OCD

Therapy for Obsessive Compulsive Disorder (OCD)

There are a lot of misconceptions about Obsessive Compulsive Disorder (OCD), especially with the current influence of social media. Despite many people portraying OCD as just being clean or orderly, OCD is an often debilitating, life consuming disorder, which can affect all areas of a person's life, including their relationships, work, or home functioning. Obsessions and compulsions span a wide range of topics as well, encompassing many more themes than the typically portrayed fear of contamination or germs. Let's break down some definitions related to OCD.

Obsessions and Compulsions

The International OCD Foundation is a great, reliable source of information on this disorder. According to their website, "Obsessions are unwanted, intrusive thoughts, images, or urges that trigger intensely distressing feelings. Compulsions are behaviors an individual engages in to attempt to get rid of the obsessions and/or decrease distress."

Obsessions are repetitive thoughts, images, or urges that seem to appear intrusively at times, much to the person's distress. These thoughts often bring feelings of anxiety or even disgust or shame. Some examples of obsessions include fear of hurting yourself or someone else, unwanted thoughts related to sexual themes, fear of being responsible for something terrible happening, fear of making mistakes, fear of offending God, or relationship-related obsessions. Again, obsessions are not in line with the person's desires or intentions, and that is why they bring so much distress.

Compulsions function only in response to obsessions. They are performed repetitively and as needed to reduce distress or to tame the obsession-- until the thought, image, or urge comes back again. Common compulsions include cleaning, checking, doing things until it feels "just right," seeking reassurance, praying repeatedly, or ruminating. These compulsions feel like they have to be performed, and often times the person is only able to put them off a short period of time before they have to relieve the distress caused by the triggering obsession. Compulsions are time consuming, taking up a significant portion of the day and interfering with daily tasks.

Exposure and Response Prevention Therapy

Exposure and Response Prevention is a specific type of therapy seen as the gold standard for treatment of OCD. Exposure and Response Prevention (ERP or EX/RP) falls under the umbrella of Cognitive Behavioral Therapy, and requires specific training and techniques. Over the course of several sessions, a therapist works with individuals to identify and assess all the themes present for obsessions and compulsions, create a hierarchy of feared obsessions, and practice exposures to these feared topics so that new learning can take place. Throughout the period of exposures, ritual prevention plans are put in place, meaning that the individual will be encouraged not to practice their compulsions so that the OCD cycle can be broken. If this sounds like a lot, that is understandable. Mental health professionals are there every step of the way to make sure that individuals feel prepared for treatment. Often, after the first few exposures, individuals start to see the change in their relationship to their obsessions and compulsions, and this hope motivates further change and movement up the hierarchy.

One of the specializations of Gabrielle at Clara Counseling is OCD, including the use of Exposure and Response Prevention with clients in session. Gabrielle attended training for ERP through the Cognitive Behavioral Institute by the trainers from the Center for Anxiety and Behavior Therapy, and she continues to stay up to date in consultation and continuing education. If you would like to talk to her more about OCD symptoms you may be experiencing, or using ERP in sessions, feel free to contact her here.

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