OBSESSIVE cOMPULSIVe diSORDER (OCD)

Common OCD themes/ subtypes:

  • health and contamination

  • harm

  • pedophile

  • relationship (ROCD)

  • existential

  • psychosis/going crazy/false memory

  • postpartum OCD

OCD is a type of anxiety disorder characterized by recurrent unwanted thoughts (obsessions) and repetitive behaviors (compulsions) aimed at reducing the anxiety of these unwanted thoughts.

These thoughts are intrusive, incredibly distressing, and latch onto our deepest fears and the things we value most. They trigger a misfire in our amygdala- the fear center of our brain- that causes us to respond to these thoughts as threats. Obsessions are ego-dystonic, which mean they go against our values and desires, however, sometimes part of the distressing nature of OCD is that the presence of these thoughts can make people question who they are, what they want, and what they are capable of OR what is safe and what is reality/ realistic.

Because of how threatening these thoughts can be, people begin to engage in compulsive behaviors to try to stop the thoughts, cancel out the thoughts, prevent the thoughts from coming true, or reassure themselves that these fears are not true. Compulsive behaviors can come in the form of: rituals, rumination, checking, reviewing, researching, reassurance- seeking, or even compulsive avoidance. The problem is, the more we engage in compulsive behaviors, the more we reinforce our fears and the idea that these thoughts are threats, rather than just intrusive thoughts- and so begins the cyclic nature of OCD.

OCD can feel like nightmare. People with OCD often feel completely consumed by these thoughts and the compulsive behaviors can begin to take over their lives. People often feel fearful and ashamed to share their thoughts and as such, often do not receive the support and proper treatment they need. Sometimes people do not even realize or know that they are struggling with OCD because of the lack of information about OCD. OCD is the most misunderstood and misdiagnosed disorder- it is so important to receive care from an OCD specialist.

*your amygdala misfires & your alarms go off*

EXPOSURE & RESPONSE PREVENTION THERAPY

Exposure & Response Prevention (ERP) is considered the gold-standard treatment for OCD. In ERP therapy, we catalogue your intrusive thoughts and compulsions and then work to specifically target the anxiety and fear associated with your intrusive thoughts while practicing non-engagement with compulsions. In this way, we work to disrupt the cycle of OCD, rewire the misfiring of the amygdala in our brain, and restore a sense of safety and self-trust. In ERP therapy, we do not aim to get rid of our thoughts or fears, but rather to learn that our thoughts do not inherently mean anything threatening, and we are capable of facing our fears.

ERP works in two main ways:

  1. Habituation- our brains become less responsive to stimuli (intrusive thoughts) over time through repeated exposure

  2. Non-engagement & Distress tolerance- we learn we are capable of feeling fear, uncertainty, disgust, and/or out of control instead of trying to get rid of these feelings

Other types of therapies might also be helpful in conjuction with ERP but ERP-informed therapy is imperative for OCD treatment because traditional talk therapy methods can sometimes make OCD worse. This is because in traditional talk therapy, we often analyze our thoughts, values, and desires, try to understand the origins of our thoughts and feelings, and make meaning of our experiences- all of which can only reinforce OCD symptoms.

How do I know I am struggling with OCD?

If you are struggling with thoughts that feel scary or distressing to you or feel like you are almost constantly worrying/ruminating about something, please reach out. A trained OCD specialist will easily be able to spot and diagnose OCD. Please know it is normal to feel embarassed, ashamed, confused, or scared about sharing these thoughts.