This page provides a brief overview of OCD along with, my treatment approach. I am a member of the International OCD Foundation and have completed the Behavior Therapy Training Institute at Menninger Clinic in Houston, Texas.
Obsessive Compulsive Disorder (OCD) is severe anxiety defined by obsessions and compulsions or rituals, which interferes significantly with social, school, or occupational functioning.
Obsessions are unwanted, intrusive, and repetitive thoughts, images, and impulses that seem beyond control. Obsessions occur in the mind, not reality based, and creates a negative emotional response. They have a disturbing presence, making no sense, and accompanied with feelings of “just right” or that things must be completed a certain way. These thoughts can be overwhelming and time-consuming, as they seem so very real even though they make no sense. OCD thoughts can be frightening and most often, are supported by shame and an extremely heightened desire to avoid all risks.
Along with obsessions come intense feelings of urgency to act, to do something now, as if there is danger and you are not safe. While OCD is much more than anxiety, this intense feeling is anxiety - our brain’s alarm system that lets us know when we are in danger. A person who struggles with OCD has a malfunction in their brain’s alarm system - so to speak, it doesn’t work properly – as if it were stuck. You experience this internal chaos because of the way a part of your brain works.
Compulsions are always activities or behaviors and can be mental (counting) or physical (hand washing). The intense need, a driven feeling to perform the compulsive behavior is intended to reduce the anxiety, to neutralize the obsession, to make the obsession go away. Compulsions are an effort to try to calm or soothe, even temporarily. Compulsions also include avoidance of places or situations that might trigger obsessions; seeking certainty or reassurance, and an increased sense of safety.
Without treatment, OCD can be all consuming and paralyzing as it is never satisfied and always wants more. Understand this: You are not your OCD, you are not stupid, and it is not your fault.
Treatment first includes a through assessment of OCD symptoms and together we form a treatment plan. This plan will include education on OCD; how your obsessions and compulsions are connected; learning CBT techniques to weaken established patterns of thoughts and rituals, and exposure and response prevention. With exposure and response prevention (ERP) you will be carefully guided systematically to confront your fears and uncertainties. As you tolerate the anxiety of staying with your exposed fear and as you resist in engaging the ritualistic urges, your anxiety will diminish. With practice, you learn that exposure reduces the anxiety from obsessions and response prevention weakens the reliance on rituals.
Depending on the nature and severity of your OCD symptoms, treatment usually ranges from 15 – 20 sessions, occurring once or twice a week for 60 – 90 minutes. It is sometimes necessary that we go out of the office to do effective ERP.
Research continues to support Cognitive Behavioral Therapy with Exposure Response Prevention as effective treatment for OCD.
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