As I’ve mentioned many times before, ERP (Exposure Response Prevention) Therapy is the treatment of choice for OCD. However, a new acronym has recently made its way into the “OCD tool box.” Basically, ACT (Acceptance and Commitment Therapy) involves mindfulness and being able to accept your actions, as well as exploring your commitment to making changes. Think Serenity Prayer.
In a wonderful seminar at the 2012 IOCDF Conference, Dr. Jonathan Grayson discussed what is seen by many as competing therapies. He argued that the two therapies are really not at odds with one another, and that ACT is actually woven into ERP Therapy. Participating in an exposure involves acceptance. According to Dr. Grayson, the problem occurs when therapists use ACT without ERP.
ACT involves a top-down approach, where the sufferer works on changing his or her relationship with the whole world. While this therapy can certainly complement ERP Therapy, Dr. Grayson prefers starting with ERP Therapy, which is a bottom-up approach that specifically targets OCD. He used the analogy of an alcoholic working on his or her life’s problems while still drinking. It isn’t going to work. You’ve got to get the drinking under control and then you can move forward.
Surely, ACT can help those who suffer from OCD. For example, it can help with the acceptance of uncertainty, which is crucial in the treatment of the disorder. It can motivate sufferers who are engaging in ERP Therapy by helping them focus on their values, and what they want out of their lives. ACT has its place in the treatment of obsessive-compulsive disorder, and may even work as the main treatment for other mental health issues.
But OCD is unique, and the treatment for it is very specific. At this particular talk, and throughout the entire conference, this fact was stressed over and over: Exposure Response Prevention Therapy is the accepted treatment for OCD, and when done correctly, it works. While other therapies may have benefits as well, if you want to rid yourself of OCD’s grip, ERP Therapy is the way to go. And while it’s not easy, I don’t know of anyone who has ever regretted committing themselves fully to it. The payback is huge…..freedom from OCD.