Mindfulnessfor OCD involves bringing open, non-judgmental present moment awareness to uncomfortable feelings or situations, rather than resisting or avoiding them. It creates space to welcome difficult emotions as part of the human experience.
Non-judgment involves noticing when we are judging feelings as “bad” and stepping back into a more objective observer role rather than interpreting or making meaning out of the feelings.
The purpose isn’t to always feel good but to create space for present moment experience.
Key Points
Rationale
Obsessive-compulsiveand related disorders (OCRDs) are serious mental health conditions involving obsessions and compulsions that can significantly impair functioning (American Psychiatric Association, 2013).
First-line treatments likeexposure therapyhave limitations, including high relapse rates and complexity in practice (Gillihan et al., 2012; Olatunji et al., 2013).
Mindfulness interventionsemphasize present-moment awareness with an attitude of non-judgment (Kabat-Zinn, 2004). They have shown promise for improving both physical and mental health across disorders (de Vibe et al., 2017; Demarzo et al., 2015; Goldberg et al., 2022).
The mindfulness skill of non-reactivity, or allowing thoughts and feelings to come and go without reacting, may be particularly helpful for managing intrusive thoughts in OCD (Hawley et al., 2017; Landmann et al., 2019).
Despite high anxiety and depression comorbidity in OCRDs (Fineberg et al., 2013), no systematic review has evaluated mindfulness interventions for the full range of OCRDs and common symptoms like obsessions and depression.
Establishing an evidence base for these interventions can inform treatment guidelines and help address the limitations of first-line approaches.
Method
Sample
Results
Implications
Future Research
More research is vital to strengthen the evidence base so these interventions can effectively help address the significant patient need.
Strengths & Limitations
The study had many methodological strengths, including:
However, this study was limited in a few ways:
Conclusion
This is the first comprehensive meta-analysis demonstrating medium to large benefits of MIs for overall symptom severity across multiple OCRDs – OCD, BDD, and TTM. The effects were sustained without exposure techniques, highlighting the unique therapeutic benefits of mindfulness.
Mindfulness allows practicing non-reactivity to intrusive thoughts, a key skill for managing obsessions in OCD. However, the meta-analysis found only transient benefits for obsessions and no effects on comorbid depression.
The lack of follow-up data for TTM and absence of trials for other OCRDs underscores the need for more research across disorders.
Considering the high psychiatric comorbidity with OCRDs, using mindfulness as an adjunct or stand-alone treatment offers promise but requires more rigorous study.
References
Primary Paper
Pseftogianni, F., Panagioti, M., Birtwell, K., & Angelakis, I. (2023). Mindfulness interventions for obsessive–compulsive and related disorders: A systematic review and meta-analysis of randomized controlled trials.Clinical Psychology Review,233-243.https://doi.org/10.1037/cps0000132
Other References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
de Vibe, M., Bjørndal, A., Fattah, S., Dyrdal, G. M., Halland, E., & Tanner-Smith, E. E. (2017). Mindfulness-based stress reduction (MBSR) for improving health, quality of life and social functioning in adults: A systematic review and meta-analysis.Campbell Systematic Reviews, 13(1), 1-264.https://doi.org/10.4073/csr.2017.11
Demarzo, M. M. P., Montero-Marin, J., Cuijpers, P., Zabaleta-del-Olmo, E., Mahtani, K. R., Vellinga, A., Vicens, C., Lopez-del-Hoyo, Y., & García-Campayo, J. (2015). The efficacy of mindfulness-based interventions in primary care: A meta-analytic review.Annals of Family Medicine, 13(6), 573–582.https://doi.org/10.1370/afm.1863
Fineberg, N. A., Haddad, P. M., Carpenter, L., Gannon, B., Sharpe, R., Young, A. H., Joyce, E., Rowe, J., Wellsted, D., Nutt, D. J., & Sahakian, B. J. (2013). The size, burden and cost of disorders of the brain in the UK.Journal of Psychopharmacology, 27(9), 761–770.https://doi.org/10.1177/0269881113495118
Gillihan, S. J., Williams, M. T., Malcoun, E., Yadin, E., & Foa, E. B. (2012). Common pitfalls in exposure and response prevention (EX/RP) for OCD.Journal of Obsessive-Compulsive and Related Disorders, 1(4), 251–257.https://doi.org/10.1016/j.jocrd.2012.05.002
Goldberg, S. B., Riordan, K. M., Sun, S., & Davidson, R. J. (2022). The empirical status of mindfulness-based interventions: A systematic review of 44 meta-analyses of randomized controlled trials.Perspectives on Psychological Science, 17(1), 108–130.https://doi.org/10.1177/1745691620968771
Hawley, L. L., Rogojanski, J., Vorstenbosch, V., Quilty, L. C., Laposa, J. M., & Rector, N. A. (2017). The structure, correlates, and treatment related changes of mindfulness facets across the anxiety disorders and obsessive compulsive disorder.Journal of Anxiety Disorders, 49, 65–75.https://doi.org/10.1016/j.janxdis.2017.03.003
Kabat-Zinn, J. (2004).Wherever you go, there you are: Mindfulness meditation for everyday life.Piatkus Books.
Landmann, C., Tuschen-Caffier, B., Moritz, B., Külz, S., & K, A. (2019). Mindfulness predicts insight in obsessive–compulsive disorder over and above OC symptoms: An experience-sampling study.Behaviour Research and Therapy, 121, Article 103449.https://doi.org/10.1016/j.brat.2019.103449
Olatunji, B., Davis, M., Powers, M., & Smits, J. (2013). Cognitive-behavioral therapy for obsessive-compulsive disorder: A meta-analysis of treatment outcome and moderators.Journal of Psychiatric Research, 47(1), 33–41.https://doi.org/10.1016/j.jpsychires.2012.08.020
Page, M., McKenzie, J., Bossuyt, P., Boutron, I., Hoffmann, T., Mulrow, C., Shamseer, L., Tetzlaff, J., Akl, E., Brennan, S., Chou, R., Glanville, J., Grimshaw, J., Hróbjartsson, A., Lalu, M., Li, T., Loder, E., Mayo-Wilson, E., McDonald, S., … Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews.Journal of Clinical Epidemiology, 134, 178–189.https://doi.org/10.1016/j.jclinepi.2021.03.001
Tolin, D. F. (2023. Mindfulness and acceptance for OCD: New direction or more of the same?Clinical Psychology: Science and Practice, 23(3), 248-250.https://doi.org/10.1037/cps0000142
Further Reading
Learning Check
How might mindfulness practice help people manage intrusive thoughts or obsessions in OCD? What skills does it teach that could be useful?If you were designing a study to test mindfulness for an OCRD, what considerations would guide your choices about the sample, protocol design, comparisons, and outcome measures?What do acceptance-based therapists do with OCD patients? How might an ERP protocol be adapted to incorporate elements of mindfulness?What might account for the larger benefits of mindfulness found in lower-income countries compared to higher-income ones? What are the implications?
Olivia Guy-Evans, MSc
BSc (Hons) Psychology, MSc Psychology of Education
Olivia Guy-Evans is a writer and associate editor for Simply Psychology. She has previously worked in healthcare and educational sectors.
Saul McLeod, PhD
BSc (Hons) Psychology, MRes, PhD, University of Manchester
Saul McLeod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.
