OCD

OCD is a commonly misunderstood challenge many individuals face. It is frequently misused in conversation to describe someone that is clean, particular and perhaps rigid in their organizational skills. However, this can’t be further from the truth as those with true OCD experience a vastly different challenge on a daily basis. You may have OCD if you experience:

  • Obsessive Thoughts that are Intrusive, Unwanted and Distressing Causing Intense Anxiety

  • Recurrent Thoughts that are Resistant to Any Efforts to Ignore or Suppress Them

  • Neutralizing Behaviors or Compulsions (frequent checking, counting, praying, hand washing, etc.)

  • Compulsive Behaviors Take up >1 Hour of Your Time Daily

  • Obsessional Thoughts Related to Perceived Flaw in Physical Appearance, Having a Medical Illness, Tics, Hair Pulling and/or Skin Picking

  • SSRI Treatment for Anxiety with Little to No Relief of Your Symptoms

Obsessive Compulsive Disorder (OCD) vs Obsessive Compulsive Personality Disorder (OCPD)

OCPD is a personality disorder categorized under Cluster C (anxious and fearful personality disorders). It involves a longstanding pattern of perfectionism, rigidity and a strong need for control. Unlike OCD, OCPD does not involve true obsessions or compulsions. Instead, individuals with OCPD tend to be preoccupied with rules, order, lists, productivity, and high standards. These traits are typically ego-syntonic, meaning the person views their behaviors and standards as appropriate, necessary or even virtuous. They may struggle with delegating tasks unless others do things exactly “their way,” devote excessive time to work at the expense of relationships and experience interpersonal conflict due to inflexibility. Because the traits are often aligned with the individual’s identity, they may not seek treatment unless relationship or occupational problems arise. True OCD is driven by anxiety and unwanted intrusive thoughts that a person wants relief from.

The Science Part…

It is still unclear of the exact mechanism of OCD but it is theorized that those with OCD have a hyperactive anterior cingulate cortex (ACC). The ACC is a part of the brain that produces error signals in response to situations or in other words shouts “THIS IS WRONG”, depending on the situation. An example would be eating with dirty hands or the idea of eating something like rocks on the ground. Our ACC shouts “THIS IS WRONG” and prevents us from doing it. However, those with a hyperactive ACC, tend to be more sensitive to the error signaling and puts them at a higher risk of developing obsessive compulsive disorders.

The themes of OCD can vary and are often grouped into smaller subtypes. Some subtypes of OCD include:

  • Contamination

  • Existential

  • Harm

  • Relational

  • Perfectionism

  • Religious

The Treatment Part…

OCD is a chronic mental health illness and treatment begins with education about the disorder. There is no “cure” for OCD, but rather techniques and modalities to lessen the intensity and frequency of the obsessions and reduce compulsive behaviors. Everyone is different as OCD presents very differently for each individual, but 1st line treatment is generally ERP (Exposure Response Prevention) with medication use depending on the severity of the symptoms. Under my close direction and with your consent we will discuss and proceed with the following:

  • Exposure Response Prevention (Gold Standard of Treatment for OCD)

    • Exposing oneself to the situations which trigger obsessions and are taught strategies to prevent compulsive responses.

    • With practice, clients become desensitized to their feared stimulus leading to an improvement in their OCD symptoms.

  • Initiation of Medications

    • OCD requires higher doses of medications than used for depression and anxiety. This is why treatment for only anxiety generally doesn’t help with OCD symptom reduction.