'Virtual Camping' uses tenets of cognitive behavior therapy to address OCD

Tuesday, August 3, 2010; HE05

"Virtual Camping" is purely a demonstration, according to its founder, psychologist Jonathan Grayson. The exercise is designed to spur participants into therapy or to reinforce goals of their current treatment modality; it is not intended as a treatment in and of itself.

The two main treatment avenues for obsessive-compulsive disorder are psychotherapy and medication. Often, a combination of the two works best.

Antidepressants are popular medications for OCD, according to the Web site of the Mayo Clinic in Rochester, Minn.; that's because many antidepressants increase levels of serotonin, which may be low in individuals with OCD. The therapy recommended most often is cognitive behavior therapy, which involves retraining a patient's thought patterns and behaviors in the hope of eliminating compulsive routines and rituals.

A type of cognitive behavior therapy called exposure and response prevention, or ERP, is considered the most effective therapy for OCD, said Stephen Whiteside, a psychologist and director of the Child and Adolescent Anxiety Disorders Program at the Mayo Clinic. Grayson's "Virtual Camping" events employ principles of ERP.

The technique involves exposing a person to the object or situation he obsesses over, such as dirt or germs, and allowing anxiety to build. (That's the exposure.) The person then commits to not engaging in his usual compulsive behavior or rituals, such as excessive hand washing, and instead sits with the anxiety until it begins to dissipate. (That's the response prevention.) The cycle of exposure and response prevention is continued for weeks or months, until the patient is no longer troubled by obsessions or compulsions.

"It's a way of learning from your own experience that OCD fears that you have don't come true and that anything that does happen is usually something you can handle," Whiteside said.

Some therapists begin exposure therapy by having the patient confront his most-feared stimuli; others take a gradual approach, such as asking the patient to think about the situation that he most fears.

In rare cases, when medication and therapy aren't helpful, hospitalization, electroconvulsive therapy, transcranial magnetic stimulation and deep-brain stimulation may be considered.

-- Dana Scarton

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