Inference-Based CBT: A Powerful Tool for Treating the Core of OCD

As a CBT therapist specializing in Inference-Based Cognitive Behavioral Therapy (I-CBT), I’ve witnessed firsthand how this approach can transform lives for people struggling with Obsessive-Compulsive Disorder (OCD). While traditional CBT techniques such as Exposure and Response Prevention (ERP) have their place, I-CBT offers a unique potential to unravel the very heart of OCD’s persistent grip.

OCD: Going Beyond Fear and Risk

While OCD is often associated with fear, it’s crucial to recognize the insidious role of doubt and distorted inferences. Individuals with OCD don’t just fear something bad happening; they wrestle with deep-rooted, nagging beliefs, such as “If I don’t check the stove 20 times, my house might burn down,” even if logic suggests otherwise. These faulty inferences fuel the relentless cycle of obsessions and compulsions.

The Power of Inference-Based CBT

I-CBT empowers you to overcome your OCD by focusing on:

  • Understanding Inferences: Together, we examine the logic behind obsessive thoughts. You will become an expert at understanding the chain of inferences that lead to the point of no longer trusting your senses, but instead finding yourself in “inferential confusion.”
  • Learn to doubt the doubt:  There are “normal” doubts, and “obsessional” doubts.  We show you how to understand the difference and make the decision to stay in the world of your senses, sense of self and common sense, rather than getting swept into the OCD narrative.
  • Understand the OCD Con-artist: If we leave the world of the senses and enter the OCD bubble, OCD will use all sorts of thinking errors and distortions to keep you there.  I’ll help you to recognise when OCD is playing it’s tricks.
  • Embracing Sensory Evidence: I-CBT emphasizes learning to trust our senses. Did you actually see evidence to support the doubt, or is imagination filling the gaps? This breaks the unhealthy reliance on endless mental checking.
  • Living with Possibility: No one can achieve absolute certainty. We work on patients accepting the presence of remote possibilities without feeling compelled to perform rituals to try and eliminate them.
  • The Vulnerable self theme vs the real self: OCD generates a story about the type of person that you fear becoming.  It is this powerful story that leads to you depending on using your compulsions, “just in case.”  I’ll teach you how to understand your vulnerable self theme, recognise when it’s influencing your thinking and behaviour, and how to develop a more realistic, and more trustworthy, perception of your self.

I-CBT vs. CBT vs Exposure and response prevention (ERP)

All of the above treatments have been shown to be effective.  However, not every treatment is suitable for every client.  Rather than feeling that “therapy doesn’t work for me”, or worry about “doing therapy right”, it’s good to know that you have options for OCD treatment.  Here are some basic distinctions between the different types of OCD therapy.  Both ERP and I-CBT are valuable in OCD treatment. However:

  • CBT:  Targets the beliefs about what intrusive thoughts actually mean, through a series of reality testing experiments and cognitive restructuring.
  • and ERP: Focuses mainly on fear reduction through in-vivo and imaginal exposure.
  • I-CBT: Targets the narrative components of OCD, which make it such a compelling, reasonable story to listen to, at the cost of trusting our senses and sense of self.

As a specialist in OCD I offer all of the above approaches, but I do find myself increasingly using I-CBT, certainly in cases when people have already experienced ERP or CBT for their OCD.  It’s another, incredibly effective tool in my OCD treatment repertoire.

If you are interested in trying out I-CBT for your OCD, then feel free to contact me at [email protected].

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