Treatment methods

Methods are selected according to the OCD pattern

OCD can involve many different themes, but the theme alone does not tell us what will help. We also explore what triggers the pattern, how you respond afterwards and the role that checking, avoidance, reassurance seeking, analysis and other strategies have come to play.

Cognitive behavioural therapy as a clinical framework

Cognitive behavioural therapy is a central clinical framework for treatment. We consider thoughts, interpretations, emotions, bodily reactions and actions together, exploring what keeps the OCD pattern going.

The work addresses both what you think and what you do in response to doubt, anxiety, urges or discomfort. The aim is to gain new experiences and greater freedom to choose a different response.

Exposure and response prevention

Exposure and response prevention is often shortened to ERP. Exposure means gradually approaching situations, thoughts or sensations that trigger OCD, in a planned way. Response prevention means practising not following OCD’s usual demands for action, analysis, control, reassurance seeking or avoidance.

The aim is not to cause as much discomfort as possible or to prove that a fear is unfounded. The exercises should be relevant and give you an opportunity to learn that you can act more freely without carrying out your usual OCD response.

Read the detailed explanation of exposure and response prevention.

Visible and mental OCD strategies

OCD is not limited to visible actions. In OCD, thoughts, analysis, doubt and mental rituals can all function as attempts to obtain relief, certainty, safety or control.

We also work on recognising when something that seems like problem-solving becomes part of the pattern. This might involve repeated mental review, checking feelings, arguing with yourself or trying to achieve complete certainty. In ERP, response prevention can therefore involve both visible and mental strategies.

Cognitive and metacognitive techniques

Cognitive techniques can help you explore the meaning you attach to thoughts, doubt, responsibility and risk. Metacognitive techniques focus on how you relate to thoughts and how much time, attention and control you give them.

The aim is not to win an argument with every OCD thought or replace every difficult thought with a positive one. The work should make it easier to recognise the pattern, reduce the need for prolonged analysis and choose a different response.

How we combine methods

The methods are not fixed stages. We adjust the emphasis according to your goals, your particular OCD pattern and what you learn along the way. At some points, the emphasis may be on specific ERP exercises. At others, we may first need to identify mental strategies, explore particular interpretations or adjust the way we work with doubt and uncertainty.

Together, we keep reviewing whether the work helps you act more freely in relation to OCD and adjust the methods accordingly.