Therapy/medication question

Is it possible to have ERP and talk therapy at the same time? Basically I self referred for therapy (I’m in the UK) and it was decided that I 100% have OCD and I’d receive CBT therapy however I’ve only had one and a half sessions with the therapist and she told me that my OCD is severe, she has no idea why the person assessing me referred me to CBT and that it won’t help, and so subsequently she’s decided to escalate my care and refer me for ERP therapy, which is great news and I’m very happy that it’s being taken seriously which brings me to my now issue which is It’s been 6 weeks since I was started on a new SSRI for OCD which is not helping at all, if anything I feel worse. My OCD isn’t worse just my mood, I have been so unbelievably depressed that functioning is hard. This is the third SSRI I’ve been put on and none of them help with my low moods, I’m still very tearful, have mood swings, I’m depressed and can then have quite high moods which makes me think I have more than just depression/anxiety and OCD. So now I’m a at a bit of a loss as I know SSRI’s are usually the medication used to treat OCD but they clearly don’t work for me and I have underlying issues that I think I might need talk therapy to deal with and unpack but is that possible to have alongside ERP?

wishmefragile†✝︎

Date posted: 14h

i imagine that it is possible, because ERP and talk therapy are treating different things (OCD patterns VS underlying issues). i think that could work very well together honestly :D i actually have a question of my own, because i am in the same position that you were. i have referred myself for therapy in the UK, they’ve offered me CBT which i am on the waiting list for. however, my OCD is severe and i suspect CBT will not be ideal for me. can i ask how you communicated the severity of your OCD? because i tend to minimise my problems and clam up. or did your therapist just pick up on it on her own?

wishmefragile†✝︎

Date posted: 14h

@wishmefragile†✝︎ though, i do want to add to not use talk therapy to overanalyse intrusive thoughts or OCD, because then that could harm the work you’re doing in ERP. but otherwise, this makes sense to me! just make sure to tell this to the talk therapy therapist and ERP therapist

anonr23

Date posted: 14h

@wishmefragile†✝︎ I was basically as honest as I could be about my intrusive thoughts and my compulsions, which is absolutely terrifying but thankfully my therapist was very understanding and she knew about OCD and knew straight off the bat that CBT wouldn’t work for me. I have basically every subtype of OCD and have both physical and mental compulsions, the only thing I’m ever cautious about talking about is POCD and that’s something I’ve never talked to a therapist about, I imagine I will when I have ERP though as I think it’s important for them to know as much as they can so they can! And the therapist I had told me that there’s not an intrusive thought she hasn’t heard about after I told her that I’d been struggling to sleep due to intrusive thoughts about a family member hurting me in my sleep. She also did a scale thing with me to see where my OCD/anxiety would sit on some sort of chart and it always came back as severe - I think though if your therapist isn’t picking up on your OCD and the severity of it then you should absolutely try and advocate for yourself and mention that CBT isn’t working, they usually want you to at least try a few sessions but my therapist knew the second time she met me that breathing exercises and grounding myself wouldn’t cut it. I hope this helps! 💛

aralways

Date posted: 14h

It all depends on your insurance and care. Generally, insurance and medical professionals want to avoid having two different people preform the same task for a patient. So having two different therapists is often not possible. But there are certain situations in which someone might have one therapist for a specific issue like OCD, and another therapist for a different specific issue - as long as there’s not an overlap in type of treatment. So I would say, try bringing it up and see if you can be allowed to receive both ERP and a different form of therapy as long as they are treating different issues. If you cannot do that, talk to your ERP therapist about incorporating ways to support you through mood issues as well.

anonr23

Date posted: 14h

@aralways Thank you! We don’t have insurance where I am, our services are free (unless you pay to go private) but that comes with its own problems as there’s long waiting lists so I think asking when I’m receiving ERP will be what I end up having to do

Asi_haunted

Date posted: 13h

I’m going talk therapy and ERP right now and so far it seems like it’s helping, I think the only thing is sometimes I’ve already talked about something so it gets a little redundant but I do always get more help and insight regardless

vBayv

User type: OCD Conqueror

Date posted: 11h

As long as your talk therapist understands OCD and when to and when not to provide reassurance, sure. Personally, I got basically nothing from talk therapy and until I started therapy with NOCD saw no improvement. I'm not sure that talk therapy is "treating the underlying issues," I think the underlying issue IS the OCD and the feelings generated by it and the compulsions done to reduce those feelings. Talk therapy is story based, ERP is about the here and now which is so important for OCD. Do whatever brings you the most improvement!

Be a part of the largest OCD Community

Share your thoughts so the Community can respond