Obsessive Compulsive Disorder

Mindfulness Improves Obsessive Compulsive Disorder as well as Drug Treatment

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Mindfulness Improves Obsessive Compulsive Disorder as well as Drug Treatment

 

By John M. de Castro, Ph.D.

 

“most OCD sufferers I know who practice mindfulness find it very helpful in fighting their disorder. To be able to focus on what is really happening in any given moment, as opposed to dwelling on the past or anticipating the future, takes away the power of OCD.” – Janet Singer

 

Obsessive-Compulsive Disorder (OCD) sufferers have repetitive anxiety producing intrusive thoughts (obsessions) that result in repetitive behaviors to reduce the anxiety (compulsions). In a typical example of OCD, the individual is concerned about germs and is unable to control the anxiety that these thoughts produce. Their solution is to engage in ritualized behaviors, such as repetitive cleaning or hand washing that for a short time relieves the anxiety. The obsessions and compulsions can become so frequent that they become a dominant theme in their lives. Hence OCD drastically reduces the quality of life and happiness of the sufferer and those around them. About 2% of the population, 3.3 million people in the U.S., are affected at some time in their life.

 

Fortunately, Obsessive-Compulsive Disorder (OCD) can be treated. Mindfulness training including Mindfulness-Based Cognitive Therapy (MBCT) has been shown to be effective in treating OCD.  A therapeutic technique that contains mindfulness training and Cognitive Behavioral Therapy (CBT) is Acceptance and Commitment Therapy (ACT). It focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes. This suggests that ACT may be an effective treatment for obsessive-compulsive disorder (OCD),

 

In today’s Research News article “A randomized clinical trial: Comparison of group acceptance and commitment therapy with drug on quality of life and depression in patients with obsessive-compulsive disorder.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8943588/ ) and colleagues recruited patients with Obsessive-Compulsive Disorder (OCD) and either treated them with drugs (SSRIs) or with Acceptance and Commitment Therapy (ACT) twice weekly for 1 hour for 4 weeks. They were measured before and after treatment and 3 months later for depression, anxiety, perceived stress, and quality of life.

 

They found that in comparison to baseline both groups had significant decreases in depression and significant increases in quality of life and these improvements were maintained the 3-month follow-up. Hence, Mindfulness training is as effective as drugs in treating Obsessive-Compulsive Disorder (OCD).

 

Since mindfulness training, unlike drugs, doesn’t have significant side effects, it would appear to be the preferred treatment for Obsessive-Compulsive Disorder (OCD),

 

“The struggle of the OCD sufferer is one in which certain internal experiences (thoughts, etc.) are viewed as unacceptable, whereas others are allowed to pass by without critique. Mindfulness suggests a different perspective on the presence of these internal experiences, that they be simply noticed, not judged or pushed away.” – Sheppard Pratt

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Ebrahimi, A., Nasre Esfahan, E., Akuchekian, S., Izadi, R., Shaneh, E., & Mahaki, B. (2022). A randomized clinical trial: Comparison of group acceptance and commitment therapy with drug on quality of life and depression in patients with obsessive-compulsive disorder. Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences, 27, 9. https://doi.org/10.4103/jrms.jrms_449_21

 

Abstract

Background:

Acceptance and commitment therapy (ACT) is one of the newest treatment strategies that has been developed rapidly to improve the treatment of patients with obsessive–compulsive disorder (OCD). The aim of this study was to evaluate and compare the effect of ACT and selective serotonin reuptake inhibitors (SSRIs) drugs on the severity of depression symptoms and quality of life (QOL) in obsessive–compulsive patients.

Materials and Methods:

A randomized clinical trial with a control group was conducted including 27 patients with OCD. Based on the Diagnostic and Statistical Manual of Mental Disorders-5 criteria for OCD diagnosis, participants were recruited from Tamasha Counseling Center and obsessive–compulsive clinic in the Psychosomatic Research Center in Isfahan, Iran. Selected patients were allocated to two groups (14 in ACT the group and 13 in the drug group with SSRI with a simple random sampling method. ACT group was treated by an ACT therapist in eight 1-h sessions. Data were collected by the World Health Organization QOL Questionnaire (WHOQOL-BREF) and Depression subscale of DASS-42 at admission, after the intervention, and 3 months thereafter. Therapists and evaluators were blind to each other’s work. Data were analyzed using analysis of variance with repeated measures method using IBM SPSS Statistics software (V 23, IBM Corporation, Armonk, NY, USA).

Results:

Results revealed that both treatments (ACT and SSRIs drug therapy) had significant impacts on reducing depression subscales scores and increasing WHOQOL-BREF scores at posttreatment (P < 0.05). There were no significant differences in QOL scores between the two groups after the intervention and follow-up (P > 0.05). Nevertheless, drug therapy presented a significantly greater improvement in depression scores of patients than those resulting from ACT (P = 0.005). The persistence of treatment effects continued after 3 months (follow-up) in both groups.

Conclusion:

ACT is equal to SSRIs drug therapy in terms of improving QOL in patients with OCD. However, SSRIs are more effective in treating depression in obsessive–compulsive patients. It may be presumed that ACT without any chemical side effect is equal to drug and is preferred for patients who either cannot use drugs or prefer not to have a drug treatment.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8943588/

 

Improve Neuropsychological Disorders with Yoga

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Improve Neuropsychological Disorders with Yoga

 

By John M. de Castro, Ph.D.

 

“yoga might be considered as an effective adjuvant for the patients with various neurological disorders including stroke, Parkinson’s disease, multiple sclerosis, epilepsy, Alzheimer’s disease, dementia, headache, myelopathy, neuropathies.” – A.Mooventhan

 

Mindfulness training and yoga practices have been shown to improve health and well-being in healthy individuals. They have also been found to be effective for a large array of medical and psychiatric conditions, either stand-alone or in combination with more traditional therapies. There has accumulated a large amount of research on the effectiveness of yoga practice for the treatment of a variety of physical and mental issues. Hence, it would be useful to summarize what has been learned.

 

In today’s Research News article “Therapeutic role of yoga in neuropsychological disorders.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8546763/ ) Nourollahimoghadam and colleagues review and summarize the published research regarding the effectiveness of yoga practice for the treatment of a variety of neuropsychological disorders.

 

They report that the published research found that yoga practice produced significant improvements in physical illnesses including migraine headaches, Alzheimer’s Disease, epilepsy, multiple sclerosis, Parkinson’s Disease, and neuropathy. Yoga practice also produced significant improvements in psychological well-being including anxiety, stress, depression, bipolar disorder, schizophrenia, somatoform disorders, obsessive-compulsive disorder, and burnout. They further report that yoga may produce its beneficial effects by altering the chemistry, electrical activity, structures, and connectivity within the brain.

 

Hence Yoga practice appears to have a myriad of positive physical and psychological benefits. The authors, however, point to weaknesses in the research including small sample sizes, short-term follow-up, confounding variables, and lack of appropriate controls. So, more and better controlled studies are needed to verify the benefits of yoga practice. Hence, the present state of knowledge supports the engagement in yoga practice to advance the physical and mental well-being of both ill and healthy individuals.

 

So, improve neuropsychological disorders with yoga.

 

“Yoga can be a helpful practice of self-care for people with multiple sclerosis (MS) and other neurological conditions (such as stroke, traumatic brain injury, Parkinson’s disease, Lyme’s disease, Lou Gehrig’s disease).” – Mary Hilliker

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on on Twitter @MindfulResearch

 

Study Summary

 

Nourollahimoghadam, E., Gorji, S., Gorji, A., & Khaleghi Ghadiri, M. (2021). Therapeutic role of yoga in neuropsychological disorders. World journal of psychiatry, 11(10), 754–773. https://doi.org/10.5498/wjp.v11.i10.754

 

Abstract

Yoga is considered a widely-used approach for health conservation and can be adopted as a treatment modality for a plethora of medical conditions, including neurological and psychological disorders. Hence, we reviewed relevant articles entailing various neurological and psychological disorders and gathered data on how yoga exerts positive impacts on patients with a diverse range of disorders, including its modulatory effects on brain bioelectrical activities, neurotransmitters, and synaptic plasticity. The role of yoga practice as an element of the treatment of several neuropsychological diseases was evaluated based on these findings.

Core Tip: A multitude of beneficial effects of yoga practice and the underlying mechanisms of action have been reported and point out its role as an influential element in the integrative therapy of various neuropsychological disorders. In the planning of further investigations, studies should be designed to achieve more accuracy and precision in the heterogeneous field of yoga practices and potential fields of application.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8546763/

 

Hallucinogenic Drugs may Effectively Treat Mental Illness

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Hallucinogenic Drugs may Effectively Treat Mental Illness

 

By John M. de Castro, Ph.D.

 

“Combined with psychotherapy, some psychedelic drugs like MDMA, psilocybin and ayahuasca may improve symptoms of anxiety, depression and post-traumatic stress disorder,” – Cristina L. Magalhaes

 

Psychedelic substances such as peyote, mescaline, LSD, Bufotoxin, ayahuasca and psilocybin 

have been used almost since the beginning of recorded history to alter consciousness and produce spiritually meaningful experiences. More recently hallucinogenic drugs such as MDMA (Ecstasy) and Ketamine have been similarly used. People find the experiences produced by these substances extremely pleasant. eye opening, and even transformative. They often report that the experiences changed them forever. Psychedelics and hallucinogens have also been found to be clinically useful as they markedly improve mood, increase energy and enthusiasm and greatly improve clinical depression. The research on the effectiveness of these drugs on mood and mental illness is accumulating. So, it makes sense to step back and summarize what has been learned.

 

In today’s Research News article “.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7880300/ ) De Gregorio and colleagues review and summarize the published research on the brain mechanisms of hallucinogenic drug actions and their effectiveness as treatments for mental illness.

 

They report that the different drugs have very different effects on the nervous system although most interact with serotonin receptors. The nervous systems effects appear to alter sensory integration and associations with these sensations resulting in altered experiences.

 

They also report that the published research suggests that psilocybin may be useful in treating anxiety, depression, alcohol abuse, and obsessive-compulsive disorder (OCD), LSD may relieve anxiety and depression, that Ketamine may improve major depressive disorder, and MDMA (Ecstasy) may help in the treatment of post-traumatic stress disorder. Hence, psychedelic and hallucinogenic drugs may be effective in treating mental illness. It needs to be kept in mind that these drugs have powerful effects so they must be administered in controlled environments by trained practitioners.

 

So, hallucinogenic drugs may effectively treat mental illness.

 

“Most powerful substances that we know of, that have powerful effects on the central nervous system, are like any powerful tool, They can have dangerous effects, or beneficial effects, if judiciously used in a context where the dangers are known and mechanisms are in place to address them.” – Matthew Johnson

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

De Gregorio, D., Aguilar-Valles, A., Preller, K. H., Heifets, B. D., Hibicke, M., Mitchell, J., & Gobbi, G. (2021). Hallucinogens in Mental Health: Preclinical and Clinical Studies on LSD, Psilocybin, MDMA, and Ketamine. The Journal of neuroscience : the official journal of the Society for Neuroscience, 41(5), 891–900. https://doi.org/10.1523/JNEUROSCI.1659-20.2020

 

Abstract

A revamped interest in the study of hallucinogens has recently emerged, especially with regard to their potential application in the treatment of psychiatric disorders. In the last decade, a plethora of preclinical and clinical studies have confirmed the efficacy of ketamine in the treatment of depression. More recently, emerging evidence has pointed out the potential therapeutic properties of psilocybin and LSD, as well as their ability to modulate functional brain connectivity. Moreover, MDMA, a compound belonging to the family of entactogens, has been demonstrated to be useful to treat post-traumatic stress disorders. In this review, the pharmacology of hallucinogenic compounds is summarized by underscoring the differences between psychedelic and nonpsychedelic hallucinogens as well as entactogens, and their behavioral effects in both animals and humans are described. Together, these data substantiate the potentials of these compounds in treating mental diseases.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7880300/

 

Improve Unmedicated Obsessive-Compulsive Disorder with Mindfulness

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Improve Unmedicated Obsessive-Compulsive Disorder with Mindfulness

 

By John M. de Castro, Ph.D.

 

“a growing pool of research coming out over the last few years suggests that those who are adding mindfulness into treatment for OCD are on the right track.” – John Hershfield

 

Obsessive-Compulsive Disorder (OCD) sufferers have repetitive anxiety producing intrusive thoughts (obsessions) that result in repetitive behaviors to reduce the anxiety (compulsions). In a typical example of OCD, the individual is concerned about germs and is unable to control the anxiety that these thoughts produce. Their solution is to engage in ritualized behaviors, such as repetitive cleaning or hand washing that for a short time relieves the anxiety. The obsessions and compulsions can become so frequent that they become a dominant theme in their lives. Hence OCD drastically reduces the quality of life and happiness of the sufferer and those around them. About 2% of the population, 3.3 million people in the U.S., are affected at some time in their life.

 

Fortunately, Obsessive-Compulsive Disorder (OCD) can be treated, and many respond to Cognitive Behavioral Therapy (CBT). But some do not. Mindfulness training has been shown to be effective in treating OCD. Mindfulness-Based Cognitive Therapy (MBCT) involves the combination of mindfulness training and cognitive behavioral therapy. It contains sitting, walking and body scan meditations, and cognitive therapy that is designed to alter how the patient relates to the thought processes that often underlie and exacerbate psychological symptoms. MBCT has been shown to reduce anxiety. So, it makes sense to examine the effectiveness of MBCT for Obsessive-Compulsive Disorder (OCD).

 

In today’s Research News article “Mindfulness-Based Cognitive Therapy for Unmedicated Obsessive-Compulsive Disorder: A Randomized Controlled Trial With 6-Month Follow-Up.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8369060/ ) Zhang and colleagues recruited adults diagnosed with Obsessive-Compulsive Disorder (OCD) and randomly assigned them to receive either drugs (SSRIs), or 10 weekly 150-minute sessions of Mindfulness-Based Cognitive Therapy (MBCT) or an active placebo control treatment, containing education about OCD, group support, and relapse prevention. They were measured before and after treatment and 6 months later for mindfulness, anxiety, depression, social function, and Obsessive-Compulsion severity.

 

They found that in comparison to baseline and the active placebo control group, both the drugs (SSRIs) and Mindfulness-Based Cognitive Therapy (MBCT) groups had significant improvements in Obsessive-Compulsion severity. But the differences were no longer significant at the 6-month follow-up where all groups were significantly improved. All groups had significant improvements in anxiety and depression that were maintained at the 6-month follow up.

 

These are interesting results that show that drugs (SSRIs) and Mindfulness-Based Cognitive Therapy (MBCT)  improve OCD severity after treatment to a greater extent than the placebo group. But 6 months after treatment all groups had equivalent significant improvements on OCD and all groups had significant reductions in anxiety and depression at all post-treatment time points. In other words, drugs, MBCT, and placebo are all effective in improving the symptoms of OCD patients. But drugs and MBCT are slightly more effective immediately after treatment. This suggests that regardless of the actual treatment, OCD is improved if the patients believe that the treatment will improve their symptoms.

 

So, improve unmedicated obsessive-compulsive disorder with mindfulness

 

“Mindfulness requires you to be aware of intrusive thoughts or triggers, accept and possibly internally analyze any discomforts caused by such thoughts and resist the urge to respond with compulsions.” – NOCD

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Zhang, T., Lu, L., Didonna, F., Wang, Z., Zhang, H., & Fan, Q. (2021). Mindfulness-Based Cognitive Therapy for Unmedicated Obsessive-Compulsive Disorder: A Randomized Controlled Trial With 6-Month Follow-Up. Frontiers in psychiatry, 12, 661807. https://doi.org/10.3389/fpsyt.2021.661807

 

Abstract

Background: This was the first randomized controlled trial (RCT) designed to compare the efficacy of mindfulness-based cognitive therapy (MBCT) on unmedicated obsessive-compulsive disorder with that of the first-line treatment for OCD (SSRIs) or a placebo, as well as to analyze the treatment acceptability and safety of MBCT.

Methods: A total of 123 unmedicated OCD patients with mild to moderate symptoms were randomly assigned into selective serotonin reuptake inhibitors group (SSRIs group), MBCT group or psycho-education group (PE group), respectively. They were intervened for 10 weeks. The Yale–Brown Obsessive-Compulsive Scale (Y-BOCS) grade was the primary outcome, and Hamilton Depression Scale-24 (HAMD-24) and Hamilton Anxiety Scale (HAMA) grades were secondary outcomes to be measured at baseline, mid-intervention, post-intervention and 14, 22, and 34 weeks of follow-up. The Five Facet Mindfulness Questionnaire (FFMQ) and Sheehan Disability Scale (SDS) were used to assess mindfulness and social functions, respectively. In addition, treatment acceptability (dropout rate and frequency of occurrence) and safety [adverse event (AE)] of MBCT were investigated.

Results: Significant differences were detected in the treatment responses among SSRIs group, MBCT group and PE group. Notably, treatment responses were significantly better in the former two groups than that of PE group (χ2 = 6.448, p = 0.04), although we did not identify significant differences between SSRIs group and MBCT group (χ2 = 1.220, p = 0.543). Observed until 6 months of follow-up, there were no significant differences in treatment response among three groups. No AE was recorded in MBCT group.

Conclusion: MBCT is effective in the treatment of unmedicated OCD with mild to moderate symptoms comparable to that of SSRIs, which contributes to maintain the treatment outcomes at follow-up. Besides, MBCT is safe with a good clinical compliance.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8369060/

 

Improve Treatment Resistant Obsessive-Compulsive Disorder with Compassion-Focused Therapy

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Improve Treatment Resistant Obsessive-Compulsive Disorder with Compassion-Focused Therapy

 

By John M. de Castro, Ph.D.

 

“A big part of learning to live with OCD is to incorporate self-compassion. Instead of avoiding your anxiety, self-compassion invites you to look at it with understanding and gentle curiosity. This approach allows you to see your pain exactly how it is without self-judgment or self-criticism.” – Nancy Larsen

 

Obsessive-Compulsive Disorder (OCD) sufferers have repetitive anxiety producing intrusive thoughts (obsessions) that result in repetitive behaviors to reduce the anxiety (compulsions). In a typical example of OCD, the individual is concerned about germs and is unable to control the anxiety that these thoughts produce. Their solution is to engage in ritualized behaviors, such as repetitive cleaning or hand washing that for a short time relieves the anxiety. The obsessions and compulsions can become so frequent that they become a dominant theme in their lives. Hence OCD drastically reduces the quality of life and happiness of the sufferer and those around them. About 2% of the population, 3.3 million people in the U.S., are affected at some time in their life.

 

Fortunately, Obsessive-Compulsive Disorder (OCD) can be treated and many respond to Cognitive Behavioral Therapy (CBT). But some do not. Mindfulness training has been shown to be effective in treating OCD. One understudied meditation technique is Compassion -Focused Therapy. It is designed to develop kindness and compassion to oneself and others. On the face of it learning self-compassion would seem to be useful in dealing with OCD. But there is little empirical evidence.

 

In today’s Research News article “Compassion-Focused Group Therapy for Treatment-Resistant OCD: Initial Evaluation Using a Multiple Baseline Design.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7835278/ ) Petrocchi and colleagues recruited patients with Obsessive-Compulsive Disorder (OCD) who had received 6-months of Cognitive Behavioral Therapy (CBT) and still have significant residual OCD symptoms. They received 8 weekly 2-hour sessions of Compassion-Focused Therapy after varying periods of baseline (Multiple Baseline Research Design). The treatment consisted of training in meditation and visualization practices during sessions and at home. It is designed to replace self-criticism with self-compassion. Before and after training and 1 month later they were measured for OCD symptom severity, OCD symptom presence and distress, depression, fear of guilt, self-criticizing, self-attacking, self-reassuring, and self-compassion.

 

They found that the patients all had large improvements in Obsessive-Compulsive Disorder (OCD) symptoms that were maintained at the 1-month follow-up. They also found significant improvements in fear of guilt, self-criticism, and self-reassurance. In additions, there were less reliable improvements in depression and common humanity. Hence, Compassion-Focused Therapy improved the symptom of OCD in patients who didn’t respond to Cognitive Behavioral Therapy (CBT).

 

These are important preliminary findings that must be followed up with a large randomized controlled trial. But these results suggest that Compassion-Focused Therapy may be effective in treating Obsessive-Compulsive Disorder (OCD) symptoms in patients who do not respond to the gold standard treatment of Cognitive Behavioral Therapy (CBT). The results may suggest that CBT should incorporate Compassion-Focused training when being employed to treat OCD. This should be explored in future studies.

 

So, improve treatment resistant obsessive-compulsive disorder with compassion-focused therapy.

 

“people with OCD may feel better if they remind themselves that it is normal to worry, and that it is not their fault if their OCD symptoms get worse.” –  Jessica Caporuscio

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Petrocchi, N., Cosentino, T., Pellegrini, V., Femia, G., D’Innocenzo, A., & Mancini, F. (2021). Compassion-Focused Group Therapy for Treatment-Resistant OCD: Initial Evaluation Using a Multiple Baseline Design. Frontiers in psychology, 11, 594277. https://doi.org/10.3389/fpsyg.2020.594277

 

Abstract

Obsessive–compulsive disorder (OCD) is a debilitating mental health disorder that can easily become a treatment-resistant condition. Although effective therapies exist, only about half of the patients seem to benefit from them when we consider treatment refusal, dropout rates, and residual symptoms. Thus, providing effective augmentation to standard therapies could improve existing treatments. Group compassion-focused interventions have shown promise for reducing depression, anxiety, and avoidance related to various clinical problems, but this approach has never been evaluated for OCD individuals. However, cultivating compassion for self and others seems crucial for OCD patients, given the accumulating research suggesting that fear of guilt, along with isolation and self-criticism, can strongly contribute to the development and maintenance of OCD. The primary aim of this pilot study was to evaluate the acceptability, tolerability, and effectiveness of an 8-week group compassion-focused intervention for reducing OCD symptoms, depression, fear of guilt and self-criticism, and increasing common humanity and compassionate self-reassuring skills in treatment-resistant OCD patients. Using a multiple baseline experimental design, the intervention was evaluated in a sample of OCD patients (N = 8) who had completed at least 6 months of CBT treatment for OCD, but who continued to suffer from significant symptoms. Participants were randomized to different baseline assessment lengths; they then received 8 weekly, 120-min group sessions of compassion-focused therapy for OCD (CFT-OCD), and then were tested again at post-treatment and at 1 month follow up. Despite the adverse external circumstances (post-treatment and follow-up data collection were carried out, respectively, at the beginning and in the middle of the Italian lockdown due to the COVID-19 pandemic), by the end of treatment, all participants demonstrated reliable decreases in OCD symptoms, and these improvements were maintained at 4-week follow-up for seven of eight participants. The intervention was also associated with improvements in fear of guilt, self-criticism, and self-reassurance, but less consistent improvements in depression and common humanity. Participants reported high levels of acceptability of and satisfaction with the intervention. Results suggest that the intervention may be beneficial as either a stand-alone treatment or as an augmentation to other treatments.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7835278/

 

Distress Is Lower during a COVID-19 Pandemic Lockdown in Mindful People

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Distress Is Lower during a COVID-19 Pandemic Lockdown in Mindful People

 

By John M. de Castro, Ph.D.

 

“During the current pandemic, there is so much uncertainty concerning the future, and many threats to our security (physical, social, emotional, and financial). It is totally natural and normal to feel anxious, fearful, and frustrated. . . Mindfulness can help us acknowledge this situation, without allowing us to be carried away with strong emotions; it can, in turn, help bring ourselves back to a centered calm. Only then can we see more clearly what it is we have control over and what it is that we do not.” – Michigan Medicine

 

Modern living is stressful under the best of conditions. But with the COVID-19 pandemic the levels of stress have been markedly increased. These conditions markedly increase anxiety. This is true for everyone but especially for healthcare workers and people caring for patients with COVID-19 and for people with pre-existing conditions that makes them particularly vulnerable. But it is also true for healthy individuals who worry about infection for themselves or loved ones.

 

The COVID-19 pandemic has also produced considerable economic stress, with loss of employment and steady income. For the poor this extends to high levels of food insecurity. This not only produces anxiety about the present but also for the future. It is important for people to engage in practices that can help them control their responses to the stress and their levels of anxiety. Mindfulness practices have been found routinely to reduce the psychological and physiological responses to stress, reduce anxiety levels, and improve mood.

 

In today’s Research News article “Mindfulness, Age and Gender as Protective Factors Against Psychological Distress During COVID-19 Pandemic.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2020.01900/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1437459_69_Psycho_20200922_arts_A ) Conversano and colleagues solicited adult participants online during a government ordered lockdown and had them complete measures of COVID-19 experiences, mindfulness, psychological distress, and mental illness symptoms.

 

They found strong negative relationships between mindfulness and psychological distress. They found that the higher the levels of mindfulness the lower the levels of psychological distress including somatic symptoms, symptoms of obsessive-compulsive disorder, internalizing symptoms, depression, anxiety, hostility, phobia, paranoia, psychoticism, and sleep disturbance. They also found weak relationships with age and gender such that younger and female participants tended to have higher psychological distress.

 

It needs to be kept in mind that these results are correlational and as such causation cannot be determined. Mindfulness may produce reduced distress or conversely distress may produce reduced mindfulness or some third factor may produce both. Nevertheless, the results show that during a pandemic lockdown that the people who have high levels of mindfulness also have low levels of psychological distress.

 

So, distress is lower during a COVID-19 pandemic lockdown in mindful people.

 

“In many ways, COVID-19 has shown us just how connected and how much the same we really are. All of us—and some of us more than others—are vulnerable to getting sick and none of us wants to become ill. Viewed through the lens of interconnectedness, practicing mindfulness as the coronavirus spreads is not only a way to care for ourselves but a way to care for everyone around us.” – Kelly Baron

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Conversano C, Di Giuseppe M, Miccoli M, Ciacchini R, Gemignani A and Orrù G (2020) Mindfulness, Age and Gender as Protective Factors Against Psychological Distress During COVID-19 Pandemic. Front. Psychol. 11:1900. doi: 10.3389/fpsyg.2020.01900

 

Objective: Mindfulness disposition is associated with various psychological factors and prevents emotional distress in chronic diseases. In the present study, we analyzed the key role of mindfulness dispositions in protecting the individual against psychological distress consequent to COVID-19 social distancing and quarantining.

Methods: An online survey was launched on March 13, 2020, with 6,412 responses by April 6, 2020. Socio-demographic information, exposure to the pandemic, and quarantining were assessed together with psychological distress and mindfulness disposition. Multivariate linear regression analysis was performed to study the influence of predictive factors on psychological distress and quality of life in Italian responders during the early days of lockdown. Pearson correlations were calculated to study the relationship between mindfulness and psychiatric symptoms.

Results: Multivariate linear regression run on socio-demographics, COVID-19-related variables, and mindfulness disposition as moderators of overall psychological distress showed that mindfulness was the best predictor of psychological distress (β = −0.504; p < 0.0001). High negative correlations were found between mindfulness disposition and the overall Global Severity Index (r = −0.637; p < 0.0001), while moderate to high associations were found between mindfulness and all SCL-90 sub-scales.

Discussion: Findings showed that high dispositional mindfulness enhances well-being and helps in dealing with stressful situations such as the COVID-19 pandemic. Mindfulness-based mental training could represent an effective intervention to stem post-traumatic psychopathological beginnings and prevent the onset of chronic mental disorders.

https://www.frontiersin.org/articles/10.3389/fpsyg.2020.01900/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1437459_69_Psycho_20200922_arts_A

 

Improve Mental Health with Yoga

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Improve Mental Health with Yoga

 

By John M. de Castro, Ph.D.

 

“for many patients dealing with depression, anxiety, or stress, yoga may be a very appealing way to better manage symptoms. . . The evidence is growing that yoga practice is a relatively low-risk, high-yield approach to improving overall health.” – Harvard Health

 

Mindfulness practice has been shown to improve emotions and their regulation. Practitioners demonstrate more positive and less negative emotions and the ability to fully sense and experience emotions, while responding to them in appropriate and adaptive ways. The ability of mindfulness training to improve emotion regulation is thought to be the basis for a wide variety of benefits that mindfulness provides to mental health and the treatment of mental illness especially depression and anxiety disorders.

 

Exercise has also been shown to improve mental health. Yoga is both a mindfulness practice and an exercise. It has been shown to have a myriad of benefits for psychological and physical health, social, and spiritual well-being. There has accumulated a wealth of research studies of the effects of yoga practice on mental health. It makes sense to take a look at what has been learned. In today’s Research News article “Applications of Yoga in Psychiatry: What We Know.” (See summary below or view the full text of the study at:), Nyer and colleagues review and summarize the published research studies of the effectiveness of yoga practice and exercise for the treatment of psychological problems.

 

They report that the published research studies found that there was a powerful effect of yoga practice on depression, including major depressive disorders, even in patients who did not respond to antidepressant drugs. They also report that yoga practice is a safe and effective treatment for anxiety disorders, including generalized anxiety disorder, obsessive-compulsive disorder, and post-traumatic stress disorder, PTSD.

 

They report that the research postulates a number of potential mechanisms for yoga’s ability to improve depressive and anxiety disorders. These disorders are associated with an imbalance in the autonomic nervous system such that sympathetic activity, activation, predominates over parasympathetic activity, relaxation. Yoga practice has been shown to rebalance these systems, strengthening parasympathetic activity. Also, high levels of perceived stress have also been found to be associated with depressive and anxiety disorders and yoga practice has been shown to reduce perceived stress levels. In addition, depressive and anxiety disorders are characterized by excessive emotions and yoga practice has been found to improve the individual’s ability to regulate their emotions. These are thought to be a potential explanations for yoga’s effectiveness.

 

So, improve mental health with yoga.

 

“In Sanskrit, yoga means to unite. As you grow in your ability to sense the relationship between your mind and body, you become more aware of dualities that exist in experience. The practice of yoga brings you to the awareness that there is a relationship between two ends of one phenomenon. You are body and mind.” – Deborah Khoshaba

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Nyer, M., Nauphal, M., Roberg, R., & Streeter, C. (2018). Applications of Yoga in Psychiatry: What We Know. Focus (American Psychiatric Publishing), 16(1), 12–18. https://doi.org/10.1176/appi.focus.20170055

 

Abstract

Yoga has been in use for thousands of years in the East as a healing modality. Western practitioners are now starting to recognize the potential of yoga-based treatments. The purpose of this article is to explore the evidence-base of yoga-based treatments for depression and anxiety with the purpose of furthering the integration of yoga into conventional Western mental health treatment plans.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6519580/

 

Improve Obsessive-Compulsive Disorder with Kundalini Yoga Meditation

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Improve Obsessive-Compulsive Disorder with Kundalini Yoga Meditation

 

By John M. de Castro, Ph.D.

 

“mindfulness meditation had “a significant and large effect” on OCD symptoms, specifically on thought-action fusion (again, the belief that having a thought is the same as acting on the thought), and the ability to “let go” of unwanted thoughts.” – Jon Hershfield

 

Obsessive-Compulsive Disorder (OCD) sufferer have repetitive anxiety producing intrusive thoughts (obsessions) that result in repetitive behaviors to reduce the anxiety (compulsions). In a typical example of OCD, the individual is concerned about germs and is unable to control the anxiety that these thoughts produce. Their solution is to engage in ritualized behaviors, such as repetitive cleaning or hand washing that for a short time relieves the anxiety. The obsessions and compulsions can become so frequent that they become a dominant theme in their lives. Hence OCD drastically reduces the quality of life and happiness of the sufferer and those around them. About 2% of the population, 3.3 million people in the U.S., are affected at some time in their life.

Fortunately, OCD can be treated and mindfulness training has been shown to be effective in treating OCD.

 

In today’s Research News article “Kundalini Yoga Meditation Versus the Relaxation Response Meditation for Treating Adults With Obsessive-Compulsive Disorder: A Randomized Clinical Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6859828/), Shannahoff-Khalsa and colleagues recruited healthy adults diagnosed with Obsessive-Compulsive Disorder (OCD) who did not respond to first line therapies. They were randomly assigned to weekly 2-hour trainings for 4.5 months of either Kundalini Yoga meditation or relaxation response meditation. They were instructed to practice at home for an hour daily. Kundalini Yoga meditation is a combination of exercise, meditation, and breathing exercises. Relaxation response meditations employs various techniques to produce deep muscle relaxation. After the 4.5-month period, the groups were combined and all participants practiced Kundalini Yoga meditation for 7.5 months. The participants were measured before and after the 4.5-month training and at 1 year for OCD symptoms, OCD severity, anxiety, depression, mood states, and physical and mental health.

 

They found that in comparison to relaxation response meditation the participants who practiced Kundalini Yoga meditation had significantly greater reductions in Obsessive-Compulsive Disorder (OCD) symptoms and severity, anxiety, depression, and mood states. The improvements were continued over the 1-year practice period. In addition, the participants who practiced Kundalini Yoga meditation had significantly higher (31%) OCD remission rates.

 

The patients in this study had not previously responded to treatment with drugs, cognitive behavioral therapy, or exposure and response prevention therapy. The present results suggest that Kundalini Yoga meditation is a safe and effective treatment for Obsessive-Compulsive Disorder (OCD) in these patients who were unresponsive to other OCD therapies. Future studies are needed to compare Kundalini Yoga meditation to first line treatments for OCD.

 

So, improve Obsessive-Compulsive Disorder with Kundalini Yoga Meditation.

 

“Mindfulness is a useful technique for decreasing anxiety because of its emphasis on accepting your thoughts. When an intrusive thought pops up, you let it exist in your mind without providing it any weight. You experience the thought, but don’t judge it, change it or try to make it go away. You wait until it passes instead of thinking it should or shouldn’t be there.” – IntrusiveThoughts.org

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Shannahoff-Khalsa, D., Fernandes, R. Y., Pereira, C., March, J. S., Leckman, J. F., Golshan, S., … Shavitt, R. G. (2019). Kundalini Yoga Meditation Versus the Relaxation Response Meditation for Treating Adults With Obsessive-Compulsive Disorder: A Randomized Clinical Trial. Frontiers in psychiatry, 10, 793. doi:10.3389/fpsyt.2019.00793

 

Abstract

Background: Obsessive-compulsive disorder (OCD) is often a life-long disorder with high psychosocial impairment. Serotonin reuptake inhibitors (SRIs) are the only FDA approved drugs, and approximately 50% of patients are non-responders when using a criterion of 25% to 35% improvement with the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). About 30% are non-responders to combined first-line therapies (SRIs and exposure and response prevention). Previous research (one open, one randomized clinical trial) has demonstrated that Kundalini Yoga (KY) meditation can lead to an improvement in symptoms of obsessive-compulsive severity. We expand here with a larger trial.

Design: This trial compared two parallel run groups [KY vs. Relaxation Response meditation (RR)]. Patients were randomly allocated based on gender and Y-BOCS scores. They were told two different (unnamed) types of meditation would be compared, and informed if one showed greater benefits, the groups would merge for 12 months using the more effective intervention. Raters were blind in Phase One (0–4.5 months) to patient assignments, but not in Phase Two.

Main Outcome Measures: Primary outcome variable, clinician-administered Y-BOCS. Secondary scales: Dimensional Yale-Brown Obsessive Compulsive Scale (clinician-administered), Profile of Mood Scales, Beck Anxiety Inventory, Beck Depression Inventory, Clinical Global Impression, Short Form 36 Health Survey.

Results: Phase One: Baseline Y-BOCS scores: KY mean = 26.46 (SD 5.124; N = 24), RR mean = 26.79 (SD = 4.578; N = 24). An intent-to-treat analysis with the last observation carried forward for dropouts showed statistically greater improvement with KY compared to RR on the Y-BOCS, and statistically greater improvement on five of six secondary measures. For completers, the Y-BOCS showed 40.4% improvement for KY (N = 16), 17.9% for RR (N = 11); 31.3% in KY were judged to be in remission compared to 9.1% in RR. KY completers showed greater improvement on five of six secondary measures. At the end of Phase Two (12 months), patients, drawn from the initial groups, who elected to receive KY continued to show improvement in their Y-BOCS scores.

Conclusion: KY shows promise as an add-on option for OCD patients unresponsive to first line therapies. Future studies will establish KY’s relative efficacy compared to Exposure and Response Prevention and/or medications, and the most effective treatment schedule.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6859828/

 

Improve Obsessive-Compulsive Disorder With Mindfulness

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Improve Obsessive-Compulsive Disorder With Mindfulness

 

By John M. de Castro, Ph.D.

 

“To be able to focus on what is really happening in any given moment, as opposed to dwelling on the past or anticipating the future, takes away the power of OCD.” – Janet Singer

 

Obsessive-Compulsive Disorder (OCD) sufferer have repetitive anxiety producing intrusive thoughts (obsessions) that result in repetitive behaviors to reduce the anxiety (compulsions). In a typical example of OCD, the individual is concerned about germs and is unable to control the anxiety that these thoughts produce. Their solution is to engage in ritualized behaviors, such as repetitive cleaning or hand washing that for a short time relieves the anxiety. The obsessions and compulsions can become so frequent that they become a dominant theme in their lives. Hence OCD drastically reduces the quality of life and happiness of the sufferer and those around them. About 2% of the population, 3.3 million people in the U.S., are affected at some time in their life.

 

Fortunately, OCD can be treated and Mindfulness training has been shown to be effective in treating OCD. In addition, changing the maladaptive thought processes occurring in OCD through Cognitive Restructuring (CR) has also been shown to be effective. In today’s Research News article “A randomized waitlist-controlled trial comparing detached mindfulness and cognitive restructuring in obsessive-compulsive disorder.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6426247/), Rupp and colleagues compare the effectiveness of mindfulness training and cognitive restructuring in treating Obsessive-Compulsive Disorder (OCD).

 

They recruited patients with Obsessive-Compulsive Disorder (OCD) and randomly assigned them to receive either cognitive restructuring or detached mindfulness training or to a wait-list control condition. The treatments were delivered in 100-minute sessions, twice a week for two weeks and contained homework assignments. Cognitive restructuring targets distorted thinking that underlies OCD and teaches the patient to observe the thoughts and question the appraisals produced by the thoughts. Detached mindfulness training also targets the distorted thinking that underlies OCD but teaches the patient to observe the thoughts and detach from them, see them as separate from themselves. They were measured before and after training and 4 weeks later for intelligence, depression, psychological disorders, and Obsessive-Compulsive Disorder (OCD) symptoms.

 

They found that compared to baseline and the wait-list control group both treatments resulted in significant reductions in OCD symptoms that were clinically significant and maintained at the 4-week follow-up. There were also small deceases in depression levels in the patients after both treatments. Hence, both treatments improved the symptoms of patients suffering from Obsessive-Compulsive Disorder (OCD). Hence brief training in cognitive restructuring or detached mindfulness are effective in treating OCD symptoms.

 

It has previously been demonstrated that Mindfulness training is effective in treating OCD. The current study suggests that an unusual mindfulness technique, detached mindfulness, may also be effective. It appears that very different types of treatments, cognitive restructuring and detached mindfulness are effective in treating the symptoms of Obsessive-Compulsive Disorder (OCD). The control condition, however, received no treatment. So, it is possible that the improvements observed may have been due to subject expectancy effects (placebo effects) and not to the treatments. Future research should include placebo control conditions.

 

So, improve obsessive-compulsive disorder with mindfulness.

 

“a person trapped by an endless cycle of washing, checking, or cleaning is experiencing exactly the same struggle with accepting thoughts, feelings, and sensations as people with intrusive thoughts.  So, mindfulness is really for anyone who wants to stop feeling like what is going on inside their mind is a burden.  It’s hard to imagine anyone with OCD who would wish to continue feeling that way.” – John Hershfield

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Rupp, C., Jürgens, C., Doebler, P., Andor, F., & Buhlmann, U. (2019). A randomized waitlist-controlled trial comparing detached mindfulness and cognitive restructuring in obsessive-compulsive disorder. PloS one, 14(3), e0213895. doi:10.1371/journal.pone.0213895

 

Abstract

Objective

Whereas research has demonstrated the efficacy of cognitive restructuring (CR) for obsessive-compulsive disorder (OCD), little is known about the efficacy of specific metacognitive interventions such as detached mindfulness (DM). Therefore, this study compared the efficacy of CR and DM as stand-alone interventions.

Design

We conducted a randomized waitlist-controlled trial. n = 43 participants were randomly assigned to either DM or CR. Out of those participants, n = 21 participants had been previously assigned to a two-week waitlist condition.

Materials and methods

In both conditions, treatment comprised four double sessions within two weeks. Assessment took place at baseline (Pre1), after treatment (Post) and four weeks after the end of treatment (FU). There was a second baseline assessment (Pre2) in the waitlist group. Independent evaluators were blinded concerning the active condition. Adherence and competence ratings for the two therapists were obtained from an independent rater.

Results

40 patients completed the treatment. Two patients dropped out because of exacerbated depression. There were no further adverse events. Both CR and DM were shown to be superior to waitlist and equally effective at reducing OCD symptoms from pre to post assessment as measured with the Y-BOCS (CR: d = 1.67, DM: d = 1.55). In each of the two treatment conditions, eight patients (40%) exhibited a clinical significant change at post assessment.

Conclusions

The results of this clinical trial suggest the potential efficacy of DM as a stand-alone intervention for OCD, however, our findings need to be interpreted with caution. Results indicate that both CR and DM should be considered as possible alternative treatments for OCD, whereas the working mechanisms of DM have yet to be elucidated.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6426247/

 

Improve the Symptoms of Obsessive-Compulsive Disorder with Mindfulness

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Improve the Symptoms of Obsessive-Compulsive Disorder with Mindfulness

 

By John M. de Castro, Ph.D.

 

“most OCD sufferers I know who practice mindfulness find it very helpful in fighting their disorder. To be able to focus on what is really happening in any given moment, as opposed to dwelling on the past or anticipating the future, takes away the power of OCD.” – Janet Singer

 

Obsessive-Compulsive Disorder (OCD) sufferer have repetitive anxiety producing intrusive thoughts (obsessions) that result in repetitive behaviors to reduce the anxiety (compulsions). In a typical example of OCD, the individual is concerned about germs and is unable to control the anxiety that these thoughts produce. Their solution is to engage in ritualized behaviors, such as repetitive cleaning or hand washing that for a short time relieves the anxiety. The obsessions and compulsions can become so frequent that they become a dominant theme in their lives. Hence OCD drastically reduces the quality of life and happiness of the sufferer and those around them. About 2% of the population, 3.3 million people in the U.S., are affected at some time in their life. Fortunately, OCD can be treated and Mindfulness training has been shown to be effective in treating OCD.

 

In today’s Research News article “New-wave behavioral therapies in obsessive-compulsive disorder: Moving toward integrated behavioral therapies.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6343420/ ), Manjula and colleagues review and summarize the published research literature on new treatments for Obsessive-Compulsive Disorder (OCD). They included in their review studies involving two mindfulness treatment techniques; Mindfulness-Based Cognitive Therapy (MBCT) and Acceptance and Commitment Therapy (ACT).

 

MBCT involves mindfulness training, containing sitting, walking and body scan meditations, and cognitive therapy That is designed to alter how the patient relates to the thought processes that often underlie and exacerbate psychological symptoms. Acceptance and Commitment Therapy (ACT) is a mindfulness-based psychotherapy technique that focuses on the individual’s thoughts, feelings, and behaviors and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes.

 

They find that the literature reports that both MBCT and ACT are successful in treating adults and children with Obsessive-Compulsive Disorder (OCD) symptoms and produces improvements in anxiety, depression, experiential avoidance, believability, the need to respond to obsessions, obsessions, and compulsions. These benefits were found to be sustained 6 months later. But the authors caution that the studies are often performed with small numbers of participants and often have methodological problems. They conclude that the present research is promising but larger better controlled trials need to be performed especially with comparisons to other therapies for OCD that do not include mindfulness training.

 

So, improve the symptoms of obsessive-compulsive disorder with mindfulness.

 

“mindfulness is really for anyone who wants to stop feeling like what is going on inside their mind is a burden.  It’s hard to imagine anyone with OCD who would wish to continue feeling that way.” – John Hershfield

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Manjula, M., & Sudhir, P. M. (2019). New-wave behavioral therapies in obsessive-compulsive disorder: Moving toward integrated behavioral therapies. Indian journal of psychiatry, 61(Suppl 1), S104-S113.

 

Abstract

New-wave behavioral therapies in obsessive-compulsive disorders (OCDs) comprise of third-wave therapies and newer cognitive therapies (CTs). This review covers outcome studies published in English until December 2017. A total of forty articles on mindfulness-based CT, metacognitive therapy, acceptance and commitment therapy, and danger ideation reduction therapy in the form of single-case studies, case series, open-label trials, two-group comparison studies, and randomized controlled studies were included. Results show that studies on these therapies are limited in number. Methodological limitations including lack of active control groups, randomized controlled trials, small sample sizes, and short follow-up periods were also noted. However, the available literature demonstrates the feasibility and utility of these therapies in addressing the issues unresolved by exposure and response prevention (ERP) and cognitive behavior therapy (CBT). These therapies were often combined with traditional ERP and CBT based on the profile and response of the client; hence, it is unclear whether they can be used as standalone therapies in the larger segment of the OCD population. Supplementary use of these strategies alongside established therapies could provide better utilization of resources. In view of the need for such integration, further research is warranted. The use of sound methodologies and establishing the mechanism of action of these therapies would assist in choosing the techniques for integration.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6343420/