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Gina Addondante on ICBT vs ERP/ACT
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- čas přidán 14. 08. 2024
- I talked with Gina Abbondante from Change of Mind Counseling about her OCD lived experience and using ICBT vs ERP and ACT. Have a listen to learn more.
If you are interested in learning more about Gina's work, check out these resources:
Website: www.changeofmindcounseling.com
For trainings or to find an I-CBT clinician: ocdlivedexperi...
#ocd #cbt #ibt
I love what Gina says near the end about how OCD kept you 'safe' at one point - while I obviously want to get over my own OCD, I've never viewed it as a monster the way some people do - I understand that everyone needs to see it in whatever way works for them, but I've always been really aware that my OCD did, at one time, give me a sense of safety - now it just needs to know I don't need it anymore - it's like a guest that outstays its welcome!
Love that… and yes everyone sees it differently…
Thank you for this great presentation!
This has come out of basically no where for me. Well, at least the harmOCD type. I went through a hard couple of months understanding it, but occasionally it’ll come up and I just ignore it.but now a whole new thing I can’t seem to shake, and my rumination has gotten so bad, i think I’ll try ICBT
Great insights! I have a question though. If you’re lost in the desert and are dying of thirst, you’re not going to believe your senses telling you there are no signs of water for miles around. You’re going to keep searching for water hoping against hope to find some at one point. In that situation it’s useless to tell someone to trust their senses and give up their search. People with OCD seem to be in a similar situation. They’re persisting in their senseless search for certainties because they don’t see any other way to obtain peace of mind. Would it be more useful for them to first experience some mental relief after response prevention and regain hope than trying to persuade themselves to trust their senses and common sense, like ICBT advocates?
One of the principles w ICBT is to re- engage with reality that is right in front of us using information that is in context in the here and now. Undergoing the full 12 modules of ICBT teaches how OCD reasoning is faulty and how we all get stuck in imagined possibilities of bad outcomes.
@@OCDWhisperer I started the ICBT modules. This prompted a question in my mind. If morale is good, you can dismiss “worst-case scenario” doubts because you feel that’s not the end of the world if you make a mistake. You know that you will survive. What about if you’re downhearted and feel that you can’t afford to dismiss a doubt when a mistake could have devastating consequences? Does it mean that ICBT works or not depending on what kind of frame of mind you’re in at the time of the doubts?
It seems like i-cbt is essentially promoting defusion from your OCD thoughts - seeing them as OCD thoughts, as ways your anxious brain is trying to 'protect' you from your imagined doomsday scenario. How is this different from ACT, which also targets metacognitive processes so we don't 'buy into' our automatic thoughts ..? I guess the biggest difference is that i-cbt seems to emphasize correcting the content of the thoughts/inferences? Is that accurate?
Hi. Inference based CBT is all about understanding obsessional reasoning to learn how a person with OCD ends up getting imaginaly absorbed.
People with OCD use dysfunctional reasoning processes when their OCD is triggered. Once a person learns to recognize that, the goal is to then resolve the obsessional doubt by coming back to reality and your sensory information and connect back to who you really are.
This has nothing to do with diffusion. Also we are not correcting OCD thought content. We are not arguing with OCD logic. We are learning how the logic is flawed so that we can choose to come back to reality in the here and now where we have relevant information. Learn to trust yourself again. Hope that helps.
@@OCDWhisperer Thanks. I certainly see how the theory of the etiology of OCD and purported therapeutic mechanisms are very different between the i-cbt and the erp/act perspectives. But, it actually seems to me that first process described in the video does reflect defusion, in that defusion entails a metacognitive shift in how one views their thoughts, resulting in cognitive distance from verbal content. By learning to recognize faulty reasoning in OCD thoughts (e.g., when learning the 'tricks and cheats of OCD' in i-cbt and seeing how obsessional doubts naturally come from a feared vulnerable self), it effectively helps the person see OCD thoughts/doubts as 'stories' and not fact. It creates cognitive distance from the obsessional doubt. Getting in touch with one's senses also seems to be consistent with ACT and other mindfulness-based therapies. For instance, when doing ACT-informed tx for people with somatic symptom disorder / chronic pain/ anxiety, I often have the person practice attunement to their bodies to have more accurate information to base their decisions on -- rather than following the anxious/hypervigiliant voice's stories. I wonder, though, whether the processes underlying i-cbt are more similar to those underlying ACT and ERP than the surface differences between the therapies suggest. Just as some studies have found that cognitive restructuring techniques may actually result in modifying the relationship with one's thoughts, rather than just changing the content of the thoughts themselves (in other words, cognitive restructuring may act through promoting defusion/decentering; doi.org/10.1016/j.beth.2018.01.005), despite differences in 2nd and 3rd-wave cbt theories and techniques. Maybe this will be clarified when more research on i-cbt emerges.
@@ker331 Hi… There is a lot here to try to explain via this platform… Quick question- have you done ICBT training? I ask bc many of us therapists when we were first learning this we were all a little confused initially. It took some time to learn and practice with clients to understand the difference. Cognitive restructuring therapy is wonderful. Here though we are not restructuring anything. We learn to see how the ocd arguments is faulty from the start. Here we are not distancing or diffusing. The goal is to resolve obsessional doubt and come back to normal doubt processes using our senses which included common sense, 5 senses, connect to real self, and our real intentions and desires, and have clarity like we did before we were triggered. How people with OCD (myself included) get imaginally absorbed is a little different process. We need to recognize we are dissociated from reality when we are triggered. And definitely more research is needed. I think what’s most important is do what helps clients gets better.
Would you say that OCD sufferers that respond better to ICBT than other therapies, are persons that heave heavier forms of OCD and thus more problems with „trusting“ their own senses? Which in conclusion would mean that those said OCD Sufferers see things that aren‘t there and vice versa? Or is it that they see it, acknowledge it but still have some sort of a heavy doubt linked to fatal consequences which causes them to have the urge to still „check“? Thanks for the vid :)
ICBT is great for any OCD theme and for those who have not responded to ERP and who have obsessive doubts leading to inferential confusion due to reasoning errors. It is not about seeing something that is not there- it is about this obsessive doubt process that is activated in the OCD brain.
@@OCDWhispererfollowing up to this conversation: the „reasoning errors“ would you say this would be a reason to be dangerous driving a car for example? In our country for example the requirements are to not have a mental illness with a meaningful impact on the perception and processing and evaluation of informations?
Because I feel like OCD attaches itself to certain topics (mostly the most important in that moment) so in general I think there is a baseline of normal perception and processing of happenings. I think there is also studies saying that folks with OCD drive as safe as everyone else