4 Days of Intensive Therapy Can Reverse OCD for Years


Two Norwegian psychologists developed a method of treating the condition that is gaining international attention for its efficiency and effectiveness.

For almost a decade, cleaning rituals ruled Kathrine’s life. The middle-aged resident of Bergen, a coastal town in the southern tip of Norway, was consumed by a fear of germs and contamination that led to endless cycles of tidying, vacuuming and washing. “I realized that I was facing a catastrophe,” Kathrine Mydland-aas, now 41, recalls. “I couldn’t help the kids with homework, couldn’t make dinner for them, couldn’t give them hugs. I didn’t do anything but cleaning. I tried to quit, but the rituals always won.”

Last year, around nine years after Mydland-aas’s cleaning rituals began, a psychologist diagnosed her with obsessive-compulsive disorder (OCD) and referred her to a clinic at the Haukeland University Hospital in Bergen. There, a team was administering a behavioral therapy for the condition that, to Mydland-aas’s surprise, was only four days long. “I thought, what can they do in four days?” she says. “[But] it changed my life.”

Mydland-aas is one of more than 1,200 people who have received the Bergen four-day treatment for OCD, a concentrated form of exposure therapy designed by two Norwegian psychologists, Gerd Kvale and Bjarne Hansen. The four-day protocol has recently gained international attention for its effectiveness and efficiency — last month Time magazine named the pair, who are both currently affiliated with the Haukeland University Hospital and the University of Bergen, as two of this year’s 50 most influential people in healthcare.

“It’s amazing that you can so get much done in such a small amount of time,” says Avital Falk, a clinical psychologist who directs an intensive treatment program for OCD and anxiety at Weill Cornell Medicine and NewYork Presbyterian. OCD treatment regimens typically involve weekly hour-long sessions spread out across several months, but more clinicians are adopting concentrated therapy. “Intensive treatment in general has been getting a lot more attention in different formats that can be anywhere from three hours a week,” Falk says. “Ten to 12 hours a week, all the way to the Bergen method, which does everything in four days.”

Kvale has been practicing intensive therapies for various disorders, including phobias and chronic fatigue, since the early 1990s. Over the years, she noticed a lack of effective psychological treatments for people with OCD in Norway, which spurred her interest in creating a concentrated therapy for the disorder. In 2010, she asked executives at her employer, the Haukeland University Hospital, to open a new clinic where she could develop this method — and they agreed. Kvale immediately recruited Hansen, who had spent many years practicing the so-called “LEan into The anxiety” or LET-technique — a method of encouraging individuals with OCD to focus specifically on anxiety-eliciting moments — which eventually formed the core foundation of the Bergen treatment. The duo completed the design of the four-day protocol by fall 2011, and tested the first group of patients in June of the following year. “It worked out exactly the way the we expected it to,” Kvale recalls. “The change we saw during those four days was really immense.”

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