What Is Inferential Confusion? Understanding the Key Points of Inference-Based Cognitive Behavioral Therapy (I-CBT)

Inference-Based Cognitive Behavioral Therapy (I-CBT) teaches us that Obsessive Compulsive Disorder (OCD) comes from doubts in our mental processing. Unlike other therapies, which view OCD obsessions as a series of “random” or “intrusive” thoughts, I-CBT gives clients a sense of control over how their brain is conceptualizing triggering concepts. 

Instead of treating the anxiety and compulsion sequence in OCD, I-CBT focuses on “doubt” — which is one piece of the broader concept of “inferential confusion.” This essentially means that people create a series of imagined possibilities related to their central doubt. This doubt (and thought process that follows) differs between people and triggers. However, it follows a shared pattern.

First, a person is triggered by something. This causes a doubt to arise, which is partnered with a consequence. The possible consequence of doubt leads to anxiety and compulsions, which are present as a way to lessen anxiety. 

By targeting the doubt, I-CBT aims to increase a person’s self-trust and confidence in processing “here and now” signals. That means, the things our senses are in touch with in this very moment. It aims to remove the “what ifs,” “could happens” and “mights” from our ways of thinking. These imagined possibilities only feed into the OCD cycle, and allow us to spiral into a deep well of possibilities — none of which are actively happening in the moment. 

Another popular OCD treatment modality, Exposure and Response Prevention (ERP), focuses on changing behaviors rather than thoughts. This is done by exposing clients to their compulsions and the anxiety attached to them. It also encourages building comfort with the “what ifs” — something I-CBT aims to eliminate. 

Neither treatment modality is better than the other. Both are evidence based, and have a long history of success behind them. ERP and I-CBT differ in treatment targets, which means some clients may react better to one or the other. 

CCBH therapists are trained in both I-CBT and ERP, and specialize in treating Obsessive Compulsive Disorder. For more information on our clinicians, or these therapy modalities, click here.