OCD Therapy

OCD stands for Obsessive-Compulsive Disorder. It is a mental health condition that includes frequent, unwanted thoughts, images, or urges (known as obsessions) and repetitive behaviors or mental acts (known as compulsions) that individuals feel compelled to perform.

Obsessions are intrusive thoughts or urges that typically cause a sense of fear and distress. Examples of common obsessions include fears of contamination, doubts about safety, distressing intrusive thoughts about hurting others or fears of having broken rules (religious, legal, social etc.).

Compulsions, on the other hand, are repetitive behaviors or mental acts that individuals engage in to try to reduce the anxiety or distress caused by their obsessions. These behaviors are often not realistically connected to the feared event or situation and may provide only temporary relief. Common compulsions include excessive cleaning or hand washing, checking behaviors (such as repeatedly checking locks or appliances), and arranging or organizing things in a particular way. They can also include excessive repetition of religious acts such as praying the rosary or going to confession multiple times a day.

What is therapy for OCD and how is it different from traditional “talk therapy”?

The first-line therapy for OCD is called Exposure and Response Prevention (ERP). Individuals work closely with a therapist especially trained in ERP. It involves gradually and gently exposing individuals to situations, thoughts, or images that trigger their obsessions and then helping them resist engaging in the corresponding compulsive behaviors or mental rituals. This process allows individuals to learn that their anxiety naturally decreases over time without resorting to their usual rituals or avoidance behaviors. Over repeated exposures, the anxiety response weakens, and individuals develop more adaptive and less distressing responses to their obsessions.

ERP is different from traditional "talk therapy" because it focuses specifically on addressing the obsessive thoughts and compulsive behaviors that characterize OCD. While traditional talk therapy may involve discussing and exploring various aspects of a person's life, including their thoughts and emotions, ERP is highly structured and goal-oriented. It aims to help individuals directly confront and manage their OCD symptoms through exposure exercises and learning new coping strategies.

Doesn’t every therapist know how to treat OCD?

While talk therapy approaches, such as psychodynamic therapy or supportive therapy, can be valuable for addressing other mental health concerns, it can actually perpetuate some OCD symptoms, rather than extinguish them. ERP is specifically designed to target the unique symptoms and challenges of OCD. It is crucial to work with a therapist who has training and experience in treating OCD to ensure that the most effective techniques, like ERP, are employed. If a person with OCD solely engages in talk therapy without receiving appropriate OCD-specific treatment, it is possible that their symptoms may persist or worsen over time. It is crucial to work with a qualified mental health professional who has training in treating OCD to ensure that the most effective strategies are employed and the individual receives the appropriate care for their specific needs.

What about medication?

Everyone is unique and many people benefit from psychotherapy alone. Others may benefit from a combination of psychotherapy and medication, or prefer to only treat their OCD with medication. I respect everyone’s ability to make choices that are right for them. I can provide psychoeducational information about common psychotropic medications but would never pressure or force someone to start taking medication. I have experience as a therapist within a primary care medical clinic where I learned to help my clients determine if medication may be a treatment option they would like to explore more with their primary care physician or psychiatrist. I am not licensed to prescribe medication but can refer you to a psychiatrist or primary care physician who is. I am happy to coordinate with them and can administer well regarded questionnaires that can be an effective way to give a snapshot of your symptoms to your prescriber. These questionnaires can also be used to communicate the progress that you are making so that your provider can make the most informed decisions about your medication dosage moving forward.

Does my OCD mean I’m crazy?

No, having OCD does not mean you are crazy. OCD is a mental health condition that affects millions of people around the world. It is important to understand that having OCD does not indicate insanity or being "crazy." OCD is characterized by unwanted, intrusive thoughts (obsessions) and repetitive behaviors or mental acts (compulsions) that individuals feel compelled to perform. These thoughts and behaviors can be distressing and interfere with daily life, but they do not reflect a loss of touch with reality or a break from rational thinking.

OCD is recognized as a mental health disorder in diagnostic manuals such as the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). It is a legitimate medical condition that arises from a combination of genetic, neurobiological, and environmental factors. It is not a sign of personal weakness or a reflection of one's character.

A helpful analogy for understanding certain aspects of OCD is to compare it to a sensitive smoke alarm. All of our brains have a part that looks out for danger, and potential mistakes. Sometimes, the brains of people with OCD are more likely to be alert to some particular dangers or problems. OCD can be likened to a sensitive smoke alarm that is easily triggered. Just as a sensitive smoke alarm may detect minor smoke or heat, individuals with OCD may have heightened sensitivity to certain thoughts or situations. They perceive them as dangerous or threatening, even when there is no real danger present. These triggers prompt anxiety and lead to recurring, distressing thoughts (obsessions) and repetitive behaviors (compulsions) aimed at reducing the anxiety. However, OCD is a complex condition that involves more than just sensitivity, and it requires appropriate treatment and support.

You’re not the only one.

You are not alone in having OCD. OCD is a relatively common mental health condition that affects people of all ages, ethnicities, and backgrounds. OCD affects millions of people around the world.