Saturday, September 24, 2011

Mental Health Treatment

Oh, there goes that yahoo OCD board, getting me all worked up again. This week, several therapists have noted that most therapy programs teach you a little about all the possible approaches to treatment- talk therapy, Gestalt, behavioral, etc. then you "pick your favorite."

We have known for how many years that exposure and response prevention is by far the most successful approach to treating OCD? A few others, including acceptance and commitment therapy/mindfulness also show promise. TALK THERAPY DOESN'T WORK. I think for a talk therapist to treat someone whose main complaint is OCD is malpractice and theft, plain and simple.

And if they aren't learning enough in their masters or PhD programs to KNOW that talk therapy doesn't work, then their program sucked, plain and simple.

I cannot even describe how mad it makes me that 20 years after these facts were established, OCD patients still get such crappy treatment in our mental health system. (And don't even get me started on the psychiatrist who never even mentioned ANY treatment except to list all the possible medications I could try). ARGH.


  1. I can't agree more with this post. I wasted 3 years of my life on Freudian Psychotherapy, not to mention thousands of dollars. I went 2x a week and this PhD swore that this was what I needed. She never once diagnosed me as OCD, this was when I still didn't know what was "wrong" with me.

    Those of us with OCD require CBT or ERPT, plain and simple. Might be hard, but so worth it in the end.

  2. When I first started therapy, my therapist and I tried ERP. It sent me into a deep depression and a near catatonic state. We have moved to a simpler CBT and have found it much better for me, at least at this time. We hope to eventually be able to go back to ERP if we can, but it just does not work for me right now. I'm just not ready for that yet.

  3. I TOTALLY agree. Don't get me started either. When it comes to the Yahoo board - I think that they are trying to be "diplomatic and objective" if they aren't completely bashing those who claim that talk therapy will work for OCD. Join the Canadian OCD Network page on Facebook. We just posted an interesting article from a very well known psychiatrist about this. Grrrrr....

  4. Lolly and Kat,
    Just want to note that more "standard" CBT is also on the "okay for OCD" list, and as you say, Kat, can be gentler.

    I'm working with a combination of the two right now.

    When I finally left my therapist a last year, it was because I had devolved basically into talk therapy and she and I both knew that wasn't getting me anywhere.

  5. I get very disheartened by this as well. Like Kat, I've needed to go slow with the ERP because of the OCD being tangled up with some deeply held beliefs of my worthlessness, but this is in the context of someone who specializes in OCD, and who knows how OCD works. I was in talk therapy for 6 years, and although it helped my depression immensely, my OCD remained, and my therapist had no idea how to treat it, or even what ERP was.

  6. I agree that ERP doesn't get its due, but I also think it can be a complex problem. It can be so hard for some of us to figure out what our "main complaint" is since a lot of us have comorbid illnesses. For me the OCD's were the squeaky wheel, but also were generated largely from issues tied closer to my GAD and CPTSD. I've needed a host of therapies, including CBT, talk therapy, somatic therapy, mindfulness, meds, and more in order to make progress. It seems a gain in one area or in one disorder can help bootstrap another one of my issues upwards, and then I see gains with a completely different therapy and different illness. ERP, some of which I did years ago, has helped with certain parts of my OCDs, but the parts linked closely to physical abuse as a child (my physical touch related contamination fears) seem to only want to let go when I work hard on somatic therapies and mindfulness.
    Adventures in Anxiety Land

  7. I could not agree more! My husband suffers from OCD and one of the biggest struggles in his OCD has been to find a good therapist. For awhile he was seeing someone who would try to get him to figure out why he had certain obsessions, therefor giving them meaning and value, and STRENGTHENING them, instead of forgetting about the obsessions and dealing with the ANXIETY! He doesn't like change though and after he had opened up to each therapist each time, it's been hard to help him to see that someone else may be able to actually help him much better. It is ridiculous that many therapists are so unaware that they don't even realize there are not providing an appropriate treatment. Good luck to you on your journey! I write about our life together at ;)