…Have a copy of a relapse prevention blueprint…

If you’re one of the members of the Facebook group of OCD FREE INDIA you must have come across various posts created by a lady named Carol Edwards, in addition to her valuable and helpful comments in innumerable posts of the others. Besides the Indian support group on Facebook, she plays the role of one of the chief admins in The Ways of the Force group. Not only that, she is determined to help one Indian at a time in the recovery from OCD for free of cost. I am very thankful to her that she agreed to share her precious time with us and her insight on OCD. Brothers and sisters, I, Gourav Kundu, on behalf of OCD FREE INDIA, welcome the renowned psychotherapist Carol Edwards ma’am to this exclusive interview series.

NOTE: The following conversation is presented before you as it took place between me and Carol Edwards with minimal minimal editing of a few words.

Namaste ma’am. I am so much obliged that you agreed to a part of this series. As many of us already know about your contribution to the online OCD support community but only a few know about your journey to this point. Can you please share your experience in this field with our readers: like how long have you been in this field and what inspired you to become an OCD therapist?

–First, namaste Gourav, and thank you for inviting me to do this interview. In answer to your question, I first obtained a certificate in counselling in 1994 which is when I first became interested in this type of work. What inspired me at the time was seeing problems associated with alcoholism and chronic anxiety in my family. It was later that I identified obsessive-compulsive disorder and related conditions that to-date shows a genetic link on both sides of my family. 

2.) Besides the virtual space do you also provide your service in the real world, if yes, may we know the location?

Yes, I work as a freelance coach in and around my hometown in England and provide individuals and families with a CBT format for working on cognitive change. This includes the exposure-response prevention model with a relapse prevention blueprint for maintaining gains following recovery.

3.) Since you’re a member of various online support and self-help groups, have you ever come across any Indian OCD therapist who practices in India?

I recently came across a counsellor named Sunil Punjabi. He asked me to do an interview for his OCD group. I’d been asked before and had turned these down (with regret) because I was practising overcoming a social anxiety issue and speaking in public or in front of a camera online. I was surprised that Sunil didn’t just leave it there and even more surprised that he offered to give me some sessions to help me with this, and the result was that I did a live interview with him which was successful. This has opened new doors for me. I definitely recommend his services.

4.) These days the clash between ideas and theories keeps on happening, not only in India but all around the world. Some people claim to have recovered from OCD without taking any medicines while others are in favour of medicines. May we know what is the role of allopathic medicines in overcoming this disorder and can therapy alone do the magic?

Yes, there will always be a clash of ideas but for the most part, I go along with the tried and tested theories that work. So in terms of medication, my view is that largely selective serotonin reuptake inhibitors (SSRIs) target the brain’s chemistry for reducing symptoms by up to 60%. Once medication reduces the symptoms for people who have moderate-severe OCD (which can take up to six weeks, sometimes a little longer) then CBT/ERP therapy is generally more effective as the active part in treatment, and in correcting the brain parts responsible for OCD. Whilst medication and therapy are the suggested requirements for reaching recovery goals for more severe symptoms, either one of these therapies is offered as a first option for mild symptoms with one or the other being included if needed.

5.) What is your opinion on emerging alternative treatments for OCD like cognitive drill therapy, rTMS, hypnotherapy, herbal medicines, homoeopathy etc? Since many people are afraid and cautious of the side effects of allopathic medicines they tend to follow other ways. May we know if one should really consider investing in aforesaid treatments?

My first opinion is to stick with the tried and tested methods. That said, everyone’s chemistry is different, and so I keep an open mind and do review new theories when they emerge.


  • I like cognitive drill therapy for the fact it holds some of the traditional cognitive and behavioural methods; but the downfall for me is the actual drilling because I’m not entirely satisfied that this changes the brain parts responsible for OCD, so biologically I have my qualms about the long-term benefits with this method, but again it’s a formed opinion so I could be wrong.
  • With rTMS, while this is an approved treatment in the UK, the National Institute for Health and Care Excellence (NICE) found that while rTMS is safe, there is insufficient evidence for its efficacy so far. Since my thoughts fit with bio-behavioural treatments, I would be in agreement, and until efficacy results are on a larger scale. 
  • I’m not keen on hypnotherapy but this is an opinion so no offence to those who practice it. I studied hypnotherapy, it was one of my modules for my CBT diploma but it didn’t fit with my bio-behavioural approach for correcting the brain parts responsible for OCD, and so I don’t integrate this model into my treatment approach.
  • As far as my knowledge stretches my concern with herbal remedies is that they don’t reduce the symptoms seen in obsessive-compulsive disorder on a biological level opposed to allopathic medicines, which do.
  • According to the National Health Service (NHS) in the UK, it says there’s been an extensive investigation of the effectiveness of homoeopathy as an alternative treatment for mental health or any other condition such as cancer. I’m in agreement with the NHS in that there’s no good quality evidence that homoeopathy is effective as a treatment for any health conditions.
  • With respect to homoeopaths, health and safety are an issue for; for example, it’s still not fully clear what causes OCD so any substances being ingested as a treatment method despite given in diluted measures, for me, raises concerns.       

6.) What methods do you use to treat OCD patients and what is the success rate of a particular method or technique that you have used on OCD patients so far?

I use cognitive behavioural therapy (CBT) in the first instance to help restructure maladaptive thoughts and behaviours. I find this works well as a foundation for preparing for exposure response prevention (ERP) – this has a person face their obsessional fears in which they resist all compulsions. The goals are habituation to one’s fears with remission being the main goal or much-reduced symptoms. I’m also in favour of mindfulness, motivational interviewing and allopathic medicine.

7.) People keep on asking this question, IS OCD curable, or about a permanent cure for OCD?

Personally, and as someone who acquired OCD from a young age and now in remission, I don’t view any treatment methods as a permanent cure for OCD; instead, I see treatment being able to restore someone back to a healthy life before OCD, just like a person who is restored back to a healthy life following successful cancer treatment. I’m in remission from both with no symptoms following remission from cancer, but I live knowing (not consciously) that the symptoms could return, although not necessarily. Similarly, my remission from OCD means I live a life like a non-OCD person; I get intrusive thoughts like a non-OCD person and let them come and go like a non-OCD person and I don’t give into rituals anymore. So this for me is a “cure” which I call remission or recovery. I may at some time in my life develop a full-blown relapse, but I might not either. For the most part, I don’t fear OCD symptoms returning; and if they did I would draw on the CBT and ERP models and practice what worked best for me during recovery. My advice to anyone in recovery would be to have a copy of a relapse prevention blueprint for maintaining gains achieved in therapy.

8.) Can you suggest some resources (books/online media) for those who know about someone close, suffering from OCD?

–It might be fitting to tell you about my “OCD Learn and Recover” course which is a 3-part programme that is suitable for teens and adults and which is also available to relatives to learn about the CBT/ERP model for OCD – this can help them work with their loved one with my support. There are also free sites that offer simple-to-follow self-help guides for understanding and treating OCD – you would just need to Google something like “free OCD guides”. Also, OCD workbooks can be helpful such as the mindfulness one by Jon Hershfield for treating OCD. Online groups can be a source of support where fellow sufferers (and their families) can be there for one another and where admins can help people locate outside help, such as referring them to the IOCDF or in the UK, OCDAction and locating CBT professionals.

9.) If someone is close to a person suffering from OCD what would be your message to them?

My message would be to first understand that they are dealing with a disorder that causes problems for the sufferer (and those around them), not the person themselves whose causing problems for themselves and their families.  I would further advise finding the resources that will help them understand OCD, what it is and how it is treated. My course can help with this, and this comes with the added benefit of having a coach (myself) there on hand when needed; and there are lots of other courses too, or books and documents, all of which can give someone the tools they need to help the person close to them. One helpful book that I recommend too is “Loving Someone with OCD” by Karen J. Landsman et al.


Dissociative States के साथ-साथ OCD से जुड़ी कुछ महत्वपूर्ण बातें

(Carol Edwards द्वारा लिखित एवं गौरव कुण्डू द्वारा अनुवादित एक लेख)

Note: This is just an excerpt from one of the articles written by Carol Edwards who is well known for her expertise in the field of Cognitive Behavioural Therapy and OCD. She can be contacted through this link. The translation will be updated on a regular basis so stay connected and keep an eye on your mail. Subscribers of this blog will be mailed on any kind of update immediately.

विषय - सूची
  • Depersonalisation-Derealisation
    Dissociative Amnesia
    Identity Confusion
    Asperger’s Syndrome and Depersonalisation
    Dissociation is not Schizophrenia
    Cognitive Behavioural Therapy
    Forming a Hierarchy (for exposure response prevention)
    Family and Friend Collusion
    Alternative Statements (in place of reassurance ones)
    Emotion Regulation Strategy
    Tackling Thinking Errors
    SSRI Intervention
    Enhanced Techniques for People Living with Asperger’s and Depersonalisation

पृथक्करण (Dissociation ) शब्द अक्सर उन घटनाओं का वर्णन करने के लिए प्रयोग किया जाता है जब किसी व्यक्ति को यह प्रतीत होता है कि उसका शरीर मानो उसका नहीं है ( इसे depersonalisation भी कहते हैं ) | यह उस अनुभव के बारे में बताता है जब किसी व्यक्ति को अन्य लोग, वस्तुएँ एवं परिस्थितियाँ और यहाँ तक कि सारा संसार झूठा लगने लगता है ( इस अवस्था को derealisation भी कहा जाता है ) | Dissociation से जुड़े अनुभव के बारे में लोग बताते हैं कि उन्हें ऐसा महसूस होता है जैसे वे खुद से और अपने आस-पास के माहौल से जुदा हो चुके हैं |

पृथक्करण के लक्षण चिंता एवं तनाव से जुड़े होने के लिए भी जाने जाते हैं | मानसिक आघात तथा बुरे बर्ताव इसके कारण हो सकते हैं हालाँकि कुछ लोग इस बात की पुष्टि नहीं करते |

Fiona बताती हैं,” मेरा बचपन काफी खुशनुमा था और मेरे माता-पिता मुझसे बेहद प्यार करते थे | वे मेरे समर्थक भी थे | किन्तु जैसे ही मैंने अपनी की पढाई पूरी की और नौकरी शुरू की मुझे अजीब सी “out-of-body” की अनुभूति हुई | एक बार जब मैं अपने दोस्तों के साथ खाना खा रही थी तो अचानक मुझे ऐसा लगा मानो मैं एक समीक्षक की भाँती सारी घटना को दूर से देख रही हूँ | ” Fiona को इस बात को जानने की तीव्र इच्छा हुई कि वास्तव में आखिर हो क्या रहा था |
“मुझे ऐसा लगने लगा जैसे मेरे हाथ, पैर और सिर मेरे शरीर से मानो अलग हो गए हो | सारा समय में अपने हाथो और पैरो को चिकोटी काटती रही ताकि जान सकू मैं सही अवस्था में तो हुँ या नहीं |

Billy बताते हैं ” मेरे साथ तो यह सब अजीब सी मायूसी भाव के लहर ले आता है | मैं दूसरों से जुड़ना तो चाहता हूँ लेकिन ऐसा हो नहीं पाता | मुझे ऐसा प्रतीत होता है जैसे कुछ भी वास्तविक नहीं है ( derealisation )| बालावस्था में मैं काफ़ी अकेला-सा महसूस करता था | एक से दूसरे पालनगृह आने-जाने के दौरान लोगो से मेरा सम्पर्क टूटता चला गया | मेरे जीवन में उनका साथ काफी अल्प समय के लिए ही रहता था | आज मैं ज़िन्दगी के तीसरे दशक में प्रवेश कर चुका हूँ लेकिन किसी से मित्रता करने में या यह विश्वास करने में कि, मेरी संभावित गर्लफ्रेंड मुझे छोड़कर नहीं जाएगी, काफ़ी मुश्किल प्रतीत होता है | कुछ भी सच्चा नहीं लगता और यहीं वजह है कि मैं दोस्ती-यारी या प्रेम-संबंधो के चक्कर में नहीं पड़ता | कभी-कभी तो मैं अपने मायूसी के भाव को भी महसूस नहीं कर पाता लेकिन मुझे यकीन है कि वो मेरे अंदर कहीं न कहीं तो है |”

Maria बताती हैं ” मेरी परवरिश एक ऐसी बहन के साथ हुई जो autism का शिकार है | हम दोनों ने अनेको खुशियों के पल साथ में बिताए और एक बहन होने के नाते मुझे हमेशा से यही लगा कि मैं उसके साथ रहूं | इस बात से कोई ज़्यादा फ़र्क़ भी नहीं पड़ा कि वह autism से जूझ रही थी आख़िरकार है तो वह मेरी सगी बहन ही लेकिन समय के साथ-साथ रिश्तों में बदलाव आने शुरू हो गए | ऐसा प्रतीत होने लगा जैसे मैं उसकी द्वितीय माँ की भूमिका निभा रही थी | मैंने उसे खाना बनाना सिखाया, मैं ही उसे शॉपिंग करने बाहर लेकर जाती थी और जब वह किसी चीज़ से भयभीत होती तो मुझे ही उसके बारे में बताती | यहाँ तक कि जब वह अवसाद के दौर से गुज़र रही थी तो सबसे ज़यादा मुझे ही उसकी फ़िक्र होती थी | दूसरे शब्दों में मैंने उसके लिए वो सब कुछ किया जो एक माँ अपने बच्चे के लिए करती है | जब कभी मैं अपने सहेलियों के साथ बाहर खेलने जा रही होती तो वह मुझे घर में ही रोक लेती और जिद्द करती कि उसके साथ घर में ही समय व्यतीत करूँ और बहुत बार मैंने किया भी |
आज भी याद है कि कैसे वो हमारे माता – पिता का ध्यान अपनी ओर केंद्रित करने की कोशिश करती और दूसरी ओर मैं अपने स्वयँ के पहचान के लिए सारा जीवन असमंजस में पड़ी रही क्यूंकि हर वक़्त तो मेरा ध्यान उसके ही परेशानियों के इर्द गिर्द घूमता रहता था| जो भी समस्याएं थी उनका निवारण जिस प्रकार से होना चाहिए था वैसे हुआ नहीं और इसके पीछे मेरे पिताजी का भी हाथ था | वो हमें हमेशा मानसिक रूप से प्रताड़ित करते थे | दोस्त भी घर इसीलिए नहीं आना चाहते थे क्यूंकि पिताजी का बर्ताव अच्छा नहीं था | माँ ने इन सब के बावज़ूद सभी को संभाला लेकिन जब पानी सर से ऊपर जला जाता तो मुझे ही हस्तक्षेप करना पड़ता था | Mental health team को भी सूझ रहा था कि आखिर क्या किया जाए और देखते ही देखते स्थिति बद से बदतर होती चली गयीं | मेरे अकेलेपन का कारण कोई नज़दीकी रिश्तेदार का ना होना भी है|
मेरे भीतर की बैचैनी धीरे धीरे बढ़ती जा रही थी और मन की भड़ास और गुस्से की ज्वाला इतनी ज़्यादा भड़की की आखिरकार मैंने अपने आप को अस्पताल में पाया| मुझे बिलकुल भी समझ नहीं आ रहा था कि वास्तव में मैं हूँ कौन ? गंभीर स्थिति की वज़ह से मैं पूरी तरह से घबरा गयी थी |

वर्तमान समय में मुझे लगता है कि मैं एक व्यक्तित्व से दूसरे व्यक्तित्व में तब्दील होती रहती हूँ और यह काफी भयावह है पर मैं साथ ही साथ सुरक्षित भी महसूस करती हूँ क्योंकि मुझे पता है कि यह मस्तिष्क का एक प्रकार का रक्षात्मक प्रक्रिया है | बचपन की यादें आखों के सामने चलचित्र की भाँति आते रहते हैं, कुछ सत्य घटनाओं पर आधारित रहते हैं तो कुछ काल्पनिक | ऐसे चिंतन मनन की प्रक्रिया कुछ इस प्रकार से चलती है जिसका कोई अंत नज़र नहीं आता |

मुझे आशा है कि एक दिन ऐसा आएगा जब मेरी अपनी वास्तविक पहचान की तलाश समाप्त होगी (हालाँकि मुझे यह तो पता है कि मैं कौन हूँ पर मैं अभी तक यह नहीं जान सकी कि इस विशाल संसार में मैं कहाँ हूँ ) | एक आम जीवन व्यतीत करना मेरी भी इच्छा है | अपनी क्षमताओं के सारी सीमाओं के बावजूद मैं अपना योगदान इस संसार को देना चाहती हूँ ताकि इस बात की प्रसन्नता रहे कि मैं दूसरों की मदद कर पायी | मैं अपनी माँ और बहन से फिर से जुड़ना चाहती हूँ ताकि हम एक दूसरे को अच्छे से समझ सकें और मुझे भरोसा है कि मुझे उन लोगो का भी साथ नसीब होगा जो मुसीबत के वक़्त मेरे साथ होंगे क्योंकि बचपन से आज तक ऐसा कभी हो नहीं पाया और यही वजह है कि मैं किसी से ना तो जुड़ पायी और न हे सच्चे स्नेह की परिभाषा जान पायी |


…Ask yourself this question if you are considering an ‘alternative’ medicine: Bill Powers


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While patients of OCD in India and other parts of the world keep looking for the “cure” of the disorder, they come across many schools of thoughts and treatments. For some, the allopathic or the western approach helps in reducing the symptoms or providing relief, other treatments also claim to impact the same way with less or no side effects. This raises a question: Are non-conventional medicines and treatments equivalent or even better than the conventional methods of treatment? To find out the answer, on behalf of OCD FREE INDIA, I Gourav Kundu, exchanged a few words with various people from all around the world. Also, in this series, I will bring to you more such unbiased content in the future, interviewing the advocates of Eastern approach as well towards the treatment of OCD so that it becomes easy for the readers in making any decision.

Today we have Mr Bill Powers from the United States to share his opinion on medicines and other treatments that helped him in the recovery from Obsessive Compulsive Disorder. Mr Powers who is 52 years old, has been to India multiple times and has studied the Hindi language at the University of Wisconsin in Madison and Landour Language School, Uttarakhand. He has not only a profound knowledge of OCD but is also a dedicated, compassionate and a very noble person in real life. He is one of the admins of the group, OCD Free India (Facebook group) as well and has been helping the members for a very long time. I thank him for his precious time to share his opinion with us.

Mr Powers says:

“All of us can point to a period in our lives during which our worldview was definitively formed. In my case, it was during my time at university. My lifelong goal had been to study biology, and I achieved that goal, graduating with a Bachelor of Science degree in aquatic biology thirty years ago. Majoring in a scientific field led me to take a very rational, objective, and analytical view towards the world. I, therefore, demand rational proof before I adopt an idea, and if available, hard scientific proof. This has carried over into the way I have chosen to have my OCD treated.
I was diagnosed with OCD the year after I graduated from university. I was very fortunate to be living in a city with a large, world-class research university that housed a teaching hospital. I found an opportunity to enrol in a research study to determine whether sertraline was an effective treatment for OCD. (This was in the fall of 1989.) My OCD treatment commenced at that time. In the nearly thirty years since then, I have had real success using drug therapy for my OCD. Since my treatment was done by doctors who had trained at the aforementioned university, the research performed there heavily influenced the treatment I received. Consequently, I received some of the latest, best, science-based research available in the US and, indeed, in the world.
This was fortunate because it was determined fairly early on in my treatment that my OCD was of the treatment-resistant type. I had been on extended courses of fluoxetine, clomipramine, paroxetine, buspirone, alprazolam, clonazepam, and fluvoxamine. I had only mild benefit from these medications. However, research being done in the early to mid-nineties showed that for patients who didn’t respond to standard, first-line treatments, the use of atypical antipsychotic medications in conjunction with SSRI, TCA, and other antidepressants yielded a greater reduction of symptoms. It was determined fairly quickly that quetiapine fumarate in particular, along with an SSRI, was helpful in reducing my symptoms.
Since the late ’90s, I have also tried venlafaxine, aripiprazole, risperidone, buproprion, and escitalopram. My doctors and I have determined the following treatment regimen to be the most effective: Three years of sertraline, then a switch to three years of escitalopram, while all the while maintaining a fairly high dose of quetiapine, is the best approach. My doctors have tried other, more unorthodox approaches, but these have not been successful.
I would advise anyone who is newly diagnosed, and who is considering what kind of treatment to undertake, to give strong consideration to Western or allopathic medications. These medications are in widespread use because rigorous, peer-reviewed research using double-blind studies have proven these medications to be effective. Can other medications stand up to peer-reviewed research? Ask yourself this question if you are considering an ‘alternative’ medicine.”

Application/Request form for free medicines

OCD FREE INDIA is lending you a hand so that you can get proper treatment despite struggling against your financial situations. Under the title “Free medicines and affordable therapy” we are not only trying to help the needy ones but also trying to convey a message of positivity. This has become possible due to the donations made so far by the members of OCD mental health support group for Indians on Facebook. We expect more donations in the future so that we can bring forth similar campaigns. The following rules have been made keeping in mind that the medicines are received only by the needy ones.

1.) Do not submit the same application more than once.

2.) Fill in the details properly and share the following documents with us:

a.) Properly scanned Prescription paper signed by a registered psychiatrist.

b.) Certificate of your annual income or any certificate issued by the Indian government which proves that you fall into the Below Poverty Line or suffering from financial crisis.

3.) Name of the medicines should match with those on the prescription paper.

4.) Link to online files sharing services (Like Google Drive) must be in working condition, any invalid link will result in rejection of the application.

5.) A proper verification/inspection will be done before sending the medicines to check the veracity and authenticity of the details provided by the applicant.

6.) In case we get multiple applications, there will be random name picked by the computer and the selection process will be demonstrated live through Facebook live video broadcast feature.