Obsessive-Compulsive Disorder (OCD) was once considered untreatable. Individuals with OCD could spend years in psychotherapy with minimal or no benefit, and medications available at the time were largely ineffective. Fortunately, the outlook improved dramatically by the end of the 20th century. In addition to a class of drugs called serotonin reuptake inhibitors, a specific form of cognitive behavior therapy known as “exposure and response prevention” (ERP) emerged as a first line treatment for OCD. Receiving a diagnosis of OCD no longer meant a lifetime of hopelessness. With proper therapy, many people could expect to have a significantly better life.
For those of us in a profession dedicated to helping people with OCD, the challenges we face today are quite different. We now know how to help many OCD sufferers, but also recognize the limitations of existing treatments. As a consequence, our efforts to advance the field are focused on discovering alternative or complementary interventions that work more rapidly, reduce symptoms more completely, or have fewer adverse effects than current treatments.
One hope for improving outcomes is to identify factors that might complicate or interfere with treatments like ERP and to develop strategies to modify those factors. Everyday Mindfulness for OCD is a fine example of this approach. In this book, Jon Hershfield and Shala Nicely attempt to enhance ERP by addressing behavioral obstacles like trying to control unwanted thoughts, toxic self-criticism, and seclusion from joyful experiences.
To combat counterproductive behavior, the authors offer strategies that can guide your effort to overcome OCD. As the title suggests, much of the book is focused on mindfulness. Being mindful teaches you how to reverse futile attempts to eliminate unpleasant thoughts, and how to accept and move past the things you cannot control. To help you abandon unforgiving self-criticism, Hershfield and Nicely prescribe exercises designed to promote self-compassion. Enhancing self-compassion includes making a concerted effort to recapture the joy that once occupied your life, not simply reducing the misery associated with OCD.
The fundamental principles of ERP have always included the imperative to stop avoiding anxiety-provoking experiences. From the perspective of cognitive behavior therapy, avoidance is the enemy of recovery and it perpetuates OCD. That means anything that facilitates your ability and willingness to counteract avoidance should enhance your chances of recovery. In this book, you will be encouraged to follow the time-honored principles of ERP, but you will also have the opportunity to learn additional concepts and strategies designed to enhance your ability to be mindful, self-compassionate, and, ultimately, to stop avoiding important aspects of your life. I hope you will embrace this opportunity. Good luck!
—C. Alec Pollard, Ph.D.
Director, Center for OCD & Anxiety-Related Disorders
Saint Louis Behavioral Medicine Institute
Professor Emeritus of Family & Community Medicine
Saint Louis University