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The differences between CBT and counselling for OCD

Woman during a psychotherapy session

When I first went to counselling, I felt absolutely desperate. It’s something I’d thought about, but, like many people, I didn’t do it until I felt like I couldn’t go on without help. After counselling I went to CBT as I realised that I may have OCD, it turned out that I was right so I have been treated with both therapies as a result.

I wanted to share my experiences, firstly to show that I sought help and got better but also to highlight that there are several avenues that you can go down if one doesn’t work for you.

Therapies for OCD

Talking therapies like counselling and CBT can go along with many other therapies including medication, meditation and self-care. My recovery took several years, and the improvements were incremental, but every step was important and an achievement in itself.

I want you to know that every part of your recovery is something to be celebrated and even if you feel like you’re going backwards, in many ways that can be part of the recovery.

If you suffer with depression, anxiety, OCD or are generally having a bad time then its always worth speaking to a professional in order to manage and/or heal your condition.

I’ve had depression in the past, but in my late twenties, anxiety and OCD became much more of a problem for me which is why I switched from counselling to CBT.

There are other types of talking therapies, but I wanted to concentrate on counselling and CBT as they are the two of the main ones. I’ve experienced them both and I wanted to summarise them, along with some of the elements you may not know about them. You can certainly try both to see what works for you, or something else entirely and whatever works is worth investing your time in.

What is counselling?

Counselling is a general talking therapy where a professional guides you through both personal and psychological problems. They can also help with your relationship problems if you go are a couple facing issues together.

Counsellors have different methods and some things that my counsellor did with me included recommending books to read, talking to an empty chair as if it was someone that hurt me, aromatherapy and creating an affirmations jar. This was along with talking about my past and present so that she could get an idea of who I was, what I was dealing with and why this had caused problems for me.

I cried a lot during my counselling sessions and I went on a real journey through my past and considering the people who had hurt me. Counselling was really the thing that helped me to realise where my problems stemmed from, and the events that had hurt me the most. Once I knew that I could start to heal.

I really recommend looking at reviews in order to find a decent therapist as it takes out some of the guesswork. You don’t have to be friends with your therapist as it’s a professional relationship with boundaries, but you do need to respect them as well as being happy to spend those hours with them.

It’s also worth knowing their schedule, as my counsellor had evening appointments which was great as I worked long hours and it didn’t mean missing work in order to go.

Counselling contract

It’s also normal to sign a contract between both of you outlining the rules of therapy that you will both adhere to. It’s nothing scary, just that everything is in confidence, unless you tell them something that could be dangerous to you or others.

The one thing that I didn’t like about counselling was that I spent a lot of time talking about my problems, which sometimes I found exhausting. If you feel that way you can schedule in fewer sessions as sometimes going once a week can be too much.

I felt drained after my sessions, so it’s worth relaxing once you get home and doing something nice like running a hot bath or eating takeaway.

If you live in the UK, you can refer yourself for counselling on the NHS via their website. Your employer may also have benefits that include mental health treatment so it’s worth speaking to HR about it. You can also pay for a private counsellor and prices start from £40 per hour.

What is CBT?

CBT stands for Cognitive Behaviour Therapy and its a method used to treat people with a spectrum of disorders, including depression, anxiety, phobias, eating disorders and addictions.

Your first session involves filling out questionnaires to rate your thoughts and feelings so that your therapist can determine what modules you need to take.

You’ll be given homework after every session, so it’s worth getting a folder to put it all in, and there may be up to 8 chapters in each module. Depending on what you’ve told your therapist, these will cover subjects like perfectionism, mindfulness, assertiveness, your worry record and self-esteem.

CBT example module on releasing tension

How does CBT work?

At the beginning of your subsequent sessions, you will make an agenda of things that you both wish to work on and discuss. CBT is a bit like a lesson and my therapist had a whiteboard that he used to describe things like thought processes, how they worked in the mind and how they can make you feel.

I enjoyed the practicality of CBT after having counselling, as I’m quite into the idea of psychology and how the brain works. I also felt that it addressed and identified many of the issues that I wanted to overcome like self-esteem and perfectionism, which hadn’t been brought to my attention before, even though they were clearly there. Another plus point was that I enjoyed hearing stories of people managing their OCD as it gave me hope.

The one drawback for me was that talking isn’t so much a part of CBT, which can be frustrating if there is something that you wish to discuss.

CBT is about offering solutions to your feelings, and less about discussing them, so there is probably a market for a mixture of both, where you spend half the session talking and half the session solving those problems. You’re in control of your sessions so it’s possible to change the agenda if you need to if your therapist is happy.

Finding a CBT therapist

You can buy books on CBT that you can work through on your own if you want to know more about it. To see a therapist, you can get an NHS referral much like with counselling, or you can find a private therapist online. Prices start at about £50 per hour.

Always reach out

I would urge anyone who is struggling with any mental health issue to speak to someone and take any help you can in order to find out what works for you. We live in a world where our mental health is slowing rising as a priority and science knows more about the brain than ever before. I went from a shell of a person who didn’t want to exist, to a happier person who is less afraid and I believe you can too.

If you or anyone you know has suffered with self-harm then I have written an article on my experiences which includes resources for self-harmers.

Resources:

Mental health resources for anyone struggling in uncertain times

Let me know if you have had any kind of talking therapy for mental health problems or mental illnesses like OCD in the comments below! I’d love to hear your thoughts!

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The differences between CBT and counselling for treating mental health problems by someone with OCD
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