Obsessive-compulsive (DOC) disorder is a disorder characterized by obsessions (thoughts, images or unwanted impulses that cause profound suffering) and compulsions (behaviors, visible or not, which the subject puts in place to reduce the discomfort caused by obsessions).
This condition can have a important impact on life of those who suffer from it, influencing personal relationships, working productivity and the ability to carry out daily activities.
Despite the awareness of the impact on one’s quality of life, it is not always easy to find the Motivation to change which allows you to effectively undertake a therapeutic path.
The motivation to change is a dynamic process, which can be influenced by multiple internal and external factors to the patient. Developing and maintaining a high motivation is essential to effectively deal with the disorder. The success of the DOC treatment depends to a good extent on the patient’s motivation to commit and persist in the proposed therapies.
Motivation barriers
The barriers to motivation in the treatment of the DOC are manifold and complex.
One of the main barriers to motivation in Treatment of obsessive-compulsive disorder (DOC) It is the fear of the consequences not to perform compulsive rituals, who leads patients to believe that these behaviors are the only way to prevent negative events or to relieve the suffering linked to obsessions.
Another significant barrier is theattachment to rituals. For some patients, compulsive behaviors provide a sense of control or security, despite being aware of their irrationality. This sense of security is not easy to abandon and often creates a lot of ambivalence in the implementation of typical exercises of the cognitive-behavioral path.
There lack of hope It is also a common barrier. Patients who have lived with the DOC for a long period without significant improvements can become pessimists regarding the possibilities of recovery, which can reduce their motivation to engage in treatments that perceive as useless.
Cognitive-behavioral strategies to increase motivation
To overcome these barriers, it is essential to implement specific strategies.
Psychoeducative interventions, typical of cognitive-behavioral therapy (TCC), can be particularly effective, providing patients with a deeper understanding of the disorder mechanisms and demystifying irrational beliefs relating to compulsions.
The TCC is one of the most effective therapies for the DOC, focused on the modification of dysfunctional thoughts and behaviors.
Through TCC, patients learn a challenge their obsessive beliefs and to question the need for compulsions, acquiring tools to manage anxiety.
The TCC can strengthen motivation by showing patients tangible progress and improvements in the management of symptoms, also thanks to behavioral experiments and exhibitions. These not only question the obsessive beliefs that maintain the disorder, but refer a Sense of self -efficacy to patients.
Like third generation cognitive therapies can help us in the increase in the motivation for change
Third wave therapies can be an excellent integration to the well-known cognitive-behavioral techniques, not only in the treatment strategy but also in the management of the motivation to change.
Acceptance and commitment therapy (ACT)
The Act stands out for its focus on the acceptance of painful thoughts and emotions without struggle, and on the commitment to actions that reflect the patient’s personal values, even in the presence of events that are difficult to manage.
This approach is based on the idea that the attempt to control unwanted internal experiences can intensify suffering and divert the individual from his life values and objectives.
In the context of the DOC, the ACT helps patients develop a different relationship with obsessive thoughts and compulsions. Instead of fighting or giving in to these thoughts and behaviors, the ACT encourage patients to recognize them, accept them as experiences, and then choose to act in ways that are more aligned with what is really important for them.
By integrating the ACT into the DOC treatment, therapists can offer patients powerful tools to increase their motivation for change.
Through acceptance, orientation towards personal values and committed action, patients can learn to live a life that reflects what is really important for them, regardless of the presence of obsessive thoughts or compulsions.
The ACT, therefore, not only helps patients a Better to manage the symptoms of the DOCbut also provides a path to a richer and more full existence, increasing the intrinsic motivation for the change and improvement of the quality of life.
Compassion Focused Therapy
The compassion focused Therapy (CFT) is particularly relevant in the treatment of the DOC, since it aims to promote self -compression and empathic understanding towards one’s psychological suffering.
This approach is based on the principle that many of the psychological difficulties, including disorders such as DOC, are rooted in hyperactive threat systems and in severe internal criticism.
Many patients with DOC fight with feelings of shame and self -heal because of their obsessive thoughts and compulsive behaviors. The CFT works for reduce these internal criticismsencouraging an attitude of kindness and understanding towards oneself.
This can be particularly liberating for patients, increasing theirs motivation to engage in treatment and to explore change strategies.
Through the exercise of compassion, patients learn to treat themselves with the same kindness and understanding that they would offer to a dear person in difficulty. This change of perspective can facilitate greater commitment in treatment, since patients begin to see the therapeutic path not as a further source of stress or criticism, but as an act of personal care.
Compassion thus becomes a powerful motor changeencouraging patients to pursue recovery not to avoid judgment, but to promote well -being and happiness.
The role of the therapist
The therapist plays an irreplaceable role in the process of change and some aspects are fundamental to facilitate the motivation of patients suffering from DOC.
The first step for a therapist is to create an environment in which the patient feels Safe, accepted and understood. The safety of the relationship and non -judgmental acceptance reduce the risk that the patient closes or withdrawing from the treatment, particularly important when dealing with difficult arguments or that generate feelings of shame.
Furthermore, even recognizing the smaller progress is vital to maintain the patient’s motivation. This recognition helps patients to see that change is possible and that they are moving steps towards recovery, even if slowly. These moments of celebration can be particularly motivating and reinvigorate the patient’s commitment in the treatment.
Finally, therapists use their empathy and competence to help patients a overcome the resistance to change. Through active listening techniques, emotional validation and constructive challenge of dysfunctional thoughts, therapists can help patients navigate through their fears and resistance.
This process not only increases motivation but also strengthens the therapeutic alliance, fundamental for effective treatment.
Final considerations
Motivation to treatment is a critical element in the success of the therapy for obsessive-compulsive disorder. Overcoming the barriers to motivation requires an integrated approach that includes psychoeducation, therapeutic support, and the application of specific therapeutic strategies such as TCC, ACT and CFT.
It is essential that therapists recognize the importance of motivation and use targeted methods to support it, thus facilitating the path of patients towards recovery and better quality of life.
Bibliography
- Melli, G. & Carraresi, C. (2023). Cognitive behavioral therapy of obsessive-compulsive disorder. Erickson
- Vogel, PA, Hansen, B., Stiles, TC, & Gotastam, Kg (2006). Treatment Motivation, Treatment Expectancy, and Helping Alliance As Predictors of Outcome in Cognitive Behavoral Treatment of OCD. Journal of Behavior Therapy and Experimental Psychiatry, 37(3), 247–255.
- Petrocchi, N., Cosentino, T., Pellegrini, V., Femia, G., D’Innocenzo, A., & Mancini, F. (2021). Compassion-Focused Group Therapy for Treatment-Vestant Ocd: Initial Evaluation Using A Multiple Baseline Design. Frontiers in Psychology11.
- Twohig, M., Abramowitz, J., Smith, B., Fabricant, L., Jacoby, R., Morrison, K., Bluett, E., Reuman, L., Blakey, S., & Ledermann, T. (2018). Adding Acceptance and Commitment Therapy to Exposure and Response Prevention for Obsessive-Compulsive Disorder: A Randomized Controlled Trial .. Behaviour Research and Therapy108, 1-9.
- Dehlin, J., Morrison, K., & Twohig, M. (2013). Acceptance and Commitment Therapy As a Treatment for Scrupulosity in compulsive obsessive disorder. Behavior Editation37, 409 – 430.
- Strappini, F., Socci, V., Saliani, AM, Grossi, G., D’Ari, G., Damato, T., Pompili, N., Alessandri, G., & Mancini, F. (2022). The Therapeutic Alliance in Cognitive-Behavoral Therapy for Obsessive-Compulsive Disorder: A Systematic Review and Meta-Aalysis. Frontiers in Psychiatry, 13951925.
