Obsessive Compulsive Disorder (OCD) Counseling
Obsessive Compulsive Disorder, or OCD, involves having unwanted thoughts, images, or urges that make a person feel anxious or distressed. These distressing mental experiences are the “Obsessions” in OCD. Those with OCD also struggle with performing ritualistic behaviors, the “Compulsions” in OCD, which are an attempt to stop obsessions. There is a lot of hope for those with OCD – there are excellent modern therapies that you can use to make this painful problem better.
Information About Obsessive Thoughts
In popular media, people with OCD are often portrayed as having a fear of germs or as being overly organized/particular. While these issues are sometimes part of the problem, there are actually an infinite number of ways that obsessive thoughts can show up. The short rule of thumb in OCD therapy is this: if you can think about it, it can become an obsession.
Here are some common examples of obsessive thoughts that people often share in therapy:
- A fear that you will harm yourself or someone else
- A fear that you will blurt out something inappropriate
- A fear that you will cause something terrible to happen
- A fear that you will get sick from germs, chemicals, or animals
- Concern that you may do something religiously blasphemous
- Fear of saying certain phrases
- Focusing on certain numbers as “good or bad”
- Experiencing unwanted images, sounds, or music in your head
- Being intensely bothered by certain noises (chewing, breathing, etc)
What To Know About Compulsive Behaviors
OCD compulsions (also known as “rituals”) are usually thought to just be extreme hand washing and turning things on/off repetitively. As with obsessions, this can be true for some people, but it only represents a fraction of the problem. Compulsions can include any action that reduces the pain associated with an obsession. Compulsions can be obvious behavioral actions, but they can also be mental acts too – such as thinking a good thought to cancel out a bad thought.
Here are some common examples of compulsions that people often share in therapy:
- Avoiding objects that could be used to harm someone
- Checking appliances and locks over and over
- Counting things in certain patterns
- Tapping or touching objects in a special way
- Cleaning one’s self or environment non-stop
- Repeating phrases to stop bad things from happening
- Monitoring that things are OK/nothing bad has happened excessively
- Re-doing the same task over and over to make sure it is “just right”
If your particular obsession or compulsion does not appear on this list, that doesn’t mean you don’t have OCD. OCD can come from many different kinds of worries and compensating strategies. Talking about your concerns with a professional is an important step to figuring out if you have OCD.
How Treatment Works
My approach to treating OCD is based on the principles of the gold standard of care: Exposure and Response Prevention (ERP). ERP has two major parts that make the therapy work. Exposure Therapy is one part, and it helps people confront and overcome their obsessions by getting them used to their uncomfortable thoughts. Response Prevention assists in reducing the number of ritualistic behaviors a person uses to cope with their obsessions. Together, these two parts combine to make a very powerful treatment for OCD.
What Healing Looks Like
As you work on your OCD in session and through structured homework, you will begin to notice that your distressing thoughts are experienced less often. Even if you do have an obsessive thought, you will be well prepared to deal with it and it won’t bother you as much.
You will also find that you have more time in your day-to-day life because you will be compulsively ritualizing less often. If you used to spend an hour or two a day doing OCD stuff, well, that time is just yours again! You can use it anyway you want: to work, spend time with friends, relax, get some chores done – whatever you want.
Life will feel more free and you will find yourself worrying less, enjoying more, and feeling a lot happier. Uncomfortable thoughts will be experienced as passing inconveniences rather than demands that have to be dealt with no matter what. Once you find yourself watching your thoughts and being OK with whatever comes to mind, you will know you made it!