WHAT IS OCD
Obsessive-Compulsive Disorder (OCD)
OCD is a mental health condition where people experience obsessions and compulsions.
- Obsessions are unwanted thoughts, images, or urges that keep coming back and feel out of control. These thoughts can cause significant distress and anxiety.
- Compulsions are behaviors that someone feels compelled to perform to reduce anxiety. These actions follow strict rules and can include things like counting, checking, or washing. Some compulsions are mental rituals, such as praying a certain way or trying to “undo” distressing thoughts.
The specific obsessions and compulsions can vary greatly from person to person but often follow common themes.
Common Obsessions Include:
- Fears of contamination
- Thoughts about harming oneself or others
- Intrusive sexual thoughts or urges
- Excessive religious or moral concerns
- Superstitions
- An obsession with things being even or exact
- The need to know things for certain
- Pathological doubt (excessive uncertainty)
Common Compulsions Include:
- Repetitive washing or cleaning
- Checking things repeatedly
- Counting
- Ordering or arranging things
- Praying in a certain way
- Seeking reassurance
- Feeling the need to confess
- Repeating activities without reason
- Avoiding situations that trigger obsessions
- Mental rituals to “undo” distressing thoughts
OCD symptoms are often very time-consuming and can interfere with daily activities. Many people with OCD realize that their obsessions and compulsions are excessive or unreasonable.
Common Misbeliefs That Fuel OCD:
Research has found that people with OCD often have six mistaken beliefs that make their symptoms worse:
- Intolerance of uncertainty: Needing 100% certainty to feel safe.
- Over-importance of thoughts: Believing that having a thought is as important as acting on it.
- Overestimation of threat: Exaggerating the chances of harm or danger.
- Inflated responsibility: Believing one has the power to prevent negative outcomes.
- Perfectionism: Thinking perfection is possible and that minor mistakes have huge consequences.
- Importance of controlling thoughts: Believing you must have complete control over your thoughts.
Treatment for OCD:
The main treatment for OCD is Exposure and Response Prevention (ERP). This therapy helps you gradually face your fears and avoid performing compulsions.
In therapy, we’ll:
- Identify your obsessions and compulsions.
- Understand how your compulsions (like rituals or avoidance) are making your OCD worse.
- Learn how your mind gets “tricked” into these behaviors.
- Design ERP tasks to help you break the OCD cycle.
- Discuss how OCD affects your life and relationships, and work together on goals that matter to you.
ERP tasks will be practiced in therapy sessions, with coaching to guide you through them. To make progress, you will need to practice outside of therapy, including in real-life situations (like at school or work).
Helpful Additional Treatments:
- Family therapy can help your loved ones support you in ways that encourage progress and address behaviors affecting your relationships.
- Compassion-focused therapy is helpful if you struggle with self-criticism or guilt.
- Medication may be helpful alongside therapy. If appropriate, a referral to a doctor for medication can be made.
Resources:
- International OCD Foundation
- Anxiety and Depression Association of America
- Association for Behavioral and Cognitive Therapies
- National Institute of Mental Health
With the right treatment, you can learn to manage OCD and lead a fulfilling life.
The following videos provide more helpful information about OCD:
What to tell teachers or caretakers.
When to tell friends about my OCD.
Talking to my siblings about OCD.
Living with OCD as a teenager.
Facts about OCD:
· The exact cause of OCD is unknown, although research shows there may be a genetic component.
· OCD impacts 1 in every 40 adults and 1 in every 100 children.
· OCD affects approximately 2% of the population every year.
· OCD usually appears in childhood, adolescence, or early adulthood.
· There is no known cure for OCD, but effective treatment is available.
· OCD affects Women and Men equally.
· On average, it takes 9 years for an OCD sufferer to get the proper diagnosis and treatment.
This is an informational website and is not intended to replace therapy or education from a mental health provider.
OCD TREATMENT
Exposure with response prevention (ERP)
Exposure with response prevention also known as ERP is the gold standard treatment for OCD. ERP is a specific form of cognitive behavioral therapy (CBT) for OCD. The basic principles surrounding ERP for OCD is to face your fear without engaging in a ritual (exposure + ritual prevention). However, we know this process can be extremely challenging and sounds much simpler than it often is. Specific steps are recommended in ERP and if possible it is best to do this type of treatment with an OCD specialist.
Important ERP steps
· Understand your OCD and OCD symptoms
· Identify a fear to work on
· Develop an OCD hierarchy for your fear
o Rank exposures for your fear on a scale from 1-10
o 1 should be at the bottom of your hierarchy which the least anxiety provoking exposures for that fear and 10 at the top with the most challenging exposures listed there
· Begin exposures with ritual prevention
o Systematically work your way up your hierarchy starting with the lower level exposures and working your way up to the high level exposures
o An exposure should be repeated multiple times without any rituals. Once an exposure no longer causes distress/anxiety you can move up to the next higher level exposure
o Continue this approach until you reach the top of your hierarchy at which point you can move onto another OCD hierarchy if you have one.
Remember repeated exposures with ritual prevention will allow you to habituate to a fear. Anytime you engage in a ritual both the fear and OCD cycle are reinforced.
FOR CAREGIVERS
I know firsthand how difficult it can be to be a caregiver of someone struggling with OCD. However, I also know how inspiring it can be to watch my child get the proper help and be able to now live a meaningful life managing her OCD. As a caregiver for someone with OCD we want to help our loved one’s the best we know how. Sometimes however we may enable versus help. It is so important for you to understand what OCD is, what CBT is and the proper ways for you to help your loved ones fight the OCD versus giving into it. Remember to take care of yourself. Having a loved one with a mental illness can be difficult so you must set aside time for yourself, otherwise it will be hard for you to be supportive if you are burnt out.
First steps for caregivers:
· Learn about OCD
· Recognize OCD Symptoms
· Find a qualified treatment provider
· Support your loved one in treatment
· Avoid participating in rituals and reassurance (*Only make this change once agreed up in therapy/when your loved one is ready)
· Communicate positively – Avoid criticism
· Create a support system – Find a support group
· Find time for yourself
· Spend time with your loved one that doesn’t revolve around OCD
SELF SCREENING TESTS
The Yale-Brown Obsessive Compulsive Scale is one of several tests available to help evaluate Obsessive-Compulsive Disorder.
Through the following links please find the YBOCS. These tests do not replace the need for assessment, diagnosis, and treatment by a qualified OCD treatment provider.
Books for Obsessive Compulsive Disorder
1. Freedom from Obsessive Compulsive Disorder (Updated Edition)
Jonathan Grayson, Ph.D.
2. Everyday Mindfulness for OCD
Jon Hershfield MFT, Shala Nicely LPC
3. The Mindfulness workbook for OCD
Jon Hershfield MFT, Tom Corboy MFT
4. The OCD Workbook
Bruce M. Hyman PhD LCSW, Cherlene Pedrick RN
Sally M. Winston PsyD, Martin N. Seif PhD, et al.
6. Rewind Replay Repeat: A Memoir of Obsessive-Compulsive Disorder
Jeff Bell
7. When in Doubt, Make Belief: An OCD-Inspired Approach to Living with Uncertainty
Jeff Bell and Michael Jenike, M.D.
8. Is Fred in the Refrigerator? Taming OCD and Reclaiming My Life
Shala Nicely, LPC
Children With OCD Books
1. Worried No More: Help and Hope for Anxious Children 2nd Edition
Aureen Pinto Wagner, Ph.D.
2. What to do when your Child Has Obsessive-Compulsive Disorder: Strategies and Solutions Aureen Pinto Wagner, Ph.D.
3. Up and Down the Worry Hill: A Children’s Book about Obsessive-Compulsive Disorder and its Treatment Aureen Pinto Wagner, Ph.D.
4. Fighting the OCD Monster: A Cognitive Behaviour Therapy Workbook for Treatment of Obsessive Compulsive Disorder in Children and Adolescents
Haanusia Prithivi Raj
Self-Help Workbooks
1. Getting Over OCD: A 10-Step Workbook for Taking Back Your Life
Jonathan S. Abramowitz PhD
2. The OCD Workbook: Your Guide to Breaking Free from Obsessive-Compulsive Disorder Third Edition Edition
3. The OCD Workbook: Your Guide to Breaking Free from Obsessive-Compulsive Disorder Bruce M. Hyman, Ph.D., LCSW and Cherlene Pedrick RN
Body Dysmorphic Disorder
- The Broken Mirror: Understanding and Treating Body Dysmorphic Disorder Katherine A. Phillips
Book for Parents of Children with Trichotillomania
- A Parent Guide to Hair Pulling Disorder: Effective Parenting Strategies for Children with Trichotillomania (Formerly “Stay Out of My Hair”)
Book for Hoarding
- Buried in Treasures: Help for Compulsive Acquiring, Saving and Hoarding
Other Good Sources for more OCD Information: