Treatment methods

New perspectives for your everyday life

If compulsive symptoms, which you perceive as excessive or absurd, lead to severe suffering and significantly impair your everyday life, you should seek professional support. As a rule of thumb, things become worrying if obsessive thoughts or actions occur for more than an hour a day. Our experts accompany you in developing individual coping strategies.

Conservative treatment methods

Obsessive-compulsive disorder treatment: our treatment concept

Since there are various causes of obsessive-compulsive disorders, our therapy also starts at several points. It is multimodal and includes the following components:  

Behavioural therapeutic methods

A central component of behavioural therapy is practising skills in order to cope with unpleasant emotional states that are triggered by the fear of compulsions. Under the guidance of a trained therapist and following careful preparation, you will be introduced to situations that trigger a fear of compulsion (gradual exposure to the compulsion with reaction management). If you do not give in to the urge to act now, you will learn that you can overcome the unpleasant feelings even without compulsive rituals. You gain more and more confidence by repeating this exercise. Often, repetition under conditions similar to everyday life (home exposure) is also necessary, as a result of which the unpleasant feelings and sensations occur less and less frequently. Even if this procedure initially seems to you to be stressful or even unimaginable: under professional guidance, exposure is by far the most effective form of treatment to date.
Looking back, many of those affected found it extremely helpful. It is generally also necessary to involve partners or relatives, who are often considerably involved in and burdened by the compulsions.

Compulsion management group

In the group, you will learn to understand how your personal vicious circle of thoughts, feelings and compulsive actions develops. Together with the other sufferers, you will develop strategies to tackle them. You learn to understand and overcome the compulsions that were originally seen as absurd. Within the framework of an individual exposure plan, you will gradually approach situations that trigger compulsions and implement the new strategies. While doing so, you will be actively supported and encouraged by other group members. The exposure situations are initially sought out with therapeutic support until you have had so many positive experiences that you can apply the strategies independently and overcome your compulsions. The ongoing standardised assessment of the severity of your compulsions gives you feedback on the progress of treatment.

Cognitive strategies

The exercise-oriented therapies are accompanied by what are known as cognitive strategies. During this, you become aware of unfavourable assessments and thoughts, their usefulness is checked and, if necessary, alternatives are devised. The aim is that you no longer perceive the thoughts experienced as disruptive and threatening as danger signals, but instead as part of an everyday stream of thoughts without any meaning. For example, you can learn that the sudden thought “I could harm someone without realising it” does not mean that you are dangerous or a bad person. You realise that thoughts only become threatening when you attach (a negative) meaning to them. The aim of obsessive-compulsive disorder therapy is to help you achieve more realistic expectations over the long term.

The exercise-oriented therapies are accompanied by what are known as cognitive strategies. During this, you become aware of unfavourable assessments and thoughts, their usefulness is checked and, if necessary, alternatives are devised. The aim is that you no longer perceive the thoughts experienced as disruptive and threatening as danger signals, but instead as part of an everyday stream of thoughts without any meaning. For example, you can learn that the sudden thought “I could harm someone without realising it” does not mean that you are dangerous or a bad person. You realise that thoughts only become threatening when you attach (a negative) meaning to them. The aim of obsessive-compulsive disorder therapy is to help you achieve more realistic attitudes over the long term.

Obsessive-compulsive disorder – medications

Medications that have an effect on the serotonin system also contribute to successful treatment. In order to achieve an effect, however, these serotonin reuptake inhibitors must be administered in sufficient doses and for a sufficiently long time. They only take effect when a certain concentration of the active substance is present in the blood and various adaptation processes have taken place in the brain. This can take up to 12 weeks. If the medication is discontinued, the compulsions usually reoccur. For this reason, behavioural therapy, in which you are supported while being exposed to compulsions, should always be carried out at the same time. In principle, medications are the second choice and should only be used if cognitive behavioural therapy is not sufficient.

Mindfulness-based treatment elements

The suppression of unpleasant thoughts and feelings does not correspond to the normal human state. Try pushing a balloon under water. The harder you push, the more it pushes towards the surface of the water.
Mindfulness-based techniques are an effective supplement to behavioural therapy methods for many patients. They lead to a better long-term ability to deal with thoughts and feelings of fear and uncertainty.

Obsessive-compulsive disorder: outpatient or inpatient therapy?

Outpatient treatment is usually sufficient if you are still able to cope well with everyday life. It often helps to perform behavioural exercises at home or in real-life situations while temporarily accompanied by a therapist. If this is not possible in the context of outpatient therapy, an inpatient stay can be helpful. Here you can use the experiences of other patients in group therapies under the guidance of a therapist in order to achieve your own goals.

If, in addition to a pronounced obsessive-compulsive disorder, other psychological disorders occur or the courage to face life decreases to become world-weariness, you should definitely consider inpatient therapy.

Cooperation
In order to continuously integrate new findings into your treatment programme, Schoen Clinic cooperates intensively with university research institutions and the German Society for Obsessive-Compulsive Disorders (Deutsche Gesellschaft für Zwangserkrankungen e.V., DGZ).