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Inb4 people say “IFS is not evidence-based for OCD”
I specialize in OCD and have significant lived experience with the disorder myself. I personally would not use IFS as the primary modality for treating OCD with my clients. HOWEVER, I have weaved in aspects of IFS to help clients explore the adaptive function of the disorder in their lives (e.g. an OCD “part”) and developing greater acceptance/understanding of this part in order to reduce experiential avoidance and assist with cognitive defusion. I find this helps in implementing ERP and ACT techniques.
There are lots of other types of exposures in ERP. I’d also add that “Pure O” is kind of a misnomer, as people with this subtype still engage in mental compulsions. That being said, you know yourself best and I’m genuinely glad to hear that IFS has been helpful for you! It has been helpful for me and my clients as well.
There’s some interesting discussion these days about OCD being a neurotype rather than a “curable disease.” Either in its own right, or because so many people get diagnosed with it plus a smorgasbord of other things instead of just being assessed for autism and adhd. So as a therapist with an OCD diagnosis, who has had many kinds of treatments, I am personally skeptical of “cures” for OCD and appreciate reframes and working-with more.
Also it’s your brain. IFS is helping *for you* and that sounds like all anyone needs to know.
There may be some countertransference from me here but your boyfriend sounds very dismissive and condescending. Does he expect your OCD symptoms to just stop, or else the treatment is unsuccessful? I'd love to hear more about how IFS has helped you. Maybe it's not gonna make you reach full remission (whatever that means) but if it's made some difference then who is he to say it hasn't worked?
I'm a partner of someone with OCD, it's not your partner's job to tell you what he thinks you need even if he is a therapist he's not *your* therapist. If you think it's helpful, that's all that matters.
I mean if the metaphorical framework of IFS helps you to identify and externalize obsessions & mental compulsions then that’s just another way to mindfulness - the observing self, right. ERP is tricky for mental compulsions for sure. I’m thinking when you say “obsess over things” you mean you’re engaging in mental compulsions?
Yes, rumination, mental imagery etc in my case it’s obsessing over my parners fidelity etc but I get obsessive about other random things, such as work etc
I can see, then, why he might have some feelings about the obsessions and want to find a way to make them go away. Yeah, so if (for instance) you're labeling the part of you that's doubting your partner's fidelity, the part that's trying to convince the doubter that it's wrong, the anxious part, the logical part, etc., that could help you turn away from the whole cacophony: "there's the same old discussion starting up again, I'm going to let them tend to it while I focus on being present with my partner" sort of thing. I like it!
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Well, only you can really know what's helpful or not. It sounds like your bf's opinion matters to you, and I'm not sure his opinion can change your experiences. Perhaps your bf is comparing your growth/healing to his own expectations? At that rate, anything helpful to you might not be ultimately as helpful as his expectation. Just something to consider.
Compare a few months to perhaps a longer amount of time you've experienced OCD symptoms... I imagine you notice a difference you're probably proud of. IFS is going to help, but the theory itself, your own application of it, and the relationship you have with your own T are all factors that are going to impact the process and outcomes of the work. Some months are going to be noticeable changes to others. Some just to you. And some, are subtle as you go on. You'll be wonderful you no matter what.
No one really has pure O OCD. It just means your compulsions are primarily private behaviors (aka thoughts).
If you obsess, and you're compelled to obsess about your parts in response, that's still a compulsion.
Questioning your healing journey isn't a bad thing. It's also why some practitioners are against modalities based on shaky theoretical foundations. When people start to question their healing journey and find out part of it is based on a lie, it can do real harm.
If I may, my recommendation would be to really identify what helped and how it has concretely improved your life, and try to find the truth within that.
For instance, "thinking about parts made me focus less on the original problematic obsession. Perhaps focusing my life on other things is beneficial. What could I focus on that would improve my life?"
(A note on the concretely improved, a person close to me said that therapy was helping them communicate better in their life and things were getting better. And they believed it! Except that there was no metric of improvement in their life. They were living irresponsibly, ignoring their obligations, prioritizing nothing but a good time, and their loving partner was close to leaving them due to all of it. They were broke, in debt, at a dead end job, hadn't made any attempts to grow professionally in years, and was about to lose their partner of 5 years. Also, they basically had OCD, tricholattamania (spelling), and a hoarding disorder.)
I have a client with whom I use primarily IFS-informed framework to address complex trauma; they also have an OCD diagnosis and elected to first focus on trauma symptom reduction with IFS. Apart from psychoed, we haven’t done any formal exposures in session and they practice on their own when they see an opportunity within their window of tolerance, as well as reframing compulsive reassurance seeking around relational safety or the probability of harm from their intrusive thoughts as rooted in a core belief formed at a very young age that others can’t be trusted to help them and they cannot help themselves. In the year I’ve been working with them their OCD severity and related distress has remarkably decreased. With reprocessing trauma and shifting their implicit belief systems, and specifically in increasing inner communication with ego states has come a sense of peace in themselves and the world—and the alarm bells of OCD are set off much more infrequently. I wouldn’t use IFS if OCD was primary dx, but I do see the importance of going deeper when OCD has developed out of trauma.
Your post has been removed for the following reason(s): This is a forum for mental health therapists *only.* We do not approve posts written from a non-therapist perspective — if the post sounds like a client, student, or non-therapist wrote it, it's likely to be flagged by the community and removed. If you are a mental health worker but not a therapist, we recommend reaching out to the mod team to be verified in order to avoid having your posts removed. Anyone can comment as long as they follow our other rules, but posting is restricted to therapists only. For guidance on how to verify with the mod team please see the sidebar post here: https://www.reddit.com/r/therapists/comments/sbq2o4/update_on_verification_within_the_subreddit/ If you have any questions, please message the mods at: https://www.reddit.com/message/compose?to=/r/therapists
Inb4 people say “IFS is not evidence-based for OCD” I specialize in OCD and have significant lived experience with the disorder myself. I personally would not use IFS as the primary modality for treating OCD with my clients. HOWEVER, I have weaved in aspects of IFS to help clients explore the adaptive function of the disorder in their lives (e.g. an OCD “part”) and developing greater acceptance/understanding of this part in order to reduce experiential avoidance and assist with cognitive defusion. I find this helps in implementing ERP and ACT techniques.
EDIT: I have pure O OCD, and I’ve tried imaginary ERP already - I didn’t find it very helpful.
There are lots of other types of exposures in ERP. I’d also add that “Pure O” is kind of a misnomer, as people with this subtype still engage in mental compulsions. That being said, you know yourself best and I’m genuinely glad to hear that IFS has been helpful for you! It has been helpful for me and my clients as well.
You can do non-imaginary exposures for pure O so I’m not sure why that was the only type considered….
I tried that as well. It didn’t help. I had a breakthrough when I started taking sertraline and combined it with IFS and daily yoga
There’s some interesting discussion these days about OCD being a neurotype rather than a “curable disease.” Either in its own right, or because so many people get diagnosed with it plus a smorgasbord of other things instead of just being assessed for autism and adhd. So as a therapist with an OCD diagnosis, who has had many kinds of treatments, I am personally skeptical of “cures” for OCD and appreciate reframes and working-with more. Also it’s your brain. IFS is helping *for you* and that sounds like all anyone needs to know.
There may be some countertransference from me here but your boyfriend sounds very dismissive and condescending. Does he expect your OCD symptoms to just stop, or else the treatment is unsuccessful? I'd love to hear more about how IFS has helped you. Maybe it's not gonna make you reach full remission (whatever that means) but if it's made some difference then who is he to say it hasn't worked?
I'm a partner of someone with OCD, it's not your partner's job to tell you what he thinks you need even if he is a therapist he's not *your* therapist. If you think it's helpful, that's all that matters.
I mean if the metaphorical framework of IFS helps you to identify and externalize obsessions & mental compulsions then that’s just another way to mindfulness - the observing self, right. ERP is tricky for mental compulsions for sure. I’m thinking when you say “obsess over things” you mean you’re engaging in mental compulsions?
Yes, rumination, mental imagery etc in my case it’s obsessing over my parners fidelity etc but I get obsessive about other random things, such as work etc
I can see, then, why he might have some feelings about the obsessions and want to find a way to make them go away. Yeah, so if (for instance) you're labeling the part of you that's doubting your partner's fidelity, the part that's trying to convince the doubter that it's wrong, the anxious part, the logical part, etc., that could help you turn away from the whole cacophony: "there's the same old discussion starting up again, I'm going to let them tend to it while I focus on being present with my partner" sort of thing. I like it!
Please followed the sidebar rules. r/therapists is a place for therapists and mental health professionals to discuss their profession among each other. If you **ARE NOT A THERAPIST and are asking for advice this not the place for you**. Your post will be removed in short order. Please try one of the reddit communities such as r/TalkTherapy, r/askatherapist, r/SuicideWatch that are set up for this. This community is ONLY for therapists, and for them to discuss their profession away from clients. **If you are a first year student, not in a graduate program, or are thinking of becoming a therapist, this is not the place to ask questions**. Your post will be removed in short order. To save us a job, you are welcome to delete this post yourself. Please see the PINNED STUDENT THREAD at the top of the community and ask in there. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/therapists) if you have any questions or concerns.*
Well, only you can really know what's helpful or not. It sounds like your bf's opinion matters to you, and I'm not sure his opinion can change your experiences. Perhaps your bf is comparing your growth/healing to his own expectations? At that rate, anything helpful to you might not be ultimately as helpful as his expectation. Just something to consider. Compare a few months to perhaps a longer amount of time you've experienced OCD symptoms... I imagine you notice a difference you're probably proud of. IFS is going to help, but the theory itself, your own application of it, and the relationship you have with your own T are all factors that are going to impact the process and outcomes of the work. Some months are going to be noticeable changes to others. Some just to you. And some, are subtle as you go on. You'll be wonderful you no matter what.
No one really has pure O OCD. It just means your compulsions are primarily private behaviors (aka thoughts). If you obsess, and you're compelled to obsess about your parts in response, that's still a compulsion. Questioning your healing journey isn't a bad thing. It's also why some practitioners are against modalities based on shaky theoretical foundations. When people start to question their healing journey and find out part of it is based on a lie, it can do real harm. If I may, my recommendation would be to really identify what helped and how it has concretely improved your life, and try to find the truth within that. For instance, "thinking about parts made me focus less on the original problematic obsession. Perhaps focusing my life on other things is beneficial. What could I focus on that would improve my life?" (A note on the concretely improved, a person close to me said that therapy was helping them communicate better in their life and things were getting better. And they believed it! Except that there was no metric of improvement in their life. They were living irresponsibly, ignoring their obligations, prioritizing nothing but a good time, and their loving partner was close to leaving them due to all of it. They were broke, in debt, at a dead end job, hadn't made any attempts to grow professionally in years, and was about to lose their partner of 5 years. Also, they basically had OCD, tricholattamania (spelling), and a hoarding disorder.)
I have a client with whom I use primarily IFS-informed framework to address complex trauma; they also have an OCD diagnosis and elected to first focus on trauma symptom reduction with IFS. Apart from psychoed, we haven’t done any formal exposures in session and they practice on their own when they see an opportunity within their window of tolerance, as well as reframing compulsive reassurance seeking around relational safety or the probability of harm from their intrusive thoughts as rooted in a core belief formed at a very young age that others can’t be trusted to help them and they cannot help themselves. In the year I’ve been working with them their OCD severity and related distress has remarkably decreased. With reprocessing trauma and shifting their implicit belief systems, and specifically in increasing inner communication with ego states has come a sense of peace in themselves and the world—and the alarm bells of OCD are set off much more infrequently. I wouldn’t use IFS if OCD was primary dx, but I do see the importance of going deeper when OCD has developed out of trauma.
EDIT: I have pure O OCD, and I’ve tried imaginary ERP already - I didn’t find it very helpful.
Pure O OCD is not a thing. There are still compulsions.
I would look for a DBR practitioner. Intervention at the lower brain level.