A common question our clients ask is, “Can you treat OCD without medication?” And the answer is a resounding, YES!

Medication has its place, as we will explore in this article.

Yet the data shows that specific science-based methodologies are proven to be your greatest ally in OCD recovery and yield incredible results.

CBT (Cognitive Behavioral Therapy) combined with ERP (Exposure and Response Prevention) can show a marked decrease in symptoms and an increase in quality of life in a matter of weeks.

That’s right! Your recovery could move at a rapid rate, and within a matter of weeks, your life could begin to look drastically different.

Sometimes, this can feel near impossible.

When you’re in the midst of an internal battle with OCD that has shrunk your world and starved you of hope, it can be difficult to imagine that things could look and feel so different in such a short time.

This is why we’re here to reignite that future of possibility and show you that recovery is possible for you (even without medication).

Can You Treat OCD Without Medication?

Research shows that if you were to choose between evidence-based treatment and medication, the meta-analysis has shown that evidence-based treatment is far more effective than that of medication.

If you were to choose between one or the other, science shows that evidence-based treatment has the greatest success in recovery. However, if you were to choose both and combine them, the combination is the gold standard of treatment.

Medication alone is not a silver bullet for OCD recovery.

Although it can often feel like a lifeline to those suffering in deep despair at the hand of those obsessions, when medication is used, it is rarely effective when taken in isolation.

Ultimately, medication only targets the physiological symptoms of OCD, not the underlying function of OCD that keeps the cycle in motion.

What is really important in OCD recovery is breaking the cycle of OCD. In breaking the cycle we can start to reduce symptoms and get sufferers back to living the life they want.

The OCD cycle looks as follows:

The OCD cycle first starts with obsessions.

Obsessions present in the form of intrusive thoughts, images, feelings, urges, and sensations trigger uncertainty and anxiety. This distress drives the urge to engage in compulsive behaviors that offer temporary relief.

The more compulsions you do, the more the cycle grows. In many cases, the cycle can grow so much that it spreads to all corners of one’s life.

The key to OCD recovery is breaking this cycle.

By using Cognitive Behavioral Therapy (CBT) and Exposure Response Prevention (ERP), we interrupt the behavioral patterns that keep you stuck and allow OCD to tighten its grip.

With every compulsive behavior, OCD has an opportunity to take a little more from your life. As you reduce these compulsions, you get your life back (and your confidence too).

In many cases, Medication alone rarely changes your relationship with your intrusive thoughts and does not change how you respond to them either. This is why proven therapeutic methods such as CBT and ERP are essential and considered the best of the best when it comes to effective OCD recovery.

When is OCD medication sometimes necessary?

For certain OCD sufferers, medication can help them manage their symptoms while they engage in the challenges of ERP treatment.

ERP treatment is relatively straightforward to implement and understand once you have all of the information and education. However, putting it into practice isn’t easy.

Medication can be a brilliant support and enhancement while doing ERP.

Medication could help with:

  • Reduced anxiety

High anxiety levels that accompany those with OCD can make it difficult to fully engage with ERP practices. Certain medications (as there are many available) can help reduce the symptoms of anxiety and make it easier to tolerate and practice those exposures, which is a crucial component of effective ERP.

  • Increased ability to resist compulsions

Certain medications can help reduce the frequency and intensity of obsessions and compulsions. One of the core components of effective ERP is to practice resisting the urge to perform compulsive rituals or engage in compulsive behaviors. Reducing the intensity of those urges can make the practice easier.

  • Cognitive flexibility

Those with OCD are typically stuck in a fixed thinking pattern and, therefore, can find it difficult to adapt and embrace the challenge of thinking and acting differently toward those obsessions. Some medication has been shown to improve cognitive flexibility, which makes it easier for sufferers to learn and apply new coping strategies during therapy.

  • Improved mood

It’s likely no surprise to hear that OCD is an immensely torturous and distressing condition to live with. Other mood-related disorders such as depression, are not uncommon in those living with OCD. Certain medications can help to improve one’s mood and relieve the heavy weight of those symptoms so they can better engage with the therapeutic practices on offer. 

IMPORTANT: Please do not use this article as a replacement for medical or mental health advice. Please speak with a medical professional before starting any medication. Medication is best used in conjunction with therapy and not in replacement of therapy.

Furthermore, medication should only be taken when prescribed by a qualified healthcare professional following the correct diagnostic procedure.

Likewise, coming off medication should only be done under the guidance of a highly qualified OCD specialist.

Best Treatment Options for OCD Recovery

The gold standard treatment for OCD remains to be CBT (Cognitive Behavioral Therapy) with ERP (Exposure Response Prevention). These two methodologies combined have been proven to achieve an astounding 80% success rate in clients.

Let’s break them down and take a closer look at each, along with other therapeutic practices which are helpful to use in tandem…

CBT (Cognitive Behavioral Therapy)

Cognitive-Behavioral Therapy (CBT) is a commonly used and effective treatment approach for Obsessive-Compulsive Disorder (OCD). CBT for OCD typically consists of two main components: cognitive therapy and behavioral therapy.

1. Cognitive Therapy: This component focuses on identifying dysfunctional beliefs that promote problematic behavior. The cognitive portion of CBT involves changing your relationship to those obsessions and giving them less validity so you can respond to them in a more helpful way. Examples of cognitive therapy techniques used in treating OCD include:

   a) Cognitive Restructuring: This technique involves identifying obsessive thoughts, such as exaggerated fears or unrealistic beliefs, and replacing them with more helpful ways of thinking. For instance, if someone with OCD has a fear of contamination and believes that touching certain objects will result in severe illness, cognitive restructuring helps them recognize the irrationality of this belief and replace it with more reasonable thoughts about how they can, in fact, tolerate the discomfort of touching certain objects. In many cases, people with OCD feel they cannot handle the anxiety, uncertainty, and discomfort, and we are there to help them see they CAN manage such discomforts.

2. Behavioral Therapy: This component of CBT for OCD focuses on changing the behavioral patterns in response to those obsessions that come in the form of compulsions or avoidance behaviors. The goal is to reduce the frequency and intensity of these behaviors. Examples of behavioral therapy techniques used in treating OCD include:

   a) Exposure and Response Prevention (ERP): ERP is considered the most effective behavioral technique for OCD. It involves gradually exposing individuals to situations, thoughts, or objects that trigger their obsessions while preventing the corresponding compulsive behaviors or rituals. For example, if someone has an obsession with cleanliness and feels the need to wash their hands excessively, ERP would involve exposing them to a mildly dirty object and having them practice resisting the urge to wash their hands for a certain period of time. 

   b) Behavioral Experiments: This technique involves testing the validity of a person’s obsessive beliefs or fears through structured experiments. For instance, if someone has an obsession about causing harm to others, a behavioral experiment might involve deliberately placing themselves in a situation where they have the opportunity to harm someone, but without actually doing so. By collecting data and examining the outcomes, individuals can challenge their irrational beliefs and reduce the associated anxiety.

ERP (Exposure Response Prevention)

Exposure and Response Prevention (ERP) is a crucial component of Cognitive-Behavioral Therapy (CBT) for OCD and is considered the most effective treatment technique for reducing OCD symptoms. 

ERP works by systematically exposing individuals to situations, thoughts, or objects that trigger their obsessions (the distressing and intrusive thoughts) while simultaneously preventing the corresponding compulsive behaviors or rituals. 

The purpose of this exposure is to help individuals learn that they can tolerate the anxiety triggered by their obsessions without resorting to compulsive behaviors.

In CBT therapy, ERP is often implemented after a thorough assessment of the individual’s OCD symptoms and triggers. 

The therapist collaborates with the individual to create an exposure hierarchy, which is a list of situations or stimuli that elicit different levels of anxiety or distress. The hierarchy is usually organized from least distressing to most distressing. The person then gradually works their way up the hierarchy, starting with the least anxiety-provoking situation and moving towards more challenging ones.

During each exposure, the individual is instructed to compassionately resist engaging in their usual compulsive behaviors or rituals. 

This prevention of the response is a crucial aspect of ERP. By not giving in to the compulsion, individuals learn that their anxiety gradually decreases over time without needing to perform the ritual. This process is known as habituation, where the brain adapts and becomes less responsive to the triggering stimuli.

Here are just some examples of ERP exposures for individuals shown in a handful of OCD subtypes:

1. Contamination OCD:

   – Touching a lightly soiled object (e.g., doorknob) and refraining from washing hands for a specific period of time.

   – Eating food without excessive handwashing or using utensils that have been touched by others.

   – Touching a public restroom doorknob and avoiding handwashing until a later time.

2. Checking OCD:

   – Leaving the house without repeatedly checking that the door is locked.

   – Sending an email without repeatedly checking for errors.

   – Not reviewing a completed task for excessive amounts of time.

3. Harm OCD:

   – Holding and using a harmless object, such as a kitchen knife, and resisting the urge to harm oneself or others.

   – Passing by a stranger without avoiding them out of fear of causing harm.

   – Refraining from seeking reassurance about the safety of others.

4. Symmetry/Ordering OCD:

   – Deliberately leaving objects unarranged or asymmetrical.

   – Intentionally disorganizing a neat space and resisting the urge to rearrange it.

   – Ignoring the need to make things “just right” and accepting imperfections.

It’s essential to note that ERP should be tailored to each individual’s specific obsessions and compulsions, and it should be conducted under the guidance of a trained mental health professional. 

The therapist provides compassion, support, guidance, and strategies to help individuals effectively face their fears, manage their anxiety, and break the cycle of OCD. 

Over time, with consistent practice and exposure, individuals can experience a reduction in their OCD symptoms and regain control over their lives.

ACT (Acceptance and Commitment Therapy)

Acceptance and Commitment Therapy (ACT) is a supplemental therapeutic approach that can be helpful in the recovery from OCD. 

ACT aims to change the individual’s relationship with their thoughts and emotions, promoting acceptance of their internal experiences while committing to actions aligned with their values. 

In the context of OCD, ACT focuses on helping individuals develop psychological flexibility and reduce the impact of their obsessions and compulsions on their lives.

Here’s why acceptance and commitment matter in OCD recovery:

1. Acceptance: Acceptance in ACT refers to acknowledging and allowing the presence of unwanted thoughts, feelings, and sensations without struggling against them or trying to eliminate them. In OCD, individuals often engage in compulsions or mental rituals to reduce anxiety caused by their obsessions. However, these efforts to control or suppress unwanted thoughts often backfire, leading to increased distress and reinforcing the cycle of OCD. Acceptance helps individuals recognize that the presence of intrusive thoughts is a normal human experience and that they can coexist with these thoughts without assigning excessive meaning or attempting to neutralize them.

2. Commitment: Commitment in ACT refers to identifying one’s values and taking committed action toward living a meaningful life, despite the presence of distressing thoughts and emotions. In the context of OCD, commitment involves engaging in activities and behaviors that align with one’s values, even in the presence of obsessions and anxiety. By focusing on their values, individuals can shift their attention away from the OCD symptoms and create a richer, more fulfilling life.

ACT exercises used in OCD recovery:

1. Cognitive Defusion: This exercise aims to help individuals defuse their thoughts and develop a more flexible relationship with them. It involves observing thoughts without judgment, recognizing that thoughts are not necessarily accurate reflections of reality, and distancing oneself from the content of the thoughts. For example, instead of viewing an intrusive thought as a command or a threat, individuals practice seeing it as just a passing mental event.

2. Mindfulness: Mindfulness exercises cultivate present-moment awareness and non-judgmental observation of thoughts, emotions, and bodily sensations. By practicing mindfulness, individuals develop the ability to observe their OCD-related thoughts and sensations without reacting or getting caught up in them. This can help reduce the distress associated with obsessions and create a space for more deliberate and values-driven responses.

3. Values Clarification: This exercise involves identifying and clarifying one’s personal values—what is truly important and meaningful to them. Through reflection and exploration, individuals can identify the areas of life they want to prioritize and the actions they can take to align with those values. Values clarification helps individuals shift their focus from symptom reduction to living a rich and meaningful life, providing motivation to tolerate the discomfort associated with OCD symptoms.

4. Committed Action: This exercise encourages individuals to take small steps towards engaging in activities that are in line with their values, even in the presence of OCD-related anxiety. It involves setting goals, breaking them down into manageable tasks, and consistently taking action towards those goals. By committing to meaningful actions, individuals can build a sense of self-efficacy and resilience in the face of OCD challenges.

Finding a qualified therapist

We understand how nerve-wracking it can feel to take that first step toward recovery and reach out to a qualified professional.

After all, if you’ve read anything about OCD recovery, you likely understand that it isn’t a walk in the park.

It takes commitment, dedication, and a willingness to do the hard work.

Yet, there’s something our team proudly shares over and over again… Our clients may come to us with fear and reservations, but they never regret starting.

Significant improvement in OCD symptoms can be seen anywhere between 16 and 24 sessions. That’s right! In only 24 weeks your life with OCD could look dramatically different. You can say goodbye to being driven by fear, and hello to a value-filled life where you finally regain control over how you choose to live your life.

Our team is a group of highly qualified OCD specialists. We offer warm and compassionate support as you begin your recovery journey.

Together, we can help you reclaim your life and be one of the many who have zero regrets about beginning treatment.

If you’re based in California or Arizona, and you suspect you may be struggling with OCD, please submit an initial intake form here.

It would be our honor to support you with a tailored treatment plan and a specialist who truly understands the pain of your current reality.

You will be welcomed without judgment, only sheer determination to help you increase your quality of life.

Alternative options for therapy

Self-study online program

If you are unable to access private therapy right now, we have an affordable and accessible alternative.

ERP SCHOOL was created by top OCD specialist Kimberley Quinlan to show you exactly how to manage those intrusive thoughts so they no longer ruin your life, and resist the urge to do compulsions.

You will be given the exact tools and techniques used to support private clients.

And you will understand how to apply them to your specific OCD themes.

You no longer have to feel trapped inside your mind and a slave to your intrusive thoughts. You can regain your freedom, and live life how YOU choose.

Join ERP SCHOOL here. 

Support groups

A journey like this is better done with people who understand.

Those who are ahead in their journey, those at the same point, and those who have just begun. There’s nothing more motivational than having the support of someone who truly get’s it.

There are many support groups available.

Please do not struggle alone, there are so many out there who can relate to your experiences and can offer the type of understanding you may not find from those who love you but have not been through what you’re going through right now.

20 tips for succeeding in your OCD recovery, without medication

  1. Practice self-compassion – OCD cannot thrive in kindness. Self-criticism and judgment are other opportunities for OCD to hook its claws in and hold on tight. Self-compassion is what allows true growth and long-lasting results. You are deserving of a better life. You did not ask for this. You must believe it.
  2. Don’t compare recovery to others – This is not a race! Another person’s success is not your failure. Go at your own pace, one step at a time. No two recovery journeys are the same, keep your eyes forward and focus on your own.
  3. Always go toward the fear, not away from it – This will feel counterintuitive, but if you feel that anxiety bubbling inside you, that is an opportunity for you to face the fear rather than avoid it. Each time you approach, you teach your brain that you can handle anxiety without using compulsive behaviors.
  4. Accept uncertainty –  Uncertainty is a part of life. We can never be 100% sure of anything, no matter how much data we collect. Becoming friends with uncertainty will be your greatest strength in OCD recovery (and life in general!)
  5. Stop seeking reassurance – Reassurance is a sneaky compulsion in disguise. Understand, no reassurance will give OCD satisfaction enough to let those obsessions go… it will only reinforce the OCD cycle and make them more intense.
  6. Accept intrusive thoughts – Notice. Accept. Carry on with your day. The more you try to wrestle with those thoughts, the more ‘important’ and intense they become.
  7. Be prepared – OCD can be ready to pounce in the strangest and most inconvenient of moments. Be prepared. Old ones and new ones can occur at any time, brace yourself and don’t let it throw you. Once you have the tools and knowledge, you can use them at any time.
  8. Do not practice thought suppression – This will have the opposite of the desired effect! In trying to stop the thought, you are giving it more of your attention, and in turn, this teaches our brain that the thought is important and must be kept an eye on! We want to teach our brain that this thought does not require our attention… thought suppression goes against this.
  9. Stop black-and-white thinking – One ‘mistake’ or ‘bad day’ does not mean your recovery is down the drain. You can always try again tomorrow. Recovery isn’t linear and you will have days where you feel like you’ve slipped up. Dust it off with compassion and try again tomorrow.
  10. Take responsibility for your recovery – While it is great when others encourage you to do your daily practices, you are ultimately responsible for your recovery. No one can do this work for you, so let’s tap into that burning desire to change your life and take responsibility for your own success!
  11. Choose discomfort over comfort – Following on from the above, when faced with two options, choose the more difficult. Every day is a beautiful day to do hard things!
  12. Do one hard thing every day – It’s not about trying to overload yourself with tasks and exercises every single day. It’s about small, incremental, actionable steps. Little by little. One hard thing each day is enough.
  13. Talk to your therapist –  They are there to support you and they want to see you win! If something feels unmanageable, voice your concerns. You have a say in your therapy, you are half of a team!
  14. Don’t wait for the perfect moment to start – There is no perfect moment. Each day you continue in the OCD cycle only solidifies its hold over you. OCD does not get better over time without appropriate intervention. Take the leap, you won’t regret it.
  15. There’s no such thing as linear recovery – Perfectionism will destroy your recovery. Don’t let this become an obsession in and of itself. You’re going to zig-zag all over the place, and that’s okay. We only ask that you try.
  16. Remind yourself of your achievements – Keep yourself motivated by recognizing how far you’ve come, Give yourself credit, you deserve it.
  17. Treat yourself how you would a friend – To really show yourself the compassion and kindness you deserve, treat yourself as you would treat someone you love. What would you say to them? How would you support them? Show yourself the same kindness.
  18. There’s no shame in having OCD – You did not ask for this, you did not deserve this. You are not a bad person. You are not going crazy. This is a common condition that causes great pain and suffering but there are incredibly effective treatments available! This does not have to be your life.
  19. Resist the urge – Every time you resist the urge to engage in compulsive behaviors – even if it’s a momentary pause – is a victory. If you can resist the urge to do compulsions, you are effectively breaking the OCD cycle!
  20. Ask for help – We do not want you to suffer in silence. We understand there is great stigma and taboo around mental health conditions like OCD, but there are people everywhere who can support you. Please reach out for help, either to a trusted loved one or a qualified mental health professional. It’s the bravest power move you could make.

If you would like support from our team of OCD specialists, please submit an initial intake form here. It would be our honor to support you in your OCD recovery.