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Will Inference-Based Cognitive Behavioral Therapy (I-CBT) Shake Up the OCD Treatment World?
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- čas přidán 11. 09. 2022
- Inference-Based Cognitive Behavioral Therapy (I-CBT) is a therapy for OCD that, while having been practiced for some time in Europe and Canada, is just starting to get more attention from practitioners, researchers, and those living with OCD in the U.S. This video looks at some of the ways this approach differs from ERP and ACT, which are the current most researched and utilized treatments in the U.S. If you like what you see, be sure to like and subscribe.
Be sure to check out my updated overview of a few key concepts of I-CBT: • 3 New Concepts from In...
Michael Parker, LCSW, is co-director at The Center for OCD and Anxiety in Pittsburgh, PA.
Check out his self-help book, The OCD Travel Guide, available on Amazon: www.amazon.com...
Visit the website for The Center for OCD and Anxiety in Pittsburgh, PA: pittsburghocdt...
Hey everyone, It's been about a year since I shared my early understanding of I-CBT with you all. I just created a new video with my updated take on the exciting new treatment. You can check it out here: czcams.com/video/PqJyBXMVgss/video.html&lc=UgyGKDjKBkwucZbujIF4AaABAg
I’m an ocd survivor and deep diver into the research I strongly believe ICBT is not another OCD treatment its a revolution. Inferential confusion is the core of OCD. If you resolve it whole disorder falls down.
Thank you Adil for sharing your experience. I agree. I think I-CBT is a massive shift in OCD treatment that is going to improve the experience of being in treatment, as well as outcomes.
I m also ocd sufferer... Your suggestions pls
Exactly right 🙌
Thank you for this video. I feel like my OCD definitely started with intrusive thoughts but now it has evolved into a more convincing belief thing. I found I-CBT today and have been researching it every chance I got and it seems hopeful!
Thanks for watching Kirstin and happy it was a helpful video for you. I'm excited to see that the field is flexible for people having different experiences with OCD. Best of luck on your journey! As of 11/14/22, you can find a list of I-CBT providers here: icbt.online/find-treatment/
My OCD started with intrusive thoughts in 2012 and then evolved into rumination in 2015. So I have both. One concern I have is that it may get even worse. Can you expound on your experience with it starting as intrusive thoughts and then evolving from there?
I had CBT therapy at start of CBT treatment in the late 80's/early 90's with Dr. Michael Kozak & Dr. Edna Foa. They did something similar with me (as a child), but called it "Reality Testing." It was a key part of my treatment & I still use it 30 years later!
Btw, thrilled to find your channel! Thanks for your info!
That's very cool. The field of OCD treatment had really moved away from the cognitive work you mention in favor of exposure, but there is definitely a return to working to change thought patterns that create obsessions. I think it's a very exciting time for those with OCD, and therapists, who are encountering these ideas for the first time.
Hi Michael. Because of the controversy I had to come up with my own therapy, which I call ARP-allowance and response prevention instead of erp. The exposure is already built into the obsession and there’s no need to do exposures on purpose. Doing exposures on purpose gives value to the obsessions and can make it worse, and it changes themes too often. Then I do the response prevention which is not doing the physical or mental compulsions. This has helped me a lot.
Happy to hear you've been able to tailor treatment to your specific issue!
Wow!!!! I have ocd and have until now been doing ERP with my therapist (helping too!!). But this sound so cool!!
I think it's cool too! Here's my next video on I-CBT (be sure to like and subscribe to see more!): czcams.com/video/RKJAmpEBffA/video.html
Do you think you could do a video on ROCD treatment under the I-CBT model?
I will definitely add that to the list!
My psychologist has told me to target the obsessions, not the compulsions. Though this may sound different from others like ERP, I find this helpful. he doesn't do the usual CBT approach that's rationalizing the thoughts. He does help me make sense as to why I have certain intrusions. Violent thoughts could be anger. Suppressed or unexpressed anger. At least for me this makes sense.
Happy that is making sense! The field of OCD treatment is returning to the notion of more directly targeting obssessions. There are a lot of new tools, such as ICBT and Metacognitive Therapy that are allowing those with OCD challenge obsessions in a more productive way than past versions of treatment were able to do.
@@OCDspace412 I am not sure how he does or knows about this approach but he's really good at "interpreting" the meaning behind the thoughts. He tries to go back to my past sometimes. I kind of think it sounds psychoanalytic. He tries to help me by understanding the thoughts to the point I don't feel so bothered by the thought.
Hi brother, thanks for the video. I'm from Brazil and we don't have any I-CBT therapits here. Can you help me with my OCD? And, who knowks, maybe it can be a door to I-CBT grow here.
Hey, I can let you know if I ever have the ability to work with people in Brazil. Just keep an eye on this list, and hopefully some people in Brazil will pop up soon: icbt.online/find-treatment/
when we initially practise ICBT i.e basically it says we have to focus on trusting the logic or truth but not our fears or ego dystonic thoughts.
But these logic doesnt come as intensively as fears and doubts keep on building up throwing different logics of possibilities. But I found repeatedly just reminding the rationality and OCD as a disorder within a glimpse of the moment , it slowly helped me eventually on most of the things, initially it sounds like compulsion but later reinforcing truth is not bad either .
But some obsessions and some amount of compulsions still bothers , and mainly Ruminations . Do we have any series of videos or practitioner who is well versed and give one to one sessions on this
Definitely check out the ICBT website: icbt.online/. It has a lot of resources, including videos!
Hi Sire , Thanks for the video. Does it works for sexual and religious ocd aswell ? If its how , do you recommend any demo videos done on different cases of ocd
I-CBT can be applied to all OCD themes, and can be particularly helpful for themes that are more cognitive/belief based such as those you mention! I'll be making some videos in the future addressing those topics. I'm also linking a list of providers that are well-versed in I-CBT: ibaocs.com/find-treatment/
I've done CBT and it helped for a short time perhaps such needs to be done for at least 3 to months. I was having 5 major OCDs one is I hated people using saliva to open bags at supermarket counters that made me wash each item I bought before I store them. My bigger OCD is necro phobeia since I was a kid and that became slowly and steadily worse in my 20s to 30s. Issue is anxiety of contaminated after seing a formal dead body gathering on TV or on social media or actual life. Compulsion is not doing anything useful or new on that day I saw such or heard words of such, immediately deleting such from computer t avoid contamination. Root cause of OCD is over-reactive amygdala due to childhood complex trauma due to poor parenting/neglect which makes the kid sensitive. This has extremely less t do with genetics.
Identifying the root of one's OCD can be so helpful. Best wishes to you on your journey with OCD!
The problem with telling people with OCD to trust their senses is that it’s possible for senses to deceive you (cf. optical illusion). People have a love-hate relationship with their OCD. OCD is causing them some distress, but it may bring them the relief they’re desperately seeking. Who knows? How can you be sure? Here lies the problem for highly suspicious minds. I-CBT may be helpful, but in my opinion, you cannot do without ERP to stop ritualizing, be willing to take reasonable risks and thus for doubts to lose some of their disturbing capacity.
Thanks Raphael! From an I-CBT perspective, exploring "what's possible" is a reasoning process that takes place in your imagination, and involves rejecting or questioning what you are sensing in the here and now. Using I-CBT you limit your reasoning to only the facts that you know for certain. You practice NOT following "your suspicious mind" since this would be obsessional doubt that would only lead you further away from your senses and reality. I-CBT is also based on the premise that even those with OCD utilize healthy, reality-based, reasoning in other areas of life where they don't doubt themselves, and so this is completely doable for anyone. Be sure to check out some of my other I-CBT videos if you'd like to learn more.
@@OCDspace412 If your food is contaminated, you might not see it. You could have it tested, but tests could be wrong. It’s not likely, but it’s possible. It may be just in my imagination, it may not be. I know it’s not logical because I trust my senses and lab testing in other areas, but not when it concerns my food. How can I persuade myself to apply the same judgment criteria to all areas of my life like you suggest? How can I convince myself that it’s not important to be 100% sure regarding the safety of what I eat, that to be reasonably sure is good enough? Personally, I find that the part of ICBT that encourages me to stop investing time and effort into the search for absolute guaranties is the most useful (sunk cost fallacy). I also find your videos very insightful.
@@rdevalentin Thank you. That is such a great question. If someone looks at their food and doesn't see any contamination and no one has told them that the food is contaminated, then that is the only information they have, and it is enough information to make a decision and move forward. Nothing in the available information suggests that contamination is a relevant concern. The only thing that would lead one to think about contamination would be obsessionally doubting the available information and going into the imagination in search for more information. Obsessional doubt never ends. Trusting what one knows for sure in the here and now is the way towards truth and resolving doubt. That, at least, would be the I-CBT approach.
How does one define obsessional doubt?
Another name for obsessional doubt is Elevated Evidence Requirements. A degree of evidence that would be enough for an OCD-free person to form a belief is not sufficient for a person who suffers from obsessional doubt. Obsessional doubts are very selective. They depend more on individual anxiety than on an objective degree of credibility of a certain belief or probability of a certain event. @@husainsattar4671
Thank you for these videos but the volume on them is bad!
Thanks for letting me know. I had one other person have a sound issue with this particular video on one of their devices, but I haven't heard that from others. And the volume seems good when I play them on my end. I'll keep an ear on this situation. I also just invested in some sound equipment so hopefully that will help in the future.
So this method involves leaving things uncertain and giving up control, which forms a big part of ERP, the long-standing gold standard treatment for OCD. This is nothing new, it's simply a small part of the current evidenced way of working with this condition.
Hi Carina, On the surface I-CBT may look similar to ERP, but the more you dig, the more you uncover dramatic shifts from ERP. I-CBT is focused on helping clients to see the reasoning strategies that are (mis)leading them to believe that the OCD concern is relevant. The individual only uses these reasoning strategies in the area of the obsession, and they are characterized by the repeated rejection of information in the real world in favor of a faulty OCD story that exists in the imagination. It's important to see that in all other areas in life, folks with OCD use healthy reasoning to dismiss irrelevant concerns (no tolerance of uncertainty necessary). The goal is to learn to use that same healthy reasoning in the area of the obsession in order to effectively resolve doubt and restore functional certainty. This means there is no need to tolerate uncertainty that one might be a bad person, might be contaminated, might not love their partner, might be a deviant, might be violent etc. The whole obsession is a faulty belief supported by a story in the imagination, and there is nothing in reality supporting it. In this way, I'd say I-CBT has loftier goals than ERP, and from my experience with it so far, these goals are achievable. Thanks again for watching. I'm an ERP-trained therapist myself, who's currently diving into this I-CBT stuff. I'll be continuing to post new info on I-CBT on a regular basis.
@@OCDspace412 Yet all the clinicians whose podcasts about OCD I listen to regularly on You Tube, including my own supervisor's, talk only about ERP as evidenced to work well with this condition. In addition, this is the therapy the UK's largest OCD charity, OCD Action, advise sufferers to engage with. I believe there is a good reason for this.
@@carinaluxford241 I completely agree with you on the many merits of ERP. It completely deserves its reputation as the first line treatment for OCD. I would also add that I don't think we should limit ourselves to a single treatment approach if evidence supports additional treatment models. I-CBT started off as an approach to address those who primarily engage in mental rituals/rumination, which I think is a subtype ERP has at times struggled to help. So, much like ACT, I'm thinking of this as an addition to the toolbox rather than a replacement.
I think it’s the term, leaving things uncertain that people struggle with. Primarily, uncertainty in my opinion sounds a lot like 50-50, when in reality, if we asked someone let’s say my wife, if she was a person who enjoys mutilating dogs or something, she would say with certainty, no. And the reason for that is because, the very thought of this act disturbs her beyond measure, and she can say with a strong conviction, no, and she would be correct too and her brain would be content with this.
Us OCD sufferers, our brains start going, well what if this, what if you do and don’t know yet, even though somewhere inside us, we know that our fears are unfounded. I think it will help people who have poor insight and are more convinced about their fears and therefore less likely to engage in therapy. Especially with certain themes like harm etc, OCD can get quite whacky, to the point that it’s practically ridiculous and borderline impossible, at least that’s my experience anyway.
Acceptance of your fear potentially coming true is very hard when you kinda know that its in your imagination and doesn’t fit with your reality.
For me, observing the person that shows up every day which is part of ICBT has helped me to see that my fears are most likely unfounded, not rooted in reality. This doesn’t stop OCD trying to find ways in, but it helps me to perform response prevention.
And I think it’s theme to theme based as well.
At the end of the day, we have to accept that we might get cancer, might crash our car, might get HIV, etc.
But when a person has been a certain way their whole life, eg, a loving, caring parent, to then tell them to accept that they might actually be the worlds most evil person, for many people it just doesn’t make sense, their brain can’t compute it.
Isn’t the goal of therapy for harm OCD to also help a person to regain trust in themselves and see that their fears aren’t based in reality?
Sorry but ocd is a feeling problem. In my experience, no treatment removes the feeling of contamination.
Interesting. Some believe that contamination OCD driven by a strong feeling of disgust might be a subtype requiring a very specific approach. Here's an article worth checking out: anxietycamp.wordpress.com/2021/10/13/disgust-based-ocd-thoughts-on-a-new-treatment-protocol/?fbclid=IwAR38_KF_kQpjqXqQwkdLHpuh59NzpHYVFKnk9Sfd4c3k1eRWh7STigaOEZw
@@OCDspace412 thank you for sharing, therapists need to read this. I'm glad he also mentions ACT, the therapy which I thought came closest to making some difference albeit small. I've gone on a deep journey trying to solve my contamination OCD (30 years now) which involved really examining the stream of thoughts relating to my trigger situations. For me, the fear isn't that I'm going to die from touching a dirty garbage bin because I know I'm not. I always argued that I was pretty rational even though your told ocd is all about intrusive irrational thoughts. Also, I'm pretty certain no two contamination OCD cases are the same. As what one person deems to be a trigger, another might not. Contamination OCD is such a complex condition and unique to each individual which makes it even more difficult to treat in my humble opinion.
@@clairegray4058 I love ACT as well!
@@clairegray4058 So happy to hear you've found the right path forward for yourself!
They said pH ull get aids how much worse can humans get