Obsessive Compulsive Disorder, more commonly referred to as OCD, is a grossly misunderstood and all-too-frequently trivialised condition. Indeed, it has been referred to by sufferers as a ‘waking nightmare’. OCD is defined as a mental health condition and typically presents as obsessive thoughts and compulsive activity. Obsessions are unwanted and unpleasant thoughts, images, or urges that repeatedly enter a person’s mind, causing feelings ranging from mild unease to clinical-level anxiety. A compulsion is a repetitive behaviour or mental act that a person feels they must carry out in order to temporarily relieve the often overwhelming feelings ignited by the obsessive thought. For example, a person with a fear of becoming ill may repeatedly and compulsively check the use-by-date on food items to ensure they are not eating anything that could potentially be contaminated.
The most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) lists, for the first time, OCD under the category ‘OCD and Related Disorders’ to reflect the increasing evidence of these disorders’ relatedness to one another and their distinction from other anxiety disorders. The disorders under this new umbrella include obsessive-compulsive disorder, body dysmorphic disorder and trichotillomania (hair-pulling disorder), as well as two new disorders: hoarding disorder and excoriation (skin-picking) disorder.
As is the case with the other anxiety disorders, OCD symptoms can range from mild to severe, with some people engaged in obsessive-compulsive behaviours for a minimal proportion of their day whilst others experience their lives as being completely taken over by these thoughts and behaviours. We are still unsure of what causes OCD although it is clear that it is often preceded by acute anxiety. It is experienced by men, women and children alike, although it most commonly emerges in adolescence. It is estimated that around 12 in every 1,000 people in the UK are currently affected.
Given OCD’s strong links with anxiety, with a correlation between yoga and anxiety reduction having been noted in many studies, it would make a tremendous amount of sense to assume that yoga could have some therapeutic benefits for this population. There is a shameful dearth of research into this area however. Thankfully, a recent study by Bhat and colleagues has attempted to formulate a generic yoga-based intervention module for OCD. And it is about time too. A yoga module was designed based on traditional and contemporary yoga literature and sent to ten yoga experts for content validation. The final version of the module was then piloted on seventeen patients with a diagnosis of OCD for both study feasibility and effect on symptomatology. Excitingly, the module, having been engaged with by the participants for just two weeks, was found not only to be feasible but also to promote improvement in symptoms of OCD on the Obsessive-Compulsive scale, which includes time spent on obsessions or compulsions, resistance, interference, distress, and control. Whilst further clinical study is needed to confirm efficacy, this is a very promising start indeed.
The few other earlier studies on yoga for OCD have also been hopeful. Two year-long clinical trials have been conducted, for example, to test the efficacy of kundalini yoga meditation techniques for the treatment of OCD, one of which was a randomised controlled trial. In the first trial by Shannahoff-Khalsa & Beckett in 1996, the intervention group showed a mean improvement of 55.6% on their OCD-Scale score. In the later RCT, conducted by Shannahoff-Khalsa and colleagues in 1999, groups of patients were randomly assigned to either twelve months of the kundalini meditation protocol or twelve months of employing the relaxation response alongside mindfulness meditation. The kundalini yoga group demonstrated greater and statistically significant decreases in a range of OCD-related symptoms.
The personal testimony of a 20-year-old female participant, enrolled in the kundalini meditation intervention in the 1999 study, is particularly poignant. Her OCD symptoms began at the age of ten, with Body Dysmorphic Disorder (BDD) and social anxiety tendencies beginning at the age of seventeen. Her obsessions revolved around a paralysing fear of inadvertently hurting others, to the point that she feared phoning her relatives in case they were driving at the time and she caused them to have a car accident. She explains;
“The very first session I had altered my experience of anxiety so much that the rushing of thoughts that seemed so constantly harrowing before had dissipated to a state of calm and relaxation. In addition to this, the body dysmorphic disorder I was experiencing totally disappeared for the rest of the day. And, finally, the OCD disappeared completely and the results again lasted for the remainder of the day…The yoga gave me balance and put me in a relaxed state of mind immediately….The most beneficial aspect of the experience, however, was the immediate release from anxiety…The continuation of the practice has led to a greater state of peace and general strength that has continued up to this day.”
We are very blessed to have Veena Ugargol, who has direct experience with the anxiety clinic at the Maudsley, working with us at the Minded Institute. Veena teaches on OCD for our Professional Yoga Therapy Training. To find out more, please contact us on email@themindedinstitute.org
Bibliography
Bhat, S., Varambally, S., Karmani, S., Govindaraj, R. &, Gangadhar, B. (April 2016). Designing and validation of a yoga-based intervention for obsessive-compulsive disorder. International Review of Psychiatry, 27, 1-7.
Shannahoff-Khalsa, D. &, Beckett, L. (1996). Clinical case report: Efficacy of yoga techniques in the treatment of obsessive-compulsive disorder. International Journal of Neuroscience, 85, 1-17.
Shannahoff-Khalsa, D. et al (1999). Randomised controlled trial of yoga meditation techniques for patients with obsessive-compulsive disorder. International Journal of Neuropsychiatric Medicine, 4, 34-46.
