Inference-based Cognitive Behavioral Therapy (I-CBT)

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

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

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.

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.

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

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.

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.