Jane had intrusive thoughts for years, but they were becoming more of a problem lately. The thoughts invaded her mind throughout the day, overwhelming her with anxiety. She never wanted to harm anyone, not even a fly, but still she had intrusive thoughts of accidentally or intentionally harming others, especially those she was closest to. Jane spent hours mentally reviewing her day to check if she may have hurt anyone without realizing. Maybe she accidentally bumped into someone, causing them to fall and hit their head? What if that was a person and not a pothole she ran over on her way to work this morning? While cooking dinner with her husband, an image of stabbing him in the back with the knife she was using flashed through her mind with alarming intensity, sending her into a panic.
The thoughts made Jane question herself, and wonder if she was actually a terrible person living some kind of double life. She didn’t want to tell anyone about them for fear that they would think she was crazy, but these thoughts were starting to take over her life. She tried to reassure herself that she didn’t harm anyone, asked others for reassurance, had her husband hide all the knives, and sometimes got out of the car to see if she hit a person. She felt so frustrated with how ridiculous it seemed, but Jane didn’t know what else to do. At least doing these things gave her some relief, but it was fleeting and never extinguished the “what if” thoughts. She felt powerless to stop this cycle, and realized it was time to get help.
What is OCD?
You may have heard the term OCD used to describe a person who is very clean or particular about how they do things, however, OCD (obsessive compulsive disorder) is actually much different. A person with OCD has thoughts (obsessions) that cause intense emotions (usually anxiety or guilt). The individual then feels compelled to respond to the obsessions in a particular way (compulsion) in order to get rid of the uncomfortable emotions. There may be some feelings of relief after completing the compulsion(s), but it is temporary.
It doesn’t take long for another OCD trigger to appear and for the cycle of obsessions and compulsions to repeat. The cycle strengthens each time it repeats. In the beginning, you may feel reassured after checking twice to make sure the oven is off, but then it may take three or four times to get that same feeling of reassurance. Then five or six times of checking the oven. The cycle is not only exhausting, but time consuming, and makes everyday life difficult.
What happens with Obsessive Compulsive Disorder is that the solution to the problem (compulsions to reduce uncomfortable emotions) becomes a problem in itself. OCD acts like a “bully” in the brain that tries to manipulate you into believing and acting how it wants. Even if you know the OCD thoughts aren’t logical, those “what if” thoughts can be so scary that not giving into them seems too risky or exhausting to attempt. As the Obsessive Compulsive Disorder becomes more powerful, it takes up more of your time and energy. It may start to affect you at home, school, work, or with friends and family. This is YOUR life, not OCD’s, and it’s time to take back control!
Prevalence and Risk Factors
Obsessive Compulsive Disorder (OCD) is estimated to impact about 1 in 100 adults, and at least 1 in 200 children and teens.1 Although OCD can occur at any age, onset typically occurs by late adolescence/early adulthood. Symptoms may come and go, fluctuating over time. Unfortunately, it takes an average of 14 to 17 years from when symptoms start to the time someone receives proper treatment.2
Current research identifies multiple risk factors for OCD, including genetics (immediate family with Obsessive Compulsive Disorder), brain structure/functioning, and environment (i.e. childhood trauma).3 More research is needed to get a better understanding of these connections.
Types of Obsessive Compulsive Disorder
OCD takes many forms. Two people can have contamination OCD, but with completely different triggers and compulsions. Some examples of Obsessive Compulsive Disorder subtypes include:
- Contamination
- Harm (self or others)
- Health
- Perfectionism
- Losing control
- Unwanted sexual thoughts
- Religious (also known as scrupulosity)
- Relationship
A cruel aspect of OCD is that it usually attaches itself to your core values and the things you care about the most.
What Our Work Together Will Look Like
Our work together will begin with learning about Obsessive Compulsive Disorder and relating it to your own experiences. A lot of my clients tell me that they feel less anxious about what they are experiencing once they have an understanding of OCD and the tricks it uses. From there, I will guide you in learning new ways of responding to thoughts, accepting/tolerating uncertainty, and mindfulness strategies. These concrete skills act like your own personal toolbox for handling whatever OCD throws your way.
After developing a strong foundation of knowledge and skills, we will create another type of individualized treatment plan (also known as an exposure hierarchy) that best targets your specific symptoms and triggers. This will guide us in your Exposure and Response Prevention (ERP) journey, which consists of gradually facing some of those triggers and emotions without doing compulsions in order to reduce their power.
If reading that brings up some anxiety, you are not alone! A lot of clients feel anxious when they think about doing ERP, but then feel so empowered after their first ERP session. Together we will create exposures that are challenging but not overwhelming, and gradually work through them. You will see your progress with each step, and feel empowered. Think of a time when you stepped outside of your comfort zone and accomplished something that you didn’t think you could do. Do you remember how you felt after? If you do, that is one example of what Exposure and Response Prevention feels like: Standing up to the anxiety, not giving in, and growing stronger!
Your Search Ends Here
Exposure Response Prevention tackles OCD at its core, making it the “gold standard” treatment. Doing Cognitive Behavioral Therapy without ERP is like cutting a weed off at the top instead of pulling it out by the root. Unfortunately, it is not uncommon for clients to receive therapy that leaves them feeling disappointed, and with the same (or sometimes worse) symptoms. Some common reasons for this are: 1. The client did not know to seek ERP therapy 2. The ERP was done improperly, or 3. The client was told they would receive ERP which was missing from treatment all together.
Please, don’t let this be you. Your mental health affects everything in your life, and is arguably your most valuable asset. Getting the right treatment is not something to play guessing games with. I have been a therapist for over eight years, am a Certified Clinical Anxiety Treatment Professional (CCATP), and have a passion for helping those with Obsessive Compulsive Disorder live their best life. Attending trainings, reading articles, books, listening to podcasts, and videos are some of the ways I keep current with best practices and new research from leading experts in the field. I am constantly striving to improve the care I provide, and my clients’ treatment outcomes. It’s time to take that first step toward feeling better. Reach out to me today. I look forward to hearing from you as we start your journey together.
Reach Out Today
References
1 International OCD Foundation. (2021, August 16). Who Gets OCD? Retrieved October 13, 2022, from https://iocdf.org/about-ocd/who-gets/
2 International OCD Foundation. (2010, October). What you need to know about Obsessive Compulsive Disorder. [Booklet]. Retrieved October 13, 2022, from https://iocdf.org/wp-content/uploads/2014/10/What-You-Need-To-Know-About-OCD.pdf
3 Obsessive-Compulsive Disorder. (n.d.). National Institute of Mental Health (NIMH). Retrieved October 13, 2022, from https://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd