Treatment for OCD

​

It's more than just wanting things a particular way. OCD is not a thing to adopt as an excuse for wanting something done well or clearly. You may have heard people (or even said yourself) "I'm just OCD about that", or "it's because of my OCD". But, that doesn't actually speak to the problem we want to help people with in OCD treatment.

​

What is OCD?

​

Many people view obsessive-compulsive disorder (OCD) as a “quirky” disorder involving liking

things to be organized in a certain way or washing one’s hands too often, but OCD can take on

a number of forms. These include fears about harming oneself or others, feeling things are not

“just right,” or feeling overly concerned about having done something immoral or in violation of

one’s religious beliefs (scrupulosity), among numerous other subtypes.

​

OCD is primarily characterized by:

​

• Intrusive thoughts or images (obsessions)

• Thoughts that are repetitive, difficult to control, and cause distress or anxiety

• Repetitive behaviors (compulsions) designed to decrease the anxiety that comes from obsessions

​

OCD manifests in a variety of forms

​

There is no one-size-fits-all obsessive-compulsive disorder pattern. 

​

Common obsessions include:

• Fears about contamination

• Fears about harm

• Scrupulosity

• Concerns about one’s relationship

• Getting stuck on things not being symmetrical or feeling “just right”

 

Common compulsions include:

• Mental checking

• Reassurance-seeking

• Physical checking

• Counting

 

For example, someone whose OCD centers around the fear of harming others may get stuck on the

obsession that they ran someone over while driving their car. This thought results in intense

anxiety and the thought is difficult to shake. This person’s compulsion may manifest in them

driving back to the spot where they thought they hit someone to check if they did actually hit

someone. For some, checking once may be enough, however, for people with OCD, they may

drive back repeatedly to check. Once they feel reassured, their anxiety will drop temporally.

However, this checking then strengthens the obsession and the need to engage in compulsions.

While we all experience intrusive thoughts at different points in our lives, individuals with OCD

become “stuck,” and end up in a loop that feeds into their OCD symptoms.

 

 

 

 

 

 

 

 

 

 

 

 

 

There is a treatment for OCD

​

Treatment for OCD can be difficult, but is effective! While there are many treatments, the gold

standard is called exposure and response prevention (E/RP). This involved a number of

components designed to break the relationships described in the OCD cycle diagram above.

 

Components of therapy for OCD include:

• Creating a list of anxiety-provoking obsessions

• Rating them from 1-100 according to the distress they cause

• Identifying compulsions

• Committing to refraining from compulsions as much as possible

• Engaging in exposure exercises in session and outside of session in which one is

• intentionally exposed to the anxiety-provoking situation

 

Exposure exercises can be:

o Imaginal: An example for the person afraid they hit someone with their car could be picturing a scenario in which this actually happens

o In vivo: For someone whose fears are about contamination, they may expose themselves by not washing their hands after coming into contact with something that results in anxiety

 

How does OCD treatment work?

​

While treatment for OCD may seem counterintuitive and
uncomfortable, it works in two ways:

​

1. By repeatedly exposing oneself to situations that make them anxious, while not engaging in compulsions,
   one eventually gets used to the situation without having such a heightened stress response.

2.  Exposing oneself without engaging in compulsions, and then finding out that what we were afraid of does not actually happen, helps our brains understand that we do not need to do the compulsion to keep what we were afraid of from happening.