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Inference-based Cognitive Behavioral Therapy (I-CBT)

Inference-Based Cognitive-Behavior Therapy (I-CBT) is an evidence-based treatment for Obsessive-Compulsive Disorder (OCD) that focuses on the idea that obsessions stem from abnormal doubts about what "could be" or "might be." Unlike traditional Cognitive-Behavioral Therapy (CBT) for OCD, I-CBT places emphasis on the reasoning narrative that precedes obsessions.

I-CBT looks at the entire underlying structure (ICEBERG) of obsessional doubts, addressing reasoning and fears related to one's identity. I-CBT offers an alternative to ERP, acknowledging that not everyone can tolerate the distress caused by it, and it may not be suitable for everyone. I-CBT is a specialized cognitive-behavioral therapy for OCD that delves into the reasoning behind obsessions, addressing inferential confusion, vulnerabilities, and fears related to identity to bring about natural resolution of obsessional doubts.

Dysfunctional Reasoning Narrative

Obsessions are seen as the result of a dysfunctional reasoning narrative characterized by distrust of the senses and an over-reliance on imagination.

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Persistent Obsessional Doubts:

Obsessional doubts can persist without resolution through compulsions because they arise from reasoning rather than random intrusive thoughts.

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Focus on Inferences & Doubts

I-CBT distinguishes itself by addressing the initial obsessions and how they arise due to reasoning, in contrast to standard CBT that focuses on consequences, appraisals, anxiety, and compulsions.

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Resolution of Obsessional Doubts

The goal of I-CBT is to bring resolution to obsessional doubts by teaching clients that these doubts don't arise in the same way as normal doubts.

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Trusting Inner and Outer Senses

Throughout treatment, clients are encouraged to trust their inner and outer senses, minimizing room for obsessional doubts.

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Inferential Confusion & Vulnerability

Obsessional doubts arise due to an "inferential confusion" where abstract possibilities are treated as actual probabilities, leading to a blurred line between reality and possibility during reasoning.  Those with OCD are more vulnerable to inferential confusion due to a specific vulnerable self-theme, often related to fears about their identity.

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Behavioral Exercises

I-CBT does not include deliberate or prolonged exposure and response prevention (ERP) techniques. Instead, it takes a more cognitive approach, focusing on resolving obsessional doubts naturally.  I-CBT is specifically designed for OCD and targets unique cognitive processes not directly addressed in other treatments.

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