Lesson 6 of 6 · When to get help, and what help looks like
What the evidence says, including its weakness
Two things worth holding at once. The evidence for this treatment is genuinely strong, and it is also honest about its own limits, which we would rather show you than tidy away. The report is the one people forget: seeking a remedy sits inside the tradition, not outside it.
Qur’an and Sunnah
Seeking a remedy sits inside the tradition rather than outside it, and this is the plainest statement of it. There is a remedy for every malady.
Jabir reported Allah's Messenger (ﷺ) as saying:There is a remedy for every malady, and when the remedy is applied to the disease it is cured with the permission of Allah, the Exalted and Glorious
Sahih Muslim 2204graded sound, sahihaynthe Arabic and its grading
The same point in the exchange people usually forget. They asked whether they should make use of medical treatment and were told to make use of it.
Narrated Usamah ibn Sharik: I came to the Prophet (ﷺ) and his Companions were sitting as if they had birds on their heads. I saluted and sat down. The desert Arabs then came from here and there. They asked: Messenger of Allah, should we make use of medical treatment? He replied: Make use of medical treatment, for Allah has not made a disease without appointing a remedy for it, with the exception of one disease, namely old age
Sunan Abi Dawud 3855graded sound, albanithe Arabic and its grading
What the research says
Across 36 trials and 2,020 people, the treatment built on facing the fear without the ritual clearly outperformed waiting and control conditions. The same authors note that trials run by researchers committed to the method report larger effects, so the true size is likely a little smaller than the headline.
36 randomised trials, 2,020 people. CBT with exposure and response prevention beat waiting lists and control conditions by a large margin, Hedges g 0.74. The same authors report that trials run by researchers with an apparent allegiance to the treatment found far larger effects than trials without, which is a real weakness in the evidence base and is stated here rather than smoothed over.
Reid JE, Laws KR, Drummond L, Vismara M, Grancini B, Mpavaenda D, Fineberg NA (2021). Cognitive behavioural therapy with exposure and response prevention in the treatment of obsessive-compulsive disorder: a systematic review and meta-analysis of randomised controlled trials. Comprehensive Psychiatry, 106, 152223 doi