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The 4 R's of Obsessive Compulsive Disorder (OCD) Treatment

Join us for a guest blog written by our amazing friends at Island Clinical Counselling! We explore the 4 R's of OCD Treatment, a system designed to help you separate from your OCD and know that you are not your OCD symptoms.


We see a cartoon head with a person holding a brain infront of it. The brain is red and says OCD.

Obsessive Compulsive Disorder Treatment:


For those living with obsessive compulsive disorder, frequent intrusive thoughts, images, and feelings can be a daily reality. These are often followed by an urge to do some kind of behaviour such as constant checking, obsessive cleaning, repeating certain words or phrases, or engaging in other rituals. These actions are meant to remove the discomfort of the intrusive thought, or to neutralize a perceived threat. They may seem “weird” or “unnecessary” to others, but in the moment, it feels very real to the individual with OCD and like the only solution. Those with OCD may question: “What is wrong with me?” “Why do I think this?” “What does this mean about me?” It is important to separate OCD from who you are as a person. Professor Jeffrey Schwartz designed the 4 R’s of OCD to help do just that. It can be used as a self-help model or alongside a professional who is trained in obsessive compulsive disorder treatment.


Relabel

  1. Unfortunately, just pushing away or ignoring intrusive thoughts doesn’t make them go away. However, this is often the strategy used by those who suffer from OCD as they try not to respond to the scary or bizarre messages they are receiving. The key to this step is to learn to recognize obsessive thoughts and compulsions as evidence of OCD. Do this by:

    Becoming aware of obsessional thoughts and compulsions, examine them, and relabel them as OCD.

    Use mindfulness to pay close attention to your thoughts in the moment. Remind yourself that intrusive thoughts do not represent your personality or values.

Reattribute

  1. Recognize that intrusive thoughts and compulsions are caused by a medical condition and current brain chemistry. Try thinking: “It’s not me, it’s OCD.” Remind yourself that just because these thoughts and images are there, doesn’t make them true.

Refocus

  1. Take action by refocusing and distracting yourself from the irrational thoughts, feelings, and compulsive behaviours. Even if it is just for a few moments, take a walk, listen to music, call a friend, or do anything that will be effective in shifting gears. You do not have to listen to what the OCD is telling you to do. Resisting compulsions can lead to long-term success in managing urges and symptoms.

Revalue

  1. By practicing the first three steps, you should notice a shift in how you are relating to OCD. You can start to revalue thoughts and urges by being aware of what is happening, questioning whether a thought is truly you, and reminding yourself that intrusive thoughts and compulsions are caused by OCD. As time passes, you may notice a difference in the number of obsessions you have and less of an urge to engage in compulsions.



The 4 R’s of OCD treatment can be used alongside other therapies under the supervision of a helping professional. If you think you are experiencing OCD symptoms and would like to learn more, please reach out to us.


Written by Cat Zydyk

References:

Welsh, R.N. (2012). Self-help: Managing obsessive compulsive disorder-Schwartz’ four step method. Harley Therapy. https://www.harleytherapy.co.uk/counselling/managing-obsessive-compulsive-disorder-ocd.htm

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