New treatment for obsessive-compulsive disorder
By Liz Lockhart
Obsessive-compulsive disorder (OCD) is a debilitating mental health disorder. Individuals with OCD suffer from obsessive thoughts which lead to compulsive behaviours. OCD suffers can be trapped in an endless cycle of fear. Common thoughts such as ‘have I locked the house?’ or ‘did I turn the cooker off?’ can lead to a cycle of checking and re-checking.
The most common treatment for OCD uses exposure and response prevention (ERP). ERP is aimed at exposing sufferers to their fears until their level of anxiety reduces. Unfortunately this kind of treatment has resulted in the patient, all too often, discontinuing the therapy as they struggle to face their deepest fears.
New research is being driven by the need to find an alternative reliable treatment for OCD patients. Adam Radomsky, a professor in the Department of Psychology at Concordia has led a study which holds much promise as an alternative treatment of obsessive-compulsive disorder.
Previous work was conducted by Radomsky and colleagues at the University of Reading (UK) and at the University of British Columbia and it is on the findings of this earlier work that Radomsky now bases his new approach to treatment. It is hoped that this work will vastly improve the quality of life for OCD sufferers who are constantly checking and re-checking.
Radomsky says ‘For years the best way to treat compulsive checking in OCD sufferers has been through a difficult therapeutic process known as exposure and prevention, or ERP. By facing their worst fears repeatedly until their anxiety declines, patients learn to diffuse their hyper-vigilant checking responses, in theory. In practise, however, this type of treatment often results in patients quickly discontinuing the therapy.’
‘Refusal rates for ERP are unacceptably high, which is why we need to develop a new and refined treatment that specifically works for compulsive checking.’
From previous study it has been found that people with OCD who compulsively check certain aspects of their surroundings do this from an inflated sense of perceived responsibility. It is from this standpoint that Radomsky is building his new treatment. ‘If I don’t turn off the stove, the house will burn down’ is a reasonable thought that can develop into an obsessive spiral of checking and re-checking, progressing into being unable to leave the house. Radomsky found, in previous research, that by performing these repeated acts, the OCD sufferer beings to lose confidence.
The cycle can be halted by modifying the patient’s inflated feelings of personal responsibility and by reducing their predictions of seriousness of anticipated misfortunes. This can be achieved through targeting the way in which people think and not the way they act. In Radomsky’s new treatment approach, people’s misconceptions about how responsible they think they are, their own memories, and the dangers they perceive are targeted. The proposed treatment progressively lets the patient experience exercises in normalising feelings of inflated responsibility. It is aimed at restoring confidence in memory and reducing self-doubt and guilt. It is hoped that this will leave the patient with confidence in themselves and give them a new insight into the world around them.
‘For me and my team this work will capitalise on all of our previous experimental research and lead us to testing a new intervention based on our previous findings. It’s our hope that this work will lead to a more substantial test of the treatment, which in turn could influence how people treat OCD in Montreal, in Canada and beyond,’ Radomsky says.
The study findings can be read in the publication Cognitive and Behavioural Practice.