Among all the types of psychotherapy, there is one that places great emphasis on the need to focus on the present in order to obtain results as soon as possible, and to enhance the effectiveness of the psychologist’s intervention. It is the case of the Strategic Brief Therapy (TBE) , developed from the works of Paul Watzlawick and Giorgio Nardone.

GBS creates intervention protocols adapted to each type of harmful psychological disorder so that the person stops feeding the problem unconsciously and starts living from healthier habits and away from the disorder. To understand how it works in the treatment of Obsessive-Compulsive Disorder, we talked to a Canarian psychologist specialized in this type of therapy: Raúl Segura Díaz .

Interview with Raúl Segura: Helping People with OCD from Strategic Briefing Therapy

Raúl Segura Díaz is the official psychologist of the Centro de Terapia Breve Estratégica de Arezzo (directed by Giorgio Nardone himself), and he attends to patients in his office in Las Palmas de Gran Canaria. On this occasion, this professional talks to us about his experience attending patients with Obsessive-Compulsive Disorder, a psychological disorder known to be related to the need to perform repetitive “ritual” behaviour patterns.

Is it possible for a psychological disorder that has been troubling a patient for years to go away in just a few months of therapy?

Just because a disorder is disabling and has affected a person for many years does not mean that the solutions to make it go away have to be of the same magnitude. If the right treatment protocol can be found, most problems are solved within a few months.

It is true that the most important thing is to unblock the disorder in the first sessions so that the patient stops suffering and then gradually work with appropriate strategies to eliminate it completely. This is how it is done in this case, in the Obsessive Compulsive Disorder (OCD), which must be eliminated completely, no small improvements are worth, if not eliminated completely then it reproduces again. We could say that it behaves like a virus.

In the case of Obsessive Compulsive Disorder, is the treatment complicated?

I would say that it is a complex disorder that cannot be solved by ordinary logic. We must understand how it works and apply the right treatment. We need to know how the problem is structured in the patient’s mind, to know the type of rituals and whether OCD is based on fear or pleasure. For example, a fear-based OCD would be performing rituals to avoid becoming contaminated, and one based on pleasure would be pulling out one’s hair, which is called trichotillomania. We need to be very clear about what the patient is doing to lessen his fear or not give in to pleasure.

Most patients with this disorder engage in rituals or compulsions that reassure them at the time and gradually become more frequent until they are completely disabling. Other strategies used by patients are to avoid what they fear, for example by not going to places where they might become contaminated, and also to involve the family in helping them.

At first it might seem that all this calms the OCD sufferer, but then it becomes part of the problem, as the disorder progressively demands more rituals, more attention from family members, more avoidance. We should advocate with specific protocols, as is done in Strategic Briefing Therapy (SBRT), to dismantle all this that the patient has built and thus free him or her from the trap of the disorder.

Being your specialty the Strategic Brief Therapy, what would you say are the distinctive aspects of this, and what distinguishes it from the rest of the psychological interventions?

One of the fundamental aspects is that Strategic Briefing Therapy is focused on change, not learning like others. Let me explain: in other therapies, we talk to the patient so that he knows his problem, so that he understands it through reason and that this leads him to act differently.

In contrast, in Strategic Briefing Therapy the dialogue is focused on the patient perceiving and feeling his problem from another perspective. It is about making him put into practice prescriptions, which sometimes may seem original, but which are based on efficiency. This helps to overcome the resistance to change that any already structured disorder has.

In ERT we make the patient relate to his problem in a different way, which makes him have a different perception of it. He begins to realize that he can stop doing certain rituals, thus breaking the rigid structure of the disorder.

In the sessions we use persuasive language, which suits the patient and his or her problem. A communication oriented to discover by himself how the disorder works and how what he has done so far to solve it maintains it or even makes it worse. All of this makes GBS one of the most effective ways to treat OCD.

How does one begin to notice that the compulsions no longer have any power over the person?

Compulsions cease to dominate the patient’s life when the patient can stop doing them, when it is no longer inevitable to carry them out. The patient realizes that more and more times the situation is dominated rather than the disorder. This can be achieved in a short time if with the appropriate stratagems we take over the symptom so that it stops being something irrepressible.

The patient notes that he may, for example, stop washing his hands, or that he may stop checking a document twenty times before sending it, or that he may stop reciting the mental formulas that were previously imposed by the disorder.

Can we all become structured, have OCD?

If we consider that OCD is based on reasonable things taken to an extreme, we could say that anyone could suffer from it. Washing your hands is okay so you don’t get contaminated, but washing them twenty times isn’t okay. It’s a good thing taken to the extreme. Being neat and clean is fine, but if it leads to spending most of the day involved in tidying and cleaning up, we go from something that’s fine to a disorder.

The logic is not wrong, what is wrong is taking it to the extreme. For example, to have a mania for luck before playing a football game is not harmful, but if it is harmful that this mania demands more and more time, that we should repeat it first ten, then twenty, thirty times…

Would you recommend the use of Strategic Briefing Therapy to most psychologists?

I would recommend GBS to those psychologists who want to solve psychological problems efficiently.

We must bear in mind that strategic GER has specific protocols for different psychological disorders that have been tested on hundreds of patients. Not only that, but at the Strategic Brief Therapy Centre in Arezzo, directed by Professor Giorgio Nardone, research is continuously being carried out to, on the one hand, adapt and improve existing protocols and, on the other hand, to develop new protocols for the pathologies that arise as a consequence of the constant change in our society.