Therapy for Obsessive Compulsive Disorder

Do you feel controlled by the uncertainty of life? Maybe you have crafted elaborate systems to make SURE about your actions or thoughts which includes a thought spiral analyzing every possible outcome and what to do about it. You probably feel exhausted at the end of each day because of the effort you put into making sure everything is just right.

Obsessive Compulsive Disorder is a widely misunderstood diagnosis that many people deal with every day. Let me take a little bit of the stigma and ~big-ness~ out of it by saying, it's just a very heightened form of anxiety AND it's extremely treatable! It's not some big bad life-ending diagnosis, it is your body figuring out systems for coping with a high level of anxiety. It may surprise you to hear that about 1 in 40 adults in the United States meet the diagnosis for OCD.

I often have people come to see me, struggling with anxiety and “over-thinking” and I treat it just like OCD. When you overthink it is usually because you are anxious about the possibilities. Overthinking is a way that you reassure yourself and lower your anxiety. This is called reassurance seeking; it may look like presenting a scenario to 5 different people to make you feel better about your decision. You are using these reassurance seeking opportunities to calm your anxiety. But the problem is, what happens when you don't have 5 people to run something by? What if you have no reassurance but the decision still has to be made? That's where these compulsions can start to really affect your life.  

What actually is OCD?

OCD is not just what we've seen traditionally displayed on shows like MTV's True Life (Remember this? Does this make me an old millennial?!?). It's not just washing hands and turning off lights. Sure, those can be a part of someone's OCD but there are actually many more “subtypes” within the OCD diagnosis that are more common. Examples of these subtypes would be unwanted aggressive impulses, hoarding/saving “just in case”, assigning meaning to the placement of objects, excessive cleaning, and a lot more.

When most people talk about their OCD they are usually talking about their COMPULSIONS, not their OBSESSIONS. Obsessions are the fears, compulsions are the things done to alleviate fear and anxiety. A quick example of this would be having an obsession that you didn't lock your door, the compulsion is to have a “ritual” that you do every time you leave your house to ensure that you did indeed lock the door. This might look like going back to check it 3 times, even if that means turning your car around if you've already left. It could look a lot of different ways depending on the person.

Another thing to be clear about is that obsessions are also referred to as INTRUSIVE THOUGHTS. What this means is that the obsession you have is intrusively placed into your brain; it's not something you are choosing to think about. This is often a key part of educating others about OCD because people think they are horrible people for the things that come into their minds intrusively.

How OCD is treated?

Now that you have a better idea of what OCD looks like...let's talk treatment! Research shows that the most effective treatment for OCD is Cognitive Behavioral Therapy (CBT) and/or medication. Within CBT, there is a specific form of therapy called Exposure and Response Prevention Therapy (Exposure Therapy). This is the ideal treatment for OCD and is what I use in my San Marcos, Tx office with my clients. Exposure therapy may have a scary name but it is very gentle yet effective.

Through exposure therapy, we will gradually expose you to the situations that trigger your OCD. The key here is gradually. We start by making a list or a hierarchy; on this list we rate from 1-100 the most feared scenarios. A 1 on this scale would be something that causes you little to no anxiety, a 100 would be something that causes you the absolute most anxiety and fear. We list out all of the different obsessions and compulsions and give them a rating. After we have completed the list then we start very slowly working through them, starting at the lowest rated scenario.

As you gain momentum you gain confidence in yourself and start to realize that the anxiety DOES pass after the initial fear that comes with OCD. You learn distress tolerance skills so that you can sit with the discomfort of doing something you fear until the fear lowers. Let me give you an example:

Say you have a fear of germs. We will set up an exposure in which you touch something “contaminated” and then prevent yourself from washing your hands for at least 10 minutes. During those 10 minutes you will feel uncomfortable but you will use the distress tolerance skills you learn in therapy. You tell yourself, “This feeling is uncomfortable but it will pass; I can handle it.” You breathe deeply. You distract yourself. These are all coping skills for anxiety.

What Now?

Ok, I hope this helps you understand OCD a little better and to have hope that there is relief out there! I offer treatment for OCD in San Marcos, Tx and truly enjoy this work. My clients are amazed at their abilities to overcome once they are equipped with the right tools. If you are curious to know more about this please don't hesitate to reach out to me! In addition, if you are ready to experience relief, start therapy for OCD today with a free consultation in my office by filling out my contact form. You CAN beat this!