Treating OCD with IFS
Just a word about treating OCD with IFS. Treating obsessive and compulsive parts with IFS is quite different from treating it in the Exposure and Response Prevention, the most commonly recommended approach. IFS treats OCD parts as what they are--managers and fire fighters who have jobs to do. If you can help the exiles underneath these protectors, there will be less need for the OCD protective behaviors. (This might be complicated if there are still constant stressors in the client's life, from which they need protection.)
I have found that IFS does alleviate OCD. I have successfully treated people with full blown OCD who now have about 5% of their original symptoms only during moments of high stress, and they do not consider themselves OCD anymore. These clients have been helped by taking SSRIs as well, which I will say more about below.
Traditional ERP works to suppress the same protectors that IFS seeks to understand and offer care. It does "work" to lessen OCD thought and behaviors; clients get a clear strategy for the thoughts that are driving them nuts. However, the folks I know who have gone through this treatment find they have to do their 'homework' forever or the OCD comes back, and they always feel it threatening to do so. In short, living this way is stressful, and the fight is never over.
For anyone doing ERP, they have to commit fully to that approach, the homework is hours a day, and one cannot be halfhearted about it or it won't work. The good thing about ERP is that it gives people some control, which they strongly desire, because they feel so powerless. However, Melissa Mose is doing some exciting work combining ERP with IFS. It applies ERP with the compassion that IFS holds sacred.
Since OCD has a strong genetic component and it can also be caused by strep infections in childhood (PANDAS) https://www.nimh.nih.gov/health/publications/pandas/index.shtml, often medication is a necessary part of the treatment. Medication is usually recommended in combination with ERP, and I believe it helps the client who is doing IFS for their OCD as well, especially in the early days to feel more hopeful and in control. Medication may be phased out or reduced later as IFS progresses and the client’s system calms down and becomes more harmonious, but not all. Some clients will benefit from medication on an ongoing basis, and great care should be taken with this decision.
