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Obsessive-Compulsive Disorder

        The New Jersey Affiliate of the
Obsessive Compulsive Foundation

Newsletter

FALL 2005 VOL. 7 NO. 3

Dr. Milton Spett Discusses "Beyond ERP" in the Treatment of OCD

By Jamie Solomon-Charney, Psy.D.

The June 13th quarterly meeting of the New Jersey Obsessive Compulsive Foundation afforded all in attendance the opportunity to learn of various cognitive techniques in the treatment of Obsessive Compulsive Disorder. The meeting’s presenter, Milton Spett, Ph.D., is the cofounder of the New Jersey Association of Cognitive-Behavioral Therapists (www.nj-act.org) and is a licensed psychologist in independent practice in Cranford, NJ. He has published many articles in various professional journals.

Dr. Spett’s informative presentation commenced with a brief explanation of Exposure/Response Prevention Therapy (ERP). According to Dr. Spett, exposure refers to exposing one’s self to situations that evoke obsessions and anxiety, while response prevention is the process of preventing one’s self from engaging in anything that would counteract the anxiety or obsessive worry.  Essentially, in utilizing ERP, one must "Experience obsessions, but don’t do anything about it. Wait for the anxiety to pass by itself." Dr. Spett emphasized the importance of keeping records during Exposure/Response Prevention exercises, explaining that records serve to increase the frequency and duration of the exercises and can help one to see previous progress made when experiencing a setback.

Cognitive techniques, according to Dr. Spett, can often improve the effect of the Exposure/Response Prevention exercises. Dr. Spett stressed the importance of viewing obsessions as positive rather than negative. Obsessions can be perceived as opportunities to challenge one’s OCD, by tolerating the anxiety and preventing performance of compulsions. In addition, it is helpful to externalize the OCD by considering it be an "alien force that is trying to control you", while perceiving yourself as a stronger force that is able to resist its demands. Further, it is important to remember that OCD is a disorder that waxes and wanes. When experiencing a setback, do not get discouraged and give in to the tendency to think "I am right back where I started." Instead, keep fighting your OCD, reminding yourself that improvement is slow and includes many setbacks. 

Dr. Spett also shared cognitive strategies that may be effective when working specifically with individuals that experience harm obsessions. According to Dr. Spett, 80% of the general population experience thoughts of harming themselves or others.  However, these thoughts tend to be fleeting in most people without Obsessive Compulsive Disorder.  Distinguishing thoughts from acts is important, as harm obsessions are not hurtful to others. 

Cognitive and behavioral techniques are both important components in the treatment of Obsessive Compulsive Disorder. However, it is imperative that the treatment also address any comorbid psychological disorders that may be present. Disorders, such as Depression, may worsen and be worsened by OCD, according to Dr. Spett.

Successful treatment for Obsessive Compulsive Disorder is contingent on many factors. Dr. Spett suggested that it is helpful to have family members involved in the treatment process. They are able to serve as "assistants", who can provide encouragement and reminders to perform ERP exercises. Further, they can support the treatment by not accommodating a family member’s Obsessive Compulsive symptoms. In addition, Dr. Spett spoke of the importance of integrating medication and therapy, when a patient is taking medication to reduce OCD symptoms. Dosages of medication should be enough to alleviate some discomfort and make ERP exercises easier to engage in, but not too much that they eliminate obsessions, anxiety and compulsive urges. Medication is only effective for the period of time that an individual is taking it. Therefore, it is beneficial for people with Obsessive Compulsive Disorder to experience enough anxiety to engage in psychological treatment so that they can learn how to make permanent reductions in their symptoms. 

Dr. Spett’s presentation provided valuable information on cognitive and behavioral strategies that are useful for professionals, as well as for OCD sufferers and their family members in the quest to challenge a disorder that often presents many obstacles. Dr. Spett may be reached at 908-276-3888 or visit his website at www.CranfordPsychology.com.

For more information or to make an appointment, you can call us at (908) 276-3888.

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