While mindfulness can help alleviate the severity of OCD symptoms for some, it is not a substitute for evidence-based treatment like exposure and response prevention therapy.
You’ve likely heard the buzz around mindfulness practices like meditation and breathwork. These practices have been proven to help people improve stress levels, reduce anxiety and even aid in the management of depressive episodes.
Recently, mindfulness practices are being explored as a way to help those with obsessive-compulsive disorder (OCD) resist compulsions. A 2013 study examined the use of mindfulness and meditation compared to the use of distraction in 30 patients with OCD. People who used mindfulness skills felt less compelled to give in to their compulsions, while those using distraction techniques saw no change.
Adding a mindfulness practice to your routine is a great way to support your mental health, but it’s not effective as a sole treatment for OCD. Instead, think of mindfulness as one tool in the toolbox of managing OCD symptoms.
What is mindfulness?
“Mindfulness is an innate ability all human beings possess but may not know how to access. At its core, mindfulness is the ability to be fully present and aware,” says Dr. Patrick McGrath, PhD, Chief Clinical Officer at NOCD. When you’re being intentionally mindful, you’re experiencing your thoughts as an observer, processing them more deeply and analyzing them critically.
In mindfulness practice, there is an emphasis on the fact that all the thoughts that pop into your head don’t represent your true values—and that you don’t have to act on them. Mindfulness tries to teach us to let all thoughts come and go without judging them as good or bad.
Some of the benefits of mindfulness, as identified by the American Psychological Association, include:
- Quelling rumination
- Lessening stress
- Improving memory
- Boosting concentration
- Reducing emotional reactivity
- Strengthening interpersonal relationships
How can mindfulness help with OCD?
In mindfulness practices, you often utilize your breath and body, giving your mind time to relax and process its surroundings. That might mean focusing on deep inhales while holding a yoga posture or concentrating on your breath while taking a walk.
In a mindfulness practice for OCD, the goal is to notice your emotional state without trying to change it. So if you’re feeling overwhelmed for example, you would take note of what you’re experiencing internally without trying to change it.
“When you have OCD, mindfulness can feel particularly challenging, because being in the present moment can include stressful thoughts, sensations, images, feelings, or urges,” explains Dr. McGrath. “However, when you practice mindfulness—rather than attempting to stop these intrusive thoughts or feelings by acting on compulsions—you’re asked to intentionally allow those thoughts to exist.” In this way, mindfulness is actually somewhat similar to exposure and response prevention (ERP) therapy.
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Using mindfulness with ERP therapy
“You can use parts of mindfulness alongside ERP to assist with managing OCD symptoms. I highlight parts because we would never do mindfulness/relaxation breathing, meditation, or any other ‘escape’ or attempt to avoid the discomfort,” says Dr. McGrath. Instead, it’s used as a way to learn various methods of how to sit with discomfort.
“We use mindfulness more as a way to learn how to focus in on the present moment as opposed to falling into rumination for instance,” says Tracie Ibrahim, LMFT, CST, and Chief Compliance Officer at NOCD.
In ERP, you’re asked to confront your triggers and resist the urge to neutralize them with compulsions. Mindfulness requires you to be aware of intrusive thoughts or triggers, and to accept them and the discomfort they cause.
“In both practices, you’re taking a deeper and longer look at your first reactions or thoughts and purposefully working not to respond to them,” explains Dr. McGrath. “In mindfulness, this action takes your brain out of fight-or-flight mode and gives you the time and space to fully process, relax your mind, and gain more control over your compulsions.”
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How to start using mindfulness practices
The most common misconception that people often have about mindfulness is that one must be sitting in silence. “This isn’t the case at all, since there are so many techniques to implement mindfulness in your life,” Dr. McGrath explains. “You could be practicing mindfulness as you run on the treadmill or listen to your favorite album.”
It’s all about taking the time to fully be in the moment, wherever you might be in that moment.”
Dr. Patrick McGrath
One of the easiest ways to get started with mindfulness is by practicing guided meditation, either while seated, walking or moving. Guided meditation allows beginners to be led through mindfulness exercises, often step-by-step.
You can also practice mindfulness using these steps:
- Find a comfortable position that allows you to relax. Whether you’re seated, standing or walking doesn’t matter, as long as you’re in a position that allows you to fully feel and notice your body.
- Set a time limit for a few minutes at a time. You can gradually increase this time as you grow more comfortable meditating, but it’s okay if you’re starting with only a few minutes.
- Notice your body: how it feels, what position you’re in, what your arms and legs are doing, if your shoulders are tense.
- Feel your breath. Follow your breath through your body as it fills your lungs. You can count slowly to four as you breathe in and out to help you focus more fully on deep breathing and relaxing.
- Notice when your mind wanders. Accept it, and return your focus to your body and breath when you can.
It’s important to remember that the goal is not to clear your mind or prevent it from wandering.
Your goal is to be present in the moment without judgement.
Working with a therapist
You can use youtube videos, podcast recordings, or apps of guided meditations to aid your practice—or go to an in-person session. You can also ask your therapist for help.
“Some of the tools I use with my members include asking yourself if what you are ‘worried/anxious/fearful/ruminating’ about is actually happening right now in this present moment,” Ibrahim says. If not, she has the therapy member move on to a values-based activity/focus instead. “I also use naming the 5 senses that are present in this moment (smell, touch, taste, hear, see) or naming things in your surroundings as you drive or wherever you may be,” she adds.
Bottom line
The beauty of practicing mindfulness is that it can be employed whenever and wherever you are. “If you start to feel intrusive thoughts creeping in, take a moment to sit with those thoughts and breathe,” Dr. McGrath says. “Let the thoughts be, and resist the urge to respond to compulsions that these thoughts might stir up.”
Mindfulness just requires a moment of stillness in which you have the ability to pause and observe those thoughts. This can help alleviate OCD symptoms, though it’s important to re-emphasize that it is not a substitute for ERP therapy, a treatment proven to be highly effective.
Key takeaways
- Mindfulness is being consciously aware of the present moment.
- Mindfulness can be used alongside exposure and response prevention (ERP) therapy, the most effective treatment for OCD.
- An ERP therapist can help you integrate mindfulness into your