weeks.

CBT works by getting you to experience the anxiety (from the current set of OCD thoughts) on a regular basis. When you experience it regularly enough, the amount of anxiety you experience goes down. This sounds counter-intuitive, but it’s not, due to the following reasons.

The first reason is that when you experience the OCD thought and no danger arises from it, your brain learns that the OCD thought is false, and so before long, it stops generating anxiety from that thought.

The second reason is that the subconscious mind will reduce the number of OCD thoughts it produces if it thinks its message is being heard. Remember, an OCD thought is a message that an underlying issue needs fixing (e.g. trauma, stress etc). You don’t need to fix that underlying issue straight away, as it gives you a grace period, so all you have to do in that grace period is experience the anxiety, at which point the subconscious assumes you are going to fix the underlying issue in the near future, and so it eases up with the number of the OCD thoughts it generates in the grace period.

With these short-term fixes, patients can improve significantly in a few months, and think they are almost fully recovered, but at some point in the future, the OCD will make a comeback. It makes a comeback because the root cause of OCD has not been dealt with.

This pattern is reflected in research showing that a large majority of people — around 80% — continue to experience persistent OCD symptoms in the long term after completing CBT. The short‑term relief is real, but without addressing the underlying causes, the symptoms tend to resurface.

A good analogy is that of headaches caused by an ear infection. You go the ‘CBT’ doctor complaining of headaches, instead of looking for the root cause (which could be an ear infection) he just deals with the symptoms of headache by giving you tablets to stop the headaches. The headaches stop for a while, but then in the future appear again, so you go back to the CBT’ doctor with the same issue, and once again he only treats the symptom (headaches), but not the underlying cause. Thus, you will be going back to the ‘CBT’ doctor regularly for the rest of your life. You will start to think the ‘CBT’ doctor isn’t very get good at fixing your headaches, and you would be correct.

If you are seeing a therapist/psychologist for your OCD, ask them if the goal of therapy they are administering is to cure the OCD, or merely reduce the symptoms (i.e. reduce the number of thoughts and associated anxieties). And, if you are up to it, you might also ask them what they make of the criticisms of CBT that I mention in the next page.

The second meaning of recovery is the true meaning of the word. That is, there is a chance that the OCD goes away and never comes back. This is because you are dealing with the root cause of OCD, which could be things like trauma and stress. The therapy that is used to find what the root causes of OCD are is called Psychoanalysis.

So, you are probably thinking ‘let’s go with psychoanalysis’. But psychoanalysis can take time to achieve results (possibly years), so it’s better to start off with CBT, as it does reduce your anxiety (from the current set of OCD thoughts) in a relatively quick time period, and once your anxiety is low enough (but not fully fixed), then you can start on psychoanalysis.

This website explains how both CBT and Psychoanalysis works for OCD.

The next section talks about CBT - please click the below button.