The use of mindfulness in obsessive compulsive disorder: suggestions for its application and integration in existing treatment

Abstract

Treatment for obsessive-compulsive disorder (OCD) is a standard activity of psychologists, particularly those in Community Mental Health Teams (CMHT). In 2005, NICE published guidelines recommending Cognitive Behavioural Therapy (CBT) with Exposure and Response Prevention (ER-P) as the evidence-based psychological treatments of choice. In recent years there have been significant developments within cognitive behavioural theory, including what has been referred to as the 'Third Wave'. This paper explores the contribution of mindfulness; a practice that has previously been integrated into other CBT models of treatment, to cognitive interventions in OCD, suggesting that in complements both CBT and ER-However it had previously been suggested by Freeston that mindfulness may prevent successful ER-P by becoming a neutralising technique. Examples of the application of a mindfulness-based approach are explored (MOCD), including reference to an OCD group run by the author, and areas of potential overlap are identified, in particular thought-action Fusion. It is concluded that if applied properly, mindfulness not only complements traditional CBT interventions, but could also increase their efficacy and perhaps prevent relapse.

Dysfunctional Metacogntive Beliefs in Body Dysmorphic Disorder

“…Findings showed that BDD has a significant positive relationship with thought fusion, metaworry, and dysfunctional metacognition, which is consistent with previous studies [7,9,[19][20][21][22].…”

Psychotherapeutic practitioners’ views of the efficacy of mindfulness for the treatment of obsessive compulsive disorder: A qualitative key informant analysis

“…This 'middle way' approach for OCD that can balance the promotion of change (through CBT) and the promotion of acceptance (through mindfulness) accords with research into the use of mindfulness to improve the long-term effects of CBT. For instance, in line with the present study's findings, Fairfax (2008) proposed that mindfulness, in conjunction with cognitive therapy, could act therapeutically by disconnecting the TAF mechanism as well as helping the individual with OCD to accept the 'self-as-is'.…”

“…This accessible model of intervention invites individuals to exert conscious attention on their behaviour and thought processes to bring about change (Leary, Adams, & Tate, 2006). It has been effective in diminishing overt compulsions that often occur in response to obsessions (Fairfax, 2008). However it fails to provide a positive treatment outcome for between a third and half of mental health service users with OCD (Schruers, Koning, Luermans, Haack, & Griez, 2005).…”

Is mindfulness‐based therapy an effective intervention for obsessive–intrusive thoughts: a case series

“…Fairfax (2008) highlights how mindfulness may provide an alternative way for people to relate to distressing intrusive thoughts, normalising such thoughts and breaking the link to unhelpful automatic responding (i.e., compulsive behaviours). As such, mindfulness could help people experiencing obsessions and compulsions feel more in control of thinking and behaving and could increase insight into the metacognitive processes maintaining their difficulties.…”

“…As such, mindfulness could help people experiencing obsessions and compulsions feel more in control of thinking and behaving and could increase insight into the metacognitive processes maintaining their difficulties. Equally, Fairfax (2008) argues that using a mindfulness-based approach which emphasizes non-judgment may help to address self-censorship due to fear of humiliation in therapy for OCD and may subsequently increase the therapeutic alliance. An additional benefi t may be the fact that mindfulness could help people to experience the anxiety provoked by obsessive-intrusive thoughts without judging it or trying to avoid the experience (Shapiro et al, 2006), thus supporting ERP techniques (Fairfax, 2008).…”