Guilt-Inducing Memories and OCD

A recent study in Frontiers in Psychiatry addresses the role guilt-inducing memories play in influencing Obsessive Compulsive Disorder (OCD) symptoms. 

Research suggests that criticism from caregivers in childhood plays a role in the development of OCD - including that obsessive behaviors may develop in children as a strategy to avoid criticism and gain approval. 

Although Exposure and Response Prevention (ERP) remains the gold standard treatment for OCD and is effective for many types of OCD, a significant proportion of people with OCD do not fully respond to this treatment. The impact of guilt-inducing memories plays a part in these cases. 

Schema Therapy (ST) provides an avenue to help those with OCD reduce the impact of guilt-inducing memories through Imagery Rescripting (ImRs). This process involves patients identifying key memories from childhood that involve being the object of criticism and evoke a sense of guilt and shame. With ImRs, patients are guided back to their childhood, reexperience these events from the felt experience of their younger self, and engage in emotionally corrective healing that enables new meaning to be made from these painful events. 

With continued ImRs treatment, patients with OCD report not only a reduction of feelings of guilt and shame, but also a reduction in overall OCD symptoms. 

I hypothesize that once patients achieve a significant reduction in feelings of guilt and reduce the impact of intrusive guilt-inducing memories, they are likely to respond better to ERP to further reduce OCD symptoms. 

I provide both ERP and ST as part of my psychotherapy practice. I believe that integrating these two powerful treatments has the potential to provide a more robust response for those with OCD - especially those who have not found significant relief from ERP alone or other therapies. 

Please contact me if you would like to schedule an assessment. Please also peruse my website to learn more about me and the services I offer.