Obsessive-compulsive disorder (OCD) is a mental health condition in which a person has recurrent and excessive thoughts that are intrusive, unpleasant, and usually irrational. People with OCD may perform repetitive behaviors, such as hand-washing, counting, or checking doors, to manage the anxiety caused by these thoughts.
Standard therapy for OCD includes cognitive behavioral therapy (CBT) with exposure and response prevention (ERP). Medications such as selective serotonin reuptake inhibitors (SSRIs) may also be prescribed. However, there is growing interest in the use of mindfulness as a complementary treatment for OCD. Research is still emerging, but studies show promise.
Read on to learn how mindfulness can be helpful for OCD and some techniques to try.
What Is Mindfulness?
Mindfulness involves being in the present and focusing on your immediate surroundings and sensations. Mindfulness exercises often use sensory experiences, visualizations, and breathing techniques to center focus. During these exercises, thoughts of any kinds—positive or negative—are acknowledged and passed without judgment. While this can be difficult for people with OCD, it can help take the power out of the intrusive thoughts, and reduce them over time.
Complementary Benefits of Meditation for OCD
Cognitive behavioral therapy (CBT), which helps people recognize and change problematic thought patterns and behavior, is a type of psychotherapy. One form of CBT is exposure and response prevention (ERP).
ERP is performed under the guidance of a mental health professional. It involves intentionally exposing the person to their objects of fear.
For people with OCD, this involves triggering their obsessive thoughts and resisting performing the compulsive behavior in response. This causes great anxiety at first, but over repeated sessions, the person learns to see that no actual harm comes from these thoughts, which reduces symptoms.
Mindfulness-based cognitive therapy (MBCT) works on a similar premise, but instead of intentionally inducing intrusive thoughts, MBCT encourages people to allow them to happen as they arise naturally and experience them without judgment or trying to stop them.
Mindfulness exercises like meditation are used to facilitate this process.
The International OCD Foundation recognizes three main ways mindfulness can be beneficial in boosting the effectiveness of traditional CBT: acceptance, assessment, and action.
Remember that using mindfulness is recommended as a complement to CBT, not a replacement for it.
Acceptance is the first step of treatment. It involves learning how the brain interacts with the mind, what CBT entails, what mindfulness means, and other concepts that help OCD and its treatment make sense.
Mindfulness means observing and accepting undesired thoughts, feelings, and sensations without assigning them meaning or judgement or trying to get them to stop.
While mindfulness can be practiced using formal meditation, it can also be performed as you go about your regular activities. It’s all about observing what you are experiencing in your body, mind, and environment. For example, pay attention to sensations, such as the feel of the water on your skin during a shower or the sound of leaves rustling in the wind.
With traditional cognitive therapy, the person is encouraged to identify distorted thinking involved with OCD.
For example, an intrusive thought might be, “My hands are not completely clean, so I am going to get a serious disease.” With cognitive therapy, that thought can be reframed as, “I don’t know how clean my hands are right now, and I am not able to predict what will happen in the future.”
Mindfulness techniques then help the person accept this uncomfortable thought by assessing the situation without using compulsions.
The focus is on assessing how the person thinks, not on the validity of their thoughts.
With ERP, people with OCD are intentionally exposed to their feared thoughts and feelings, which causes discomfort that, ideally, decreases with repeated exposures.
Incorporating mindfulness into this treatment helps the person with OCD be more open to and accepting of experiencing this discomfort. Learning to lean into the experience instead of pulling away reduces the urge to relieve the anxiety with compulsions.
How OCD Affects Mental Health
People with OCD experience chronic, recurring intrusive and distressing thoughts. While everyone experiences thoughts like these from time to time, people with OCD experience them at a level that impacts their level of functioning.
People with OCD typically recognize these thoughts are irrational and can see the thoughts logically, but the thoughts can’t be reasoned away.
Many people with OCD perform repetitive physical or mental behaviors to reduce the anxiety caused by intrusive thoughts. These may relate to the obsession (for example, compulsive hand washing in response to a contamination obsession), but often are completely unrelated.
Mindfulness Techniques for All Levels
Some mindfulness techniques require dedicated space and time commitment, but others can be practiced anywhere, even at work.
- Get into a comfortable position, on your back or any way you can stretch out.
- Close your eyes and focus on your breathing.
- Shift your focus to your left foot, feeling all sensations in that area.
- If thoughts arise, acknowledge them without judgment and return your focus to your foot.
- Gradually shift focus from your left foot to your left ankle and repeat the process, slowly moving through all areas of your body.
There are many types of yoga to choose from. A 2019 trial found that Kundalini yoga meditation showed promise as an option for people with OCD who have not responded to first-line treatments.
Look for classes in your area, or check out the many online options, including free instructional videos on YouTube.
Make sure to check with your healthcare provider before starting yoga or any exercise program.
Progressive Muscle Relaxation
- Dress in loose clothing, find a quiet place, and get comfortable sitting, lying down, or reclining.
- Slowly take five deep breaths.
- Apply muscle tension to a specific part of the body, such as your left foot. Squeeze the muscles in that area as hard as possible without hurting yourself for about five seconds as you take a slow, deep breath.
- Relax the tensed muscle, letting go of all the tension as you exhale. Pay close attention to the different sensations of tensed versus relaxed.
- Relax for about 15 seconds, then repeat the tension and relaxation, moving through each of your other muscle groups.
Guided imagery helps you use your mind to create a sensory experience.
For example, instead of just thinking of an orange, you would imagine it in great detail, incorporating all of your senses. You would imagine its smell, how the peel feels on your fingers, its weight in your hand, the juices squirting when you take a bite, and tasting its tart and sweet flavor.
Settings for guided imagery can be any relaxing place, such as a beach, garden, or anywhere that makes you feel safe and comfortable.
Guided imagery can be done with an instructor, audio files, or a script that you follow.
To Support Your Work Routine
Mindful meditation can be done in as little as five minutes per session.
- Sit in a quiet place.
- Breathe naturally.
- Be present, keeping your focus in the moment.
- If intrusive thoughts arise, acknowledge them without judgment, and let them go, gently bringing your focus back to the present moment.
You can pull out belly breathing whenever and wherever you need it.
- Find a comfortable position, sitting or lying down.
- Place one hand on your chest and the other on your belly (just below your ribs).
- As you take a deep breath in through your nose, feel your belly push your hand out while your chest stays still.
- Purse your lips (like whistling) and breathe out through your mouth, feeling the hand on your belly go in.
- Repeat three to 10 times, taking your time with each breath.
Start in the same position as belly breathing, one hand on belly, one on chest.
- Slowly breathe in deeply from your belly as you mentally count to four.
- Hold your breath as you mentally count from one to seven.
- Breathe out as you mentally count from one, trying to get all the air out of your lungs by the time you reach eight.
- Repeat these steps three to seven times or as many as you need.
Resources to Help You Get Started
You can also check IOCDF’s directory of support groups and get some advice on starting your own if there isn’t one in your area.
OCD involves recurrent, intrusive thoughts and repeated or ritualized behaviors. First-line therapy treatments for OCD are cognitive behavioral therapy (CBT) and exposure and response prevention (ERP). However, emerging research suggests that mindfulness techniques can complement these therapies.
Mindfulness techniques include exercises such as mindful meditation, guided imagery, belly breathing, progressive muscle relaxation, and yoga.
A Word From Verywell
If you have OCD, discuss first-line treatment options with your healthcare provider or mental health professional. Proper treatment is essential to living and functioning well with OCD. In addition to these treatments, consider adding mindfulness exercises to your routine and asking if they can be incorporated into your treatment plan.
Frequently Asked Questions
There’s no one technique that has been conclusively shown to be the best. A 2012 study found that participants reported a three-minute breathing exercise as being particularly helpful to them, but it ultimately comes down to what works best for you.
Different mindfulness exercises require varying time commitments, and personal preference plays a part too. Breathing exercises and mindful meditation can be completed in as low as a few minutes, while techniques such as progressive muscle relaxation and yoga take longer.
If you find mindfulness exercises are making you feel worse, talk to your healthcare provider or mental health professional about adjustments to your treatment plan. Mindfulness can be helpful, but it’s not for everyone.