April 6


Ketamine Assisted Psychotherapy and Acceptance and Commitment Therapy: Two Powerful Tools Useful for Treating OCD. 

By Tatyana Kholodkov

April 6, 2023

OCD: Being Caught in a Powerful Trap

Obsessive Compulsive Disorder, or OCD, can feel like being caught in a powerful trap. The mind imagines various scenarios, asks “what if…” questions, and can make one second guess nearly everything they do. Sometimes, there are mental rituals one completes These can include reviewing and reassuring themselves, or performing specific thought patterns in a particular way. There can be just a constant onslaught of thoughts, without any visible action, sometimes referred to as “pure O OCD.”

There are Often External Behaviors that Accompany OCD

Often, there are accompanying external behaviors, referred to as compulsions or rituals, which a person can feel compelled to complete. The internal struggle with incessant thoughts and questions, coupled with urges to complete actions or checking, can result in a tremendous loss of time. The distress one endures is often invisible, and others simply don’t understand the struggle within.

Lone Joshua Tree framed against the sky. Overcome OCD with ACT and Ketamine Assisted Psychotherapy in Durham, NC.

OCD and Trauma can overlap. 

At times, OCD can also manifest after we have lived through experiences where control was lost or taken, For example, after traumatic experiences, controlling or abusive relationships, and early childhood environments that were chaotic and disruptive. Many of the therapy clients I work with as a therapist at Project Yes PLLC have both OCD and PTSD. At times, OCD emerges close in time after trauma.

OCD Can be Directly Tied to Trauma Themes

At other times, the OCD has persisted for a long time in a person’s life, and their therapy journey includes recognizing aspects of their life that were traumatic and they did not realize this before. OCD can be directly tied to trauma themes (e.g., as a result of feeling dirty or wanting to assure safety in some way). For others, the OCD intrusive thoughts or compulsions are unrelated to what a person has experienced, However, they are still a form of trying to grasp for control. 

OCD gets worse during times of stress and change. 

For other individuals, OCD comes after a period of acute or chronic stress. For example, a major life change or a situation where a high level of pressure is persistently applied. These can be even positive life events. Maybe it’s a new academic program, the birth of a child, or getting engaged. They may also see that their OCD symptoms ebb and flow. Further, they may increase when stressors are added or they are reaching a point of “overwhelm.” Then, even behaviors or repetitive thoughts that otherwise feel managed to re-emerge, engulf the person once again.

Uncertainty Pervades Human Existence

One of the key discomforts in OCD is uncertainty, and yet, uncertainty pervades our human existence.  Much of our life is actually out of our control. Individuals with OCD may have a harder time tolerating the unknown. In addition, their nervous system maintains a high level of arousal and watchfulness. The environment or one’s behaviors are constantly being scanned and analyzed. Additionally, thoughts intensify to the point that they are convincing and taken as truth.  

Bright sky and a field of grass representing the freedom that can be found with ACT and Ketamine Assisted Psychotherapy in Durham, NC.

Therapy starts with identifying psychological inflexibility in OCD.

Therapy for OCD at Project Yes starts with observing the struggle. Together we assess how OCD is maintained by psychological inflexibility, which we can define in a few ways. First, our emotions, thoughts, images, and memories dominate our awareness and drive our actions.  We then attempt to get rid of these uncomfortable feelings, sensations, and thoughts. Often we do this through some form of ritual or compulsive behavior. Furthermore, we repeat these behavior patterns even when doing so is draining, or problematic for our lives.  We start to then lose sight of the present moment. In addition, we begin to lack clarity about what is important to us as our thoughts and urges take the driver’s seat.  Then we become more disconnected from what is meaningful to us and can feel like a shell of ourselves. 

Acceptance and Commitment Therapy can help with OCD.

Acceptance and Commitment Therapy, or “ACT” (said just like what you do in the theater) is an approach that can be used for many different forms of suffering and patterns of behavior, rather than any one specific diagnosis. It also is a very adaptable, compassion-focused process rather than a set protocol. ACT is one of the evidence-based treatments for OCD. From its description, we even can intuit why it may be helpful. Acceptance and Commitment Therapy tools help us take a step back from our thoughts, accept the life before us, strengthen the quality to observe ourselves, and be more conscious in the present moment.  Taken together, these processes develop psychological flexibility. This is the ability to make mindful decisions and act skills, making choices that are guided by our values.

ACT Helps You Turn Off Autopilot

When applied to OCD, individuals are able to start slowing down the seeming autopilot they find themselves on between a thought entering their mind and the urge to act on that thought.  It becomes possible to start seeing thoughts as thoughts. Furthermore, we begin observing what is worthy of acting on/paying attention to versus what thinking is driven by OCD.  Instead of examining whether each thought is true and possibly reacting as if those thoughts are facts, a person will make more and more choices that enhance their life (irrespective of the chatter of the mind). Uncertainty, and its associated anxiety, start to become tolerated rather than immediately relieved or acted upon. The present moment can feel more possible to really be present with. 

Ketamine Assisted Psychotherapy for OCD.

Ketamine Assisted Psychotherapy, like other psychedelic therapy, directly impacts our physiology. The term “neuroplasticity” refers to a period of the rapid growth of neurons. Essentially, our brain is able to form new pathways and connections. For individuals wanting to address their mental health, the time window of neuroplasticity becomes important to take advantage of because new behaviors and ways of being in the world are easier to adapt. In addition to what is occurring on a molecular and cellular level, psychedelic journeys are often characterized by shifts in how one typically thinks.

KAP Can Help Offer a Break From OCD Worries

I have had clients with OCD notice that they get a “break” from their typical OCD worries, and even after a medicine session, they may find a bit more distance from their usual thoughts. The triggers may still be there, but some of them may become easier to not act upon. A person may find themselves more easily able to refocus on what they are wanting to pay attention to or trying to do, even if intrusive thoughts arrive. Essentially, the same processes outlined above that fall under ACT are also facilitated by Ketamine Assisted Psychotherapy. 

The Psychedelic Journey Helps You Relinquish Control

A psychedelic trip or journey can also force us to let go. We are taken for a ride that is over when it is over. This release of control may be helpful for individuals seeking therapy for OCD. Further, this kind of experience can help foster radical acceptance of things as they are. Although this feeling may not last indefinitely, the openness created can help individuals wanting to heal their OCD to become more willing to tolerate uncertainty, reduce the need to react to intrusive thoughts and adapt to the ever-changing world. 

Stem covered with roses framed by the bright blue sky. Overcome OCD and find peace with ACT and Ketamine Assisted Psychotherapy in Durham, NC.

KAP and ACT combined can help you with OCD. 

It is noteworthy that both KAP and ACT can also help provide relief from symptoms of depression that often co-occur with the imprisonment of OCD.  These approaches are a wonderful complement to each other, making it possible to help with being more open to living life based on how you want to, rather than what anxiety may force you to do. The tools offered by Ketamine therapy for OCD or Acceptance and Commitment Therapy both require an intention to change and a readiness to be courageous. Taken together, these therapy options for OCD offered in Durham, NC create a possibility of a more fulfilling life!

Overcome OCD Today With Acceptance and Commitment Therapy and Ketamine-Assisted Psychotherapy in Durham, NC

If you have been struggling with your OCD and traditional treatments have not worked we can help. ACT and Ketamine Assisted Psychotherapy for OCD is proven alternative treatments that can address mental health issues that have proven treatment-resistant in the past. At Project YesDr. Kholodkov is trained extensively in both ACT and KAP Processes and is here to help you on your journey to healing beyond. Follow the steps below to get started:

Other Services Offered by Project Yes

In addition to Ketamine-Assisted Psychotherapy, we offer Psychotherapy Services for AnxietyInsomniaIntegrative HealthOCD, Trauma and PTSD as well as Yoga and Meditation Options. We look forward to guiding you on your journey toward optimal physical and mental well-being.

If you want to learn more about Ketamine Assisted Psychotherapy and our other services please check out our blog here!

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  1. This post is very easy to read and understand without leaving any details out. Great work! Thanks for sharing this valuable and helpful article.

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