OCD
Obsessive compulsive disorder (OCD) does not mean you’re a “Type A” person or high strung. It isn’t a synonym for being clean or tidy, and it’s not just having intrusive thoughts that you left the front door unlocked. OCD includes a combination of obsessions (unwanted intrusive thoughts/images/urges causing distress) and compulsions (behaviors completed to reduce the obsessions and emotional distress).
Some common obsession themes include:
1. Fear of contamination
2. Fear of harming self or others
3. Repeated checking
4. Needing things to look or feel “just right”
5. Other disturbing thoughts that include violent or sexual themes
For more information, see: The International OCD Foundation https://iocdf.org/about-ocd/
We all occasionally experience intrusive and upsetting thoughts. For example, on my way to the airport, I might have an image of my passport falling out of my purse and onto my garage floor. Then I might imagine myself turning around to return home and missing my flight. For that split second, my heart might skip a beat, I might feel a sick feeling in my stomach, and my palms might even sweat a little. But I’ll be able to swat away the thought like a pesky mosquito and choose to keep driving. I might briefly consider checking my purse but I won’t because I can cope with the tiny risk that the passport fell out. But if I’m living with OCD, that thought might be so upsetting that I feel compelled to stop the car and check in my purse to make sure that the passport is there. And each time the thought resurfaces, I will stop and check all over again.
Someone might fantasize about quitting his job and giving his boss the middle finger on the way out. But he’s not disturbed by the fantasy because he knows that thinking about something won’t make it automatically come true. However, if he’s living with OCD, he might call in sick that day to avoid “accidently” making the thought come true.
The compulsions, sometimes called rituals, can take over a person’s life. Ordinary tasks of life such as showering, cooking, sending emails, and driving your car can include elaborate routines that are designed to reduce the risk of something bad happening. However, the compulsions cannot ever provide 100% certainty that the bad thing won’t happen. The compulsions provide the illusion of control but maintain long term anxiety and insecurity.
The treatment for OCD involves a behavioral therapy called Exposure and Response Prevention Therapy. Exposure and Response Prevention, the gold standard of OCD treatment, is a type of CBT therapy that involves exposing the client to situations that trigger the obsessive thought and preventing the compulsions that maintain the OCD. It is structured, gradual, and involves continuous collaboration between the client and therapist. Other treatment methods are less effective because they do not combine exposures (real life and/or imaginal) AND prevention of the compulsions.
Each time you do a compulsion after an obsession makes you anxious, you are reinforcing the OCD. Compulsions temporarily reduce your anxiety, but they maintain your OCD.
If you are ready to tackle your OCD, you will commit to about 25 weekly sessions of ERP. The sessions are different from traditional talk CBT therapy because we will be completing exposures in session including daily homework between sessions. The treatment protocol is rigorous but I will coach you through it. The exposures WILL increase your anxiety and this is intentional. This evidenced based practice is THE gold standard because it works.
In ERP therapy, you learn:
1. I can tolerate anxiety
2. Eventually, my anxiety and urge to complete a compulsion will decrease
3. Oftentimes, my worst-case scenario won’t actually happen
4. If my worst-case scenario happens, I have the internal resources to cope with it
5. I can cope with uncertainty
6. Thinking something doesn’t mean it will happen
For more information about the effectiveness of ERP, please see: https://www.treatmyocd.com/blog/gad-and-ocd
OCD is a common mental health disorder with an effective treatment protocol. I’ve received additional training from the Cognitive Behavior Institute on using ERP therapy to treat clients with OCD. Step out of shame and get help. For OCD counseling in Carrollton, Texas, contact me today.