Additionally, severely depressed patients are not likely to benefit from ERP until their depressive symptoms are under control. Other conditions that may interfere with successful ERP are severe personality disorders, or persons with a psychotic disorder. Following the initial assessment phase, Dr. Hyman will inform you whether ERP is likely to be helpful for you. While the treatment differs somewhat from patients with compulsions, persons with pure obsessions and intrusive thoughts can be helped significantly with cognitive-behavioral procedures. However, there is little evidence that so-called unconscious forces or psychological factors play a role in the development of OCD symptoms.
Symptoms often surface under the stresses and strains of life events, transitions and changes.
Talk therapy may provide you with support, insight and guidance in managing stress and handling the problems of life, but it is not likely to break the disturbing cycle of obsessions and compulsions. Many patients benefit from concurrent behavior therapy as an adjunct to the talk therapy that helps them in many other ways. These changes are beneficial similarly to those changes seen resulting from successful treatment with anti-obsessional medications. The severity tends to wax and wane over time, with the greatest susceptibility occurring during periods of significant life stress. Without treatment, the symptoms tend to worsen over time.