Therapy for OCD
“The only certainty is that nothing is certain” - Pliny the Elder
OCD is about as common as it is misunderstood.
Often deemed “the doubting disorder”, obsessive compulsive disorder can involve perpetual doubt of our senses, desires, memory, and ultimately, ourselves. Here are some things it sounds like:
“I know it’s silly, but I feel like I have to do it”
“It’s like I’m playing tug of war with my mind”
“Rationally I know it doesn’t make any sense, but…”
“I can’t stop thinking about it”
Obsessive compulsive disorder consists of two things: obsessions and compulsions. Sounds simple, right? Unfortunately, that doesn’t tend to be the case. It is suggested that it takes, on average, about 9 years (some studies suggest longer) to receive a proper diagnosis of OCD. Why? Because OCD is sheisty - there, I said it. The experience of OCD can look entirely different person to person. Because of this, while we care about the content of your thoughts, what we’ll really focus on in therapy is the process and the cycles that keep you feeling stuck.
What OCD is not:
Note: while OCD can contain some elements of the above, none of these behaviors alone constitute OCD.
What OCD can look like:
a love for organization a la The Home Edit
washing your hands a lot
an adjective “I’m so OCD about this”
being “obsessed” with something (like a new song or guacamole)
able to be “talked out of”
responsive to suggestions to “just relax” or “stop worrying” (man, I hate these)
checking to make sure something bad didn’t or won’t happen “Am I sure I locked the door?”, “Am I sure the hair straightener is unplugged?”
engaging in repetitive behaviors (to prevent something bad from happening, or until it feels “right”)
constantly Googling things such as symptoms
replaying events or memories over and over in your head “Did I say something stupid?”, “Did I offend someone?”
intrusive thoughts about a loved one dying
“what if” thoughts about doing something you don’t want to do “What if I lose control and hurt my dog/baby/self?”
seeking reassurance from others
trying to “stop” a thought
an avalanche of thoughts that you don’t want to have
a sense of responsibility to prevent bad things from happening
hyperfocusing on parts of your body
doubting your intentions and desires “Does the thought mean I want to do that?”, your relationships “How do I know they’re the one?”, doubting yourself “Am I real?”
It’s important to note that a lot of compulsions can be “mental”, meaning that they are behaviors others can’t see. This often contributes to OCD being missed, and highlights the importance of seeing a therapist or mental health professional who specializes in OCD.
Context matters, and unfortunately, Dr. Google isn’t so great at that.
My Approach
Together, we will find the most success managing OCD by using cognitive and acceptance strategies with exposure and response prevention as needed, based on your presentation of OCD. (I-CBT+ACT+ERP). While it is not necessary whatsoever to memorize these acronyms, it is important when seeking OCD treatment to find a provider who is knowledgable in OCD. Traditional talk therapy often focuses on developing insight into problems, which while incredibly helpful for most things, is not shown to be effective at treating OCD (and sometimes, can even worsen it).