Integrative Ayurveda and Acceptance and Commitment Therapy for ObsessiveCompulsive Disorder: A Case Report

Obsessive-Compulsive Disorder (OCD) is a chronic, debilitating psychiatric illness marked by intrusive thoughts and repetitive behaviours aimed at reducing associated distress. Despite the availability of evidence-based treatments such as selective serotonin reuptake inhibitors (SSRIs) and Cognitive Behavioural Therapy (CBT), including Exposure and Response Prevention (ERP), many patients with long-standing or spiritually-influenced symptom profiles remain partially or non-responsive to conventional care approaches¹. This case report is unique in its integrative use of Ayurvedic medicine and Acceptance and Commitment Therapy (ACT), demonstrating a novel combination of traditional and third-wave psychotherapeutic frameworks. The inclusion of spiritually-aligned interventions such as Agnihotra makes this case particularly relevant in socio-culturally sensitive contexts. To date, there is limited scientific literature documenting the combined application of Ayurvedic therapeutics with ACT principles in OCD management, thereby contributing a valuable perspective to integrative mental health practices²˒³. The patient, a 48-year-old male, presented with an eight-year history of intrusive religious obsessions such as persistent fears of divine punishment and compulsive prayer rituals accompanied by emotional dysregulation, anxiety, frequent crying episodes, and a markedly increased frequency of bowel movements (10–12 per day). These symptoms significantly impaired his occupational functioning and interpersonal relationships. He was clinically diagnosed with OCD as per DSM-5 criteria, with a Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) score of 26, indicating moderate-to-severe symptom severity. Ayurvedic assessment revealed Vata-Pitta imbalance and Manovaha Srotas vitiation, correlating with the classical description of Unmada, particularly Atatvabhiniveshaa pathological attachment to non-rational ideas⁴˒⁵. The therapeutic intervention was twofold: first, classical Ayurvedic treatments including Sarvanga Abhyanga, Shirodhara, Nasya, Matra Basti, and internal medications; and second, six structured ACT sessions targeting psychological inflexibility through mindfulness, cognitive diffusion, and values-based action. Additionally, daily Agnihotra was used as a culturally resonant spiritual ritual to foster emotional regulation and symbolic release. Within two weeks, the patient showed marked improvement, with the Y-BOCS score dropping to 12, normalization of bowel movements, reduction in ritualistic behaviours, improved emotional regulation, and restored work performance.