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Treatment for Obsessive Compulsive Disorder

Suzie is trained in both Inference-based Cognitive Behavior Therapy and Exposure and Response Prevention. In ERP the target of change is the compulsion (behavior), and it often is highly effective. Likewise, I-CBT is evidence-based, highly effective, and Suzie has gravitated towards this modality due to it having  trauma-informed qualities. In I-CBT, rather than targeting the compulsion (behavior) the target of change is the reasoning process (cognition) forming the initial doubt that comes right after the trigger that leads to the compulsion. Suzie can explain both modalities and you can choose what you would like to begin with. EMDR can also be used in specific instances, most often it is appropriate and effective when there is previous trauma informing the reasoning process.


If you choose I-CBT, you will learn to recognize your own sequence going from the trigger to the compulsion, which often feels like a two-step sequence because it happens so quickly! But, together we will slow it down and you will begin to notice what is in the middle: There is a trigger (locking the door and brief certainty about that because you saw, felt and heard it), and then a doubt (“What if it isn’t really locked?), a consequence (“If it isn’t locked, someone may break in and harm me or my family members,”), the horrible feeling or emotion/anxiety (“I won’t be able to live with myself if my family is harmed or dies; it feels excruciatingly painful to think about,”), leading to the compulsion (checking and rechecking and rechecking) until neutrality of emotion is reached – over and over again.

In I-CBT therapy you will identify your specific reasons for your doubt that make up the narrative or story that keeps the OCD relevant. You will learn to identify the specific reasoning process behind the inferential confusion being experienced; this falls into three categories: Over-Reliance on Possibility ("But it's possible!"), Dismissal of Actual Evidence (dismissing or ignoring the sense data you could be trusting), and Irrelevant Association (over-valuation of past events, rules, facts, personal experience, and hearsay). Sometimes it is more than one reasoning error causing the inferential confusion. Once you understand your own reasoning error or errors; how your fear of becoming the feared possible self is causing you to switch from normal reasoning into obsessional reasoning (Inferential Confusion) constantly scanning for threat; and how the ensuing story fueling the OCD is built on a sandy foundation, you will have what you need to begin to take control of the OCD, rather than it controlling you.

Through learning and practicing I-CBT, you will  notice where certainty is in the process and how to discern it, notice when you go into the imagination and how to discern it, and how to use reality sensing to make a choice (to not go over the bridge into the imagination or to return to the here and now from the imagination). Throughout the I-CBT process you will be using your senses to identify what the REAL story is, and that is where your power to change lies. Most importantly, you will learn WHO YOU REALLY ARE and return to trusting yourself! It will become very evident that the feared possible self is not the truth about you.

Spoiler alert: Your feared self is the opposite of who you really are; truly it is, but you don’t have to believe me…let’s find out together!

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