what is CBT

[Guest guest]

CBT -- As I understand it after reading 5 or 6 books

and 6 months monitoring the 'OCDsupport' (probably the

most helpful) site (and doing it with my 14 y/o son)

CBT (Cognitive Behavior Therapy) is, as you said,

everywhere these days -- even used for sleep problems.

It is sort of replacing " talk " therapy (in alot of

cases). Talk therapy basically was built on the idea

that we are mostly a product of our upbringing and

past experiences(Freud). But talking about it

apparently didn't cure us very well. Hence the jokes

about being in therapy for years and years and not

getting better. Dwelling on a bad past might just

make the brain connections stronger (re: the bad exp)

Instead -- CBT spends part of the time " adjusting "

problematic thinking that the patient may have fallen

into (the cognitive part) then emphasizes changing

behavior (the " B " part of CBT). It has been proven in

brain scans that changing behavior ACTUALLY PHYSICALLY

CHANGES the brain!!!

In the case of OCD the Cognitive part of the therapy

would be (for example) telling someone who is afraid

of germs that their thinking on this subject needs to

be adjusted, that germs are unavoidable and natural

and have been around forever and it's actually better

to not avoid them all because they make our immune

system stronger.

The behavior part of CBT for OCD is to NOT DO what the

OCD is telling you to do. Show the OCD monster that

you are stronger than it is. Don't give in! Little

kids might name the OCD something negative (some call

it the OCD bully) so that they can more easily refuse

to do what it is telling them to do.

We all know that doing what a bully tells you to do is

not going to make things better in the long run.

" Feeding the OCD monster " is a great analogy I think.

The more you feed it the stronger it becomes. The

more parents give into the fears (enabling) the more

the kid thinks their fears are warranted. The longer

the kid gives into their " need " to do certain rituals

the stronger the pathways in the brain become that

tell them they need to do the ritual.

In OCD the behavior therapy part is usually called ERP

(Exposure Response Prevention). It is a specific type

of therapy. Not all CBT therapists know much about it

and even less know how to do it. There are lots of

good books about it on the OCFoundation website. A

good one that is mentioned often here is Tamar

Chansky's " Freeing Your Child From OCD " or something

like that. It is possible to learn how to do it on

your own with your child (if you read enuf books). A

good therapist is preferable at least for a while but

the parent needs to learn how to do it at home in

between sessions because the home is where most of the

problems arise.

One of the hardest parts may be changing our own

behavior (of enabling). There are all kinds of things

I do for my son that he should be able to do for

himself and I constantly fight this tendency .

Re-assuring our kids alot (about whatever there fears

are) is also enabling.

OCD was originally called the " doubting disease "

because sufferers pretty much all want absolute

certainty about things

--am I SURE the door is locked

--am I SURE there are no germs on my hands

--am I SURE I won't kill someone with that knife

--am I SURE I did all my homework perfectly

--am I SURE I washed every single germ off my body in

the shower

--even tho I KNOW it's ridiculus to think my parents

will die in a car accident if I don't do certain

things everytime I go through a doorway -- am I SURE

that if I don't do them they will be all right?

The adult sufferers on the site who have done serious

Exposure Therapy for OCD say it is quite painful to do

the therapy -- to not do what the " OCD Monster " is

telling them to do. This is because the monster

targets those things which the person holds most dear.

It tricks them by saying (for example) " your mother

will die if you don't do what I am telling you to do " ,

but the ones who have really done it say it is

definitely worth it in the long run.

But it is a specific type of CBT called ERP. It's

pretty common sense if you think about it. Face your

fears. If you give in to them they will probably get

worse.

Like maybe: they pay some attention to how others

don't worry about germs very much at all and they

survive