Obsessive-Compulsive Disorder

OCD

OCD is a tormenting disorder of the brain in which the mind becomes the enemy. It is characterized by obsessive thoughts or fears that cause anxiety which can only be appeased by the performance of specific behaviors, either external (actions) or internal (thoughts, prayers, counting); these behaviors are called compulsions.

While perhaps the best-known obsession is fear of contamination, with its accompanying compulsion of hand-washing, there are many varieties of obsessions, and their strangeness can be a source of embarrassment and shame to the sufferer. People with Harm OCD worry they might harm people they love, or themselves; often their obsessions are accompanied by intrusive troubling, violent and troubling images. Clients with this obsession may attempt to avoid anything they fear might trigger the behavior, such as refusing to touch knives, be around little children, or even spend time with the person they fear harming.

Until fairly recently OCD was little understood and clients with Harm OCD were sometimes assumed by therapists to be suppressing real aggressive desires. In fact studies show that people with OCD are actually less likely than others to hurt people, and if anything tend to be sensitive, empathetic and creative people. The truth is that OCD is a tricky, persistent tormenter which often latches onto what is most important to the sufferer, from her love for her family to her sense of responsibility. The lie OCD tells is that if the person only complies with its demands, thus performing the compulsions, the sufferer will find relief and the terrible obsessions will disappear. While there may be a brief cessation of anxiety in the short term, this only reinforces the behavior, and in the long run the disorder worsens. As the demands of the disorder increase sufferers’ worlds become smaller and smaller: they may require three hours to leave the house because they have to perform so many decontamination rituals, give up jobs they loved for fear of contaminating the workplace, avoid their children for fear of harming them, and fail to develop into functioning adults because dealing with the OCD leaves little time for anything else.

Fortunately there have been great strides made in the treatment of Obsessive Compulsive Disorder.

The gold standard of treatment is Exposure and Response Prevention, in which clients take the (very scary) step of exposing themselves to situations that trigger the obsessions, then refuse to perform their usual rituals. ERP is based on research showing that with repeated exposures the anxiety diminishes in both intensity and duration. The brain, which has been so effectively trained by OCD to perform the compulsions or else, learns that actually nothing at all happens if this seemingly inviolable rule is broken.

I am proud to be a member of the International Obsessive Compulsive Disorder Foundation and to have been trained by the Behavioral Therapy Training Institute in Exposure and Response Prevention, as well as other evidence-based techniques for working with OCD. I recently completed a Master’s Clinician training in the latest discoveries and practices, and look forward to continuing my training. I find working with clients suffering with this disorder to be a moving and rewarding experience: they are suffering so much when they begin therapy, but there is such hope for their improvement.

If this page describes you, please dare to take the first step to defy the OCD monster. Together we will work to create a hierarchy of your fears, and based on these we will come up with appropriate exposures for you to practice in home and sometimes in the office. Therapy will help you endure the anxiety that arises with the exposures, and we will develop motivational scripts to give you support during the hard times. While anxiety is uncomfortable, it is not deadly, and it fades with time; and I promise you it is worth enduring for the long-term goal of you being the one in charge of your life, not OCD.

For a wealth of information and support, take a look at the IOCDF’s website, http://www.iocdf.org.