Mindfulness-based therapies encourage people to replace the distress and avoidance associated with obsessions with a non-judgemental awareness and acceptance of their inner mental state. This is proving effective even in those who have been not been helped by other treatments.
Mindfulness-based therapy for Obsessive Compulsive Disorder
Mindfulness, with its focus on the non-judgemental awareness of the present, can help people with OCD to conquer the recurrent, intrusive thoughts, images or impulses (obsessions) and repetitive mental or overt acts (compulsions) characteristic of this particular form of anxiety.
By definition, mindfulness is a state which can be viewed as the antithesis of obsession and compulsion: in adopting a mindful approach, we can learn to change the way in which we relate to our private experience, thus breaking the cycle between obsessions and compulsions that can otherwise seem overwhelmingly impossible to overcome.
An important feature of OCD, shared with other forms of psychological concern, is ‘experiential avoidance’: an intolerance of aspects of our inner experience accompanied by methods of avoidance to remove ourselves from these undesirable factors. In the case of OCD, the affected person is often highly distressed by and ashamed of their obsessions, which can be highly disturbing in nature (often violent or sexual).
Mindfulness: non-judgemental awareness of the present
The compulsions are the mind’s attempt to distract from this distress: for example the compulsion to flick all the light switches in the building on and off three times in the belief that this will prevent the imminent threat of death to one’s family.
Unfortunately, these ‘safety responses’ serve only to reinforce the OCD: they rule out any opportunity for ‘disconfirmation of threat’: when the person performs the repetitive behaviours with the light switches and their family comes to no harm, this only strengthens the bond between their obsessions and compulsions because they haven’t allowed themselves to see what will actually happen if they resist the compulsions (i.e. that their family will not all suddenly die).
An alternative to avoidance
What mindfulness offers is an alternative to this experiential avoidance. Mindfulness-based therapies help us to accept exposure to various aspects of our inner states which we may fear or be horrified by. Fabrizio Didonna, president of the Italian Institute for Mindfulness, suggests that the power of mindfulness in the fight against OCD comes from the status of the mindful state as “a pre-metacognitive attitude or mode that prevents patients from falling into the speciļ¬c evaluations, judgments, and biases that maintain and/or over-activate the psychopathological problems.
“It allows people to recognise and accept their obsessions instead of jumping into the compulsive behaviours which can be so disabling to them… “it teaches patients how to “observe” their experience without entering into the mode of meta-evaluation.”
The other factor that makes OCD particularly susceptible to mindfulness-based interventions is the fact that people with OCD generally have very good insight (i.e. they recognise that their behaviours are problematic). Because awareness is so crucial to mindful practice, it is understandable that an awareness that you have a problem at all is essential in order for you to begin to fix it!
The evidence
Empirical support for the effectiveness of mindfulness-based therapies is growing rapidly. Much concerns the co-called ‘third wave’ of cognitive behavioural therapies which are strongly influenced by mindfulness techniques. In 2007, a group of psychologists from Los Angeles investigated the effectiveness of mindfulness-based behaviour therapy, which combines exposure and response prevention (ERP, a component of CBT) with mindfulness training and writing exercises.
When this therapy was given to 139 patients with severe or extreme OCD who had previously proved resistant to other psychological interventions, their OCD as measured by the Yale-Brown Obsessive-Compulsive Scale decreased substantially, along with measures of phobia, generalised anxiety and depression. Their insight and general functioning improved. If such substantial improvements can be elicited with groups who have previously struggled to find relief with other therapies, mindfulness may just be the key to freedom from obsessions and compulsions for many people.
The House Partnership, 11th October 2015
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Steve Blacknell, 55, used to sneak into the kitchen in the middle of the night to eat in secret. He has been recovering from bulimia for 20 years. At The House, our therapists and counsellors are experienced in helping people overcome issues with food and eating.
House Therapists are trained in a variety of approaches, and can integrate them to tailor the therapeutic experience to your particular needs and concerns. Rather than trying to match the client to a therapy, we prefer to match therapies to the client.
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A man's problems with his wife keep him awake during a whole night. An animation about insomnia, by Marie-Margaux Tsakiri-Scanatovits, promoting the short story 'Night Thoughts' by Helen Simpson, for Granta magazine's issue on feminism.
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This powerful film by documentary filmmaker Martin Hampton introduces us to the lives of four people struggling with compulsive hoarding; each vignette more uncomfortable that the last.
Levni Yilmazis is an independent film-maker, artist and publisher. In this short animation he provides a wry how-to guide for breaking up . . . in 64 easy steps!
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Kadam Morten Clausen, resident teacher at the Kadampa Meditation Centre in New York, discusses how stress is all about our perceptions of others and of the world. Mindfulness practices, as encouraged at The House Partnership, can help you find a path to a life free of stress.
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Levni Yilmazis is an independent film-maker, artist and publisher. This is his ironic take on the less-than-helpful advice some people give when you're experiencing depression.
Though it has been proposed that food issues such as extreme dieting, anorexia and bulimia are on the rise and influenced by media pressures, analysis of texts about and by many of history's key figures suggests that these problems have been around for centuries.
A clip from the BBC's Weird Nature series showing how Vervet Monkeys in the Caribbean have taken to stealing cocktails from people on the beach. Studies show that they have the same percentage of teetotal and alcoholic individuals as the human population.
