Wednesday, June 25, 2014

Book Review: The Mindfulness Workbook For OCD: A Guide to Overcoming Obsessions & Compulsions Using Mindfulness and Cognitive Behavioral Therapy

By Jon Hershfield & Tom Corboy

When I received this book I had 2 different thoughts.  The first was that I wanted to actually work thru the workbook, not just read it and comment on it.  The second thought was that I figured I'd have to look back at my past to see how this book could or would have helped me with my OCD journey had I had it earlier in my battle.  So I worked thru the exercises.  Some of them I found I was answering them with past thoughts, like I figured I would.  I  don't have H-OCD anymore, although I did during my university years.  I didn't know then what it was.  I had been taught that bad thoughts were sins, so I just felt guilty and tried to keep them out of my mind, or at least way in the back where I could function normally and do my school work. (The workbook talks about using guilt as a ritual in its section on Scrupulosity OCD). 

  But then I remembered that I still have a few OCD rituals I do because I haven't yet get  managed  to eradicate them.  They have too many of what I think are 'real' not 'OCD' thoughts.  Garbage cans and bags are (sometimes) dirty, right?  Laundry is 'dirty' right, especially if I put in towels I used to wipe my hands dry after doing a ritual-  they could have any left-over contamination on them.  The black marks inside books have to be something disgusting, even if they're not old dried up mouse droppings. Hence, one must wash after  touching them- and in the case of garbage or laundry change clothes in case they got contaminated too.  So I realized that for at least some of the exercises (the Contamination OCD ones) I could answer with current problems and see how the book helps me.    (See for how I used what I learned from this workbook to help me overcome 1 of my remaining contamination fears.) 

The Mindfulness Workbook for OCD is divided into 3 parts.  The first discusses the OCD mind and that people with OCD pay attention to thoughts that others either ignore or don't even register that they have.  The authors assert  that feelings and sensations are just that.  Feelings aren't facts and thoughts don't need to be acted upon no matter how intense they are. 
They describe my daily life for years: 
'If you live with OCD it's likely that you often wake up feeling guilty and spend your day investigating yourself and trying to find a way of appropriately sentencing yourself for the crime.  Or maybe you just feel that something is off.'( pg. 11) 

People can suffer from different thought distortions.  They include: Black & White or All or Nothing Thinking,  Catastrophizing or Jumping to Conclusions, Magnifying, Discounting the Positive, Emotional Reasoning, Tunnel Vision, Shoulding or Perfectionism, Comparing, Mind Reading, Hyper-responsibility, Magical Thinking. OCD uses these thought distortions to get you to do rituals.  It's challenging these types of thoughts that give us the courage to do the next part of Cognitive Therapy- ERP or sitting with the thought and feeling the discomfort instead of performing a ritual. 

 They demonstrate how thought records are done- the same as I do, except that they don't rate the mood at the beginning of the exercise and your mood at the end, to see whether your anxiety has decreased. See here: or  for a thought record sample.

The authors talk about how meditating on your breath helps you strengthen your ability to come back to the present moment rather than being lost in an obsessive thought. 
Chapter 3 discusses what people can and can't control and how it's behavior that changes the intensity of the obsessive thoughts.  While people with OCD try and try (usu. unsuccessfully) to control their thoughts so everything will go well without having to do rituals, Hershfield & Corboy say that it's behavior that can be controlled.  Thoughts, feelings, bodily sensations come and go. While we can control our emotions some of the time,  we only have 100% control of our behaviors.  When the behavior is changed through Exposure-Response Prevention therapy, ( i.e. you don't do the  ritual, but just sit with the dread and emotions until they dissipate), " then your mind has to admit that compulsions are a choice.  If that's true, it must mean that the obsessions are not as automatically important as previously assumed. If that's true, then they may not be worth any response..." (p45)  Instead of sitting with your obsessive thoughts, sit with that one for a while! 

Then comes the work of listing compulsions that you do or situations you avoid so you don't have to do a ritual, then begin exposing yourself to these one at a time without doing the corresponding ritual.  For thought -OCD's or harm OCD, the authors teach a method of imagining that you have acted upon the horrible thought .   Then you practice sitting with the emotions and feelings. Over and over until your mind gets bored with the thought and "  OCD ...finally falls from exhaustion.  You may be sore and mentally bloodied but are the one remains standing in the end.  This is because of the reality behind mindfulness: thoughts cannot kill you"  (p.53)

A quote I found very interesting probably because my daughter usually does this to deal with her OCD is found on page 60 as follows:  " When you avoid something, you aren't returning a message of safety; you are returning a message of narrowly escaped danger."
Part Two of the book goes into detail about many different types of OCD -even some that are not mentioned very often,  or that are usually slipped in under another heading.  Their list is as follows: Contamination, Responsibility/Checking,  'Just Right', Harm, Sexual Orientation, Pedophile, Relationship, Scrupulosity and Hyperawareness OCD.  Each chapter includes examples, how to use mindfulness and acceptance and thought records to focus on the thoughts and then use Exposure & Response Prevention (ERP) to overcome them.
The last part of this workbook is about how you deal with the OCD diagnosis- advantages and disadvantages of sharing your diagnosis, explaining OCD to others, how to deal with OCD flare -ups and stressors (including hormones)  after you have 'finished' your therapy program.
They give on-line and book resources to follow up with.  However while giving the American and the British OCD Foundation websites, they omit Canada's which is:  And while they give discussion boards for OCD, they have neglected the blogging world where people with OCD share their journey and struggles living with and overcoming OCD. Just search blogger & OCD.  My blog is   Reading others' blogs about OCD was very helpful to me as I didn't feel alone anymore.  Personally I found the forum sites I visited 5 years ago very negative and whining, while the bloggers were upbeat  and often funny- unless it was a bad day.  Hopefully the forums have become more positive and focused on healing too. 

A final quote:  '
Mindfulness is about seeing that [OCD] pain land on your satellite and accepting it with open arms. Let it wash over you. Let it be rain that slips across you and down a gutter, instead of snow that builds and builds until you are crushed and buried. Let your fear of resisting compulsions be replaced by a curiosity with what's on the other side.' (pg.77)
An excellent workbook that deals directly with OCD.
Disclosure note:  I received this copy free from Harbinger Press to do a book review on it.


  1. This sounds like a helpful book, Karin. I have studied mindfulness and am practicing it--still have a long way to go. But it has made it easier to recognize when I'm letting my thoughts control how I feel and what I do. Being mindful of the moment even for short periods of time has helped me.

    1. My therapist taught me mindfulness because I had insomnia. I found it hard to relax enough to go to sleep. She said to focus on my senses- see if I can hear, feel, smell, see 4 things.

  2. I bought this workbook a few months back, read the first chapter and then nicely put it away. At that time I just couldn't focus long enough to actually do any of the exercises and it was when I was just "coming to terms" with my long history with OCD. After reading your review I am going to dust off the book and give it another go. Thanks.

  3. good luck, No Doorknobs! I know how hard it is to be mindful when your whole body is full of dread, or screaming at you to just do that ritual and get it over with. Hang in there. It's hard, but it is so worth it, but it does take time.

    I used to practice what I was going to touch for real, in my head first, feel all the feelings. And then do it again. I think they called it 'flooding' here. I just called it practising- to make sure that the dread would go away before I did it for real.
    My life started to make sense after my OCD diagnosis. I didn't know that OCD could just be in my head.