Last weekend, the Quebec Obsessive-Compulsive Disorder (OCD) Foundation held their 11th annual conference in Montreal, a one-day event designed to update the OCD community on new treatments for this problem. MindSpace Clinic Assistant Director Sarah Roberts took part in the OCD foundation conference, speaking to the group of clinicians, students, and patients about mindfulness and mindfulness-based interventions for OCD. Mindfulness refers to the practice of attention and awareness in the present moment with an open and non-judgmental attitude. Mindfulness is developed through meditation practice.
OCD and Mindfulness
OCD is characterized by persistent and intrusive obsessive thoughts, and by compulsive behaviours designed to decrease the anxiety generated by the thoughts. For example, an individual with OCD may have recurrent obsessions about contamination, and compulsively wash her hands to alleviate anxiety about germs. In another example, an individual with OCD may experience recurrent and distressing sexual thoughts or images, and perform a mental ritual (e.g., counting, praying) in an effort to “neutralize” the unwanted thoughts and images.
Mindfulness means practicing being awake in the present moment, and using awareness of feelings, triggers, and reactions to make informed decisions about how to behave. When we practicing mindfulness, we adopt an accepting and nonjudgmental attitude toward ourselves and our experience, and let go of the need to constantly manipulate or change our circumstances. We gain perspective on our thoughts and feelings and recognize that the mind has a “mind of its own.” This recognition allows us to view thoughts and feelings as mere spontaneous mental events that don’t need to be controlled.
Mindfulness Training for OCD
First, mindfulness training can help individuals with OCD accept OCD symptoms without judgment, developing self-compassion rather than labelling themselves as sick or weird. Second, mindfulness training can help individuals with OCD become less reactive. Compulsions are usually an autopilot reaction to an obsessive thought, and the self-awareness and decreased reactivity cultivated through mindfulness training can help break the link between obsessive thought and automatic compulsive behaviour. Third, mindfulness training helps individuals with OCD accord less importance to their thoughts. For example, the obsessive thought “What if I left the door unlocked?” is viewed as a mere string of words generated by the mind, not an imperative to be addressed. Simultaneously, acceptance and willingness to experience discomfort allows individuals with OCD to tolerate uncomfortable thoughts without needing to get rid of them via compulsive behaviour.
There is significant anecdotal and clinical support for the use of mindfulness for OCD, but OCD treatment research has traditionally focused on cognitive-behavioural therapy (CBT). Several recent studies (see references below) have explored the use of mindfulness for OCD symptoms and concluded that mindfulness may be effective as an isolated intervention, and may also constitute an excellent complement for CBT. Research into mindfulness for a wide variety of psychological symptoms and disorders is growing rapidly, and clinicians, students, and patients can expect concrete clinical data on the use of mindfulness for OCD in the next few years.
Baer, R. A. (2003). Mindfulness Training as a Clinical Intervention: A Conceptual and Empirical Review. Clinical Psychology: Science and Practice, 10, 125-143.
Fairfax, H. (2008). The Use of Mindfulness in Obsessive Compulsive Disorder: Suggestions for its Application and Integration into Existing Treatment. Clinical Psychology and Psychotherapy, 15, 53-59.
Hanstede, M., Gidron, Y., & Nylicek, I. (2008). The Effects of a Mindfulness Intervention on Obsessive-Compulsive Symptoms in a Non-Clinical Student Population. Journal of Nervous and Mental Disease, 196, 776-779.
Hertenstein, E., et al. (2012). Mindfulness-based cognitive therapy in obsessive-compulsive disorder—A qualitative study on patients’ experiences. BMC Psychiatry, 12, 185-195.