What is Obsessive Compulsive Disorder?
OCD is a condition where a individual has obsessive thoughts accompanied by compulsive behaviour(s). In OCD, an obsessive thought is a thought, image or urge that is unwanted, unpleasant and causes anxiety. A compulsive behaviour is something someone feels they have to do to prevent an obsession coming to fruition. This could be a physical or a mental act.
OCD affects individuals differently, and the OCD may range from mild, taking up perhaps an hour a day, or severe, controlling someone’s whole life.
Most people with OCD show a repeated pattern of thoughts and behaviour which involve four steps:
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obsessions– their mind is overwhelmed by an obsessive thought or fear
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anxiety– the obsession makes them feel very uncomfortable and distressed
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compulsions– they adopt a pattern of compulsive behaviour to reduce the anxiety and distress
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temporary relief– the compulsive behaviour brings short-term relief from anxiety but the obsession and anxiety soon return, causing the cycle to begin again
Symptoms of OCD
An OCD diagnosis requires the presence of obsessions and compulsions, which are time-consuming (at least 1 hour a day) and cause distress or impairment in social, work or other important areas of functioning.
The DSM-5 describes the symptoms of Obsessions & Compulsions as:
Obsessions
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Recurrent and persistent thought, urges and images that are experienced as intrusive and unwanted, and that in most individuals cause marked anxiety or distress and,
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The individual attempts to ignore or suppress such thoughts, urges or images, or to neutralize them with some other thought or action (e.g. by performing a compulsion).
Compulsions
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Repetitive behaviours (e.g. hand washing, ordering, checking) or mental acts (e.g. praying, counting, repeating words silently) that the individual feels driven to in response to an obsession or according to rules that must be applied rigidly and
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The behaviours or mental acts are aimed at preventing or reducing anxiety or distress, or preventing some dreaded event or situation; however, these behaviours or mental acts are not connected in a realistic way with what they are designed to neutralise or prevent, or are clearly excessive
Treatment for OCD
The evidence based preferred approach to OCD is Cognitive Behavioural Therapy (CBT), a talking therapy that aims to change your behaviour by changing the way you think about them. Treatment may involve exposing you to situations that cause anxiety and trying to avoid the compulsive behaviour this normally triggers. This can be frightening but can also be effective if you can handle it.
Antidepressant medications, such as Selective Serotonin Reuptake Inhibitors (SSRIs), are often prescribed to reduce the severity of OCD symptoms. These drugs increase the levels of serotonin in the brain in order to improve mood and make people more likely to be receptive to CBT. SSRIs can have side effects, are not recommended for children or pregnant women, and should not be mixed with alcohol. In addition, medications don’t provide a long term solution, as symptoms usually return if the person ceases to take them.
OCD and neurofeedback
Brain scans have shown that people with OCD have an imbalance of serotonin.and abnormal activity in the parts of their brain associated with strong emotions and their reaction to them. A substantial body of research reveals that OCD symptoms are related to the functioning of specific regions in the front of the brain. If these areas are working too slowly or quickly, an individual will find it difficult to stop repeating certain thoughts or behaviours.
Neurofeedback trains the areas of the brain associated with control and emotional reactivity. Neurofeedback therapy gives the brain direct feedback on how well it is working, and through this feedback the brain can regulate itself better, calm itself, improve mood and reduce symptoms of OCD. Through multiple training sessions the brain learns to work better without the feedback, leading to permanent changes and benefits.
The results of one research study, published by Hammond (2003), describes how neurofeedback reduced OCD Symptoms by 89% as measured by the internationally-recognised OCD test The Padua Inventory. The research also followed the participants for 12 months after the initial neurofeedback training and discovered that OCD symptoms did not return.
Hammond, D. C. (2003). QEEG-guided neurofeedback in the treatment of obsessive compulsive disorder. Journal of Neurotherapy, 7(2), 25-52.
Many practitioners who treat OCD using neurofeedback note marked reduction of OCD symptoms after brain training. People with OCD report that they no longer have to struggle with unwanted repetitive thoughts and behaviours. They also describe their minds as much quieter and calmer.
Why is neurofeedback the best treatment for OCD?
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Effective
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Non-Invasive
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Drug free
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Painless
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No undesirable side effects
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Enduring improvement with sufficient training