Obsessive Compulsive Disorder

Cutting edge treatment for obsessive-compulsive disorder


“I just can’t get you out of my head” (Kylie Minogue, 2001)


Obsessive-compulsive disorder (OCD) is characterised by the experience of repetitive, intrusive, unwanted thoughts, also known as obsessions.


Many OCD sufferers keep their obsessions secret because they find the content of these thoughts embarrassing, shameful, or repulsive. But the truth is, unwanted intrusive thoughts are an extremely common, if not universal human experience (studies suggest that up to 99% of people experience them on a regular basis). Furthermore, the themes and content of peoples’ everyday intrusive thoughts are identical to the themes and content of obsessions experienced by people with OCD. The difference is how we interpret the thoughts.


If we view the thoughts as meaningful, dangerous or important, then we are more likely to feel anxious about them, or responsible for them, and thus more motivated to do something. We may feel the urge to perform some action (whether internal or external) to reduce the anxiety, fear or disgust we are feeling and/or to stop the feared consequences of the thought from coming true.  When these actions become excessively frequent they are termed compulsions. Obsessions and compulsions typically create a vicious cycle whereby they repeat more and more frequently, causing more and more anxiety, eventually giving rise to the disorder. 


OCD is common, experienced by 1-4% of the population. The onset of the disorder is typically gradual however it can also emerge suddenly in the wake of stressful life events. OCD tends to be a life-long problem. If left untreated about two-thirds of OCD sufferers will experience symptoms of varying severity over many decades. In addition, many people with untreated OCD develop a secondary depression as the symptoms and loss of self-esteem wear them down. Avoidance and excessive reassurance-seeking behaviours compound symptoms and further reduce quality of life.  Unfortunately, failure to seek help is a common problem.


However, OCD need not be a life sentence. Treatment for OCD has come a long way over recent decades. Cognitive Behaviour Therapy (CBT) for OCD is now effective for most people who undertake it.


In 2008, clinical psychologist Dr Andrew Nicholls commenced a series of scientific investigations at the ANU Research School of Psychology with the goal of enhancing existing treatments for OCD. Andrew’s 2016 doctoral thesis proposed new conceptual and treatment paradigms for obsessive-compulsive disorder that identified, for the first time, the critical influence of negative emotions on the interpretation of intrusive thoughts. Andrew subsequently developed a scientifically-supported emotion-regulation skills training (ERST) program which utilises mindfulness and acceptance-based techniques to augment and enhance existing cognitive-behavioural treatments for the disorder. This cutting edge approach to OCD treatment has been shown to significantly enhance both therapeutic engagement and clinical outcome for OCD sufferers. 


 “Where the addition of cognitive therapy helped ‘set the dining table’ for behaviour therapy, allowing individuals with OCD to better prepare for exposure, the addition of emotion regulation therapy now ‘sets the mood’ – dimming the lights and adding some background music, if you will – helping the diner stay longer at the table and consume more of the therapeutic meal.” (Nicholls, 2019)


Dr Andrew Nicholls is currently offering specialised treatment for obsessive-compulsive disorder (and a range of other psychological issues) at the Burleigh Heads Psychology Clinic.