Obsessive-Compulsive and Related Disorders

intrusive thoughts“My thoughts are embarrassing. I feel guilty and ashamed by these thoughts that don’t make sense.”

OCD isn’t just about handwashing – but it can be.

Disturbing intrusive thoughts can take many forms – and often are related to what matters most to you. Here are a few examples:

Maybe you continually fear that you have an illness or are responsible for something terrible happening to others (kids, family members, society at large).

Or, you seem to have a lot of thoughts about doing things in a certain way, fear about saying the wrong thing, doing something embarrassing, needing to know or remember things.

Your things have to be arranged in a certain order or be symmetrical.

Certain sounds bother you.

Other thoughts that seemingly are “not normal” to others consume your time?

Things just don’t feel “right.”

These thoughts (or others specific to you) seem irrational to you – and maybe even disconcerting.

You get “preoccupied” by them and cannot focus on work, your family, or “just living.”

You don’t want to live like this.

intrusive thoughtsDo you feel like you have to do SOMETHING to make them go away?

Maybe you developed a series of activities or a ritual to feel less anxious when those thoughts come to mind. Perhaps, you are asking others for reassurance “all of the time.”

Maybe you wash your hands until they are raw, red, or bleeding, or you are spending hours rearranging your belongings.

Are you late leaving the house or going to bed because repeatedly you have to check the lock, stove, doors, and appliances?

Do you find yourself picking at your skin or pulling your hair out – quite literally?

Sometimes other people notice and tell you to stop. You want to. But you can’t. If you don’t do this thing, you feel more anxious, unable to sleep.

Or have you resolved yourself to just avoiding what triggers you?

You avoid people and places that trigger these thoughts and things you do.

Cutting things and people out of your life doesn’t feel good. You miss seeing friends, family and being social. You miss being able to go out – even to the grocery store – and not plan the day around avoiding public bathrooms or dangerous intersections.

Maybe avoidance worked for a while… But it’s not working any longer. These thoughts creep up in new ways. New triggers are always seeming to show up.

Are you concerned you might just have to live with it?

Nothing seems to work. Talking about it makes you anxious and sometimes panicked.

Even if you see these thoughts and the things you do as irrational, it feels impossible to shake this all off.

You worry the rest of your life will be consumed by these thoughts and actions. Life will never be normal. And you worry you will be alone in suffering forever.

worried manOther people just don’t get it…

You’re probably sick of people telling you to “get over it” or “just stop.”

You don’t want to be living this way – consumed by fear and worry – concerned that something is contaminated… or that something bad will happen to you or someone you love… or that you’ll get sick… or that you’ll say something you’ll regret.

My gosh, you WISH it were that simple. If it were, you would have stopped these things by now.

They seem to think that you WANT to check the locks… or perform ritualized hygiene, wash your hands, pick your skin, pull your hair, or re-write things until they are perfect.

They dismiss your “need” to say things repeatedly, ask them if everything is okay, or fear saying or doing the wrong thing as “just weird.”

They look at your struggle and write it off as some “quirk” or “just your personality.”

But it’s not. You feel ashamed, and somehow that just makes the symptoms worse.

Then, they make the jokes. “I wish I had OCD and my life would be so organized.” Maybe they compare you to TV characters with OCD, like Monica or Monk. They might say things like, “I feel so OCD today,” after doing routine chores.

But they don’t get it. They can move on with their days… with their lives. You can’t.

Obsessive-Compulsive and Related DisordersTherapy can help, but…

Research has shown that “any old talk therapy” based on gaining insight into the problem is ineffective in treating OCD or related issues.

The most effective and proven treatments for OCD are a specific type of Cognitive Behavioral Therapy (CBT) called Exposure and Response Prevention (ERP) and medication.

So, ERP can help and often in conjunction with medication. I have been trained extensively in ERP, so I have you covered there. As for medication, it may or may not be wanted or needed. We can discuss that for sure. If you decide to go the medication route to supplement therapy, I will coordinate with your prescriber if you wish.

This is what treatment actually looks like…

When we first meet, I’ll do a complete assessment of your background to help clarify your diagnosis. If OCD or a related issue is indeed the diagnosis, we will move into ERP.

With ERP, you will start to face the things that trigger your fear and anxiety. We’ll devise a plan to gradually expose you to the thoughts, images, objects, and situations while also fighting against the rituals or compulsive behaviors you use when they come up.

They will be mini-experiments to “face your fears” and be very specific to your specific thoughts or rituals, or actions. For example, it might be not washing your hands after touching that sticky thing or intentionally skipping checking the locks.

This can be challenging.

Whatever we devise will be specific to you and will make you feel more anxious while doing it. You have developed ways of avoiding the anxiety, and it is normal to want to continue to do that. So, this work will be hard.

But, we will gradually do it over time. We won’t jump into the deep end of the pool. We will start somewhere in the middle – not the baby, shallow end because that would be too easy and ironically wouldn’t help you.

The gradual approach will help you build upon success.

It will make you feel vulnerable at times.

All of these things you have done or the thoughts that consume you make you feel less anxious. At one time, they helped you feel safe. To strip them away means you may feel vulnerable as you can’t rely on them to comfort you when you feel anxious during our experiments.

It can also be scary.

It’s not always easy to give up the rituals that ease your distress, but “facing the fear” is the only way to get control over what’s been controlling you – it’s the only way to live the life you want. But don’t worry: I will be here along the way to guide and support you.

To be successful in overcoming the issues, you will have homework. Doing these experiments without me present may sound even scarier. It may be – but we will talk through that, too.

The goal is to tolerate or overcome the distress, naturally lowering your anxiety so that you don’t feel compelled to perform these onerous rituals.

You can live a life free from the control of these intrusions.

While OCD and related issues may present themselves again or be triggered by new events (even good ones like having a baby, getting married, a new job, or moving), the good news is the skills and tools learned in ERP will always be with you. You will have the ability to apply them in the future or have a “booster session” or therapy to get you back on track.

If you are ready to learn to manage your symptoms and get your life back on track, call now to schedule an initial appointment: (724) 271-8503!