Obsessive Compulsive Disorder (What is it, and how is it treated)

Obsessive-compulsive disorder (OCD) is a mental health condition that affects millions of people around the world. It is defined by intrusive, repetitive thoughts (obsessions) and behaviors (compulsions) that can significantly impair a person's daily life. In this blog, we will discuss how to detect OCD and what to expect from ERP therapy (Exposure Response Prevention).

OCD can manifest in many different ways, and not everyone with the disorder experiences the same symptoms. Themes can often include, but is not limited by, some of the following topics; harm, contamination, perfectionism, health, sexuality, relationships, religion and memory. However, there are several common signs and symptoms that can indicate the presence of OCD. These include:

• Intrusive, persistent, and unwanted thoughts or images that cause anxiety or distress

• Repetitive, compulsive behaviors or rituals that are performed in response to these thoughts

• Avoidance of certain situations or objects due to fear of triggering obsessions or compulsions

• Excessive worry or concern about cleanliness, orderliness, or symmetry

• Difficulty controlling one's thoughts or behaviors

Exposure and response prevention (ERP) therapy is a type of cognitive-behavioral therapy that is considered the gold standard treatment for OCD. ERP works by exposing the individual to their feared thoughts, situations, or objects, and then preventing them from engaging in compulsive behaviors or rituals. This helps to break the cycle of obsessions and compulsions and teaches the individual to increase comfort with their anxiety without resorting to compulsions.

Here's what to expect from ERP therapy:

1. Assessment: Before starting ERP therapy, a mental health provider will conduct a thorough assessment to understand the individual's symptoms and how they are impacting their life. (I often pair assessment with personal tracking for the first few weeks of therapy).

2. Treatment plan: Based on the assessment, the provider will develop a customized treatment plan that outlines specific exposures and response prevention techniques for the individual to practice.

3. Education: I spend a minimum of one session providing education around OCD to further identify compulsions and understand how OCD functions.

4. Exposure: The individual will be exposed to their feared thoughts, situations, or objects in a controlled environment. This can include imaginal exposure (e.g., visualizing a feared scenario), in vivo exposure (e.g., facing a feared situation), or a combination of both. (Exposures are mutually agreed upon, and are established in a way that allows us to complete less distressing exposures before increasing difficulty)

5. Response prevention: During exposure, the individual is prevented from engaging in compulsive behaviors or rituals. This may involve gradually reducing the time spent engaging in these behaviors, delaying them, or refraining from them altogether.

6. Practice: The individual will practice these exposures and response prevention techniques outside of therapy, gradually increasing the level of difficulty over time.

7. Maintenance: Once the individual has mastered these techniques, they will continue to practice them regularly to maintain their progress and prevent relapse.

ERP therapy can be challenging, but it is shown to be highly effective in reducing OCD symptoms and improving quality of life. It is important to work with a mental health provider who is experienced in providing this type of therapy to ensure the best possible outcome. If you are concerned for a client, yourself or a loved one, please reach out for a consultation