Have you been diagnosed with or believe that you may have Obsessive Compulsive Disorder? OCD is an anxiety disorder that consists of obsessive thoughts (distressing/intrusive thoughts that happen over and over) about a specific theme, and often more than one theme, followed by compulsions (mental or physical rituals/checking/avoidance behaviors in an attempt to decrease the level of anxiety that the obsessive thoughts create).

While OCD can be quite stressful for the person experiencing it, the good news is that there is effective treatment that can significantly reduce and in some cases eliminate the OCD cycle. Approximately 3% of the population has OCD and most cases are not accurately diagnosed for an estimated 10-17 years after the onset of symptoms!! This means that there are many, many people going through their day to day lives, suffering with untreated OCD, and often do not even know what the symptoms mean or that there is effective treatment available. OCD can be scary, embarrassing, frustrating, exhausting and feels quite isolating. Clients often say things like “I didn’t know other people had these types of thoughts/rituals like I do” or that there was a name for these weird thoughts I have, and understanding that they are not alone is a huge relief, and provides a much needed sense of hope.

There are a variety of therapies that can treat symptoms of OCD including I-CBT, Acceptance and Commitment Therapy and the gold standard treatment for OCD is Exposure and Response Prevention Therapy. SSRI medications can also reduce symptoms. I am trained in ERP and LOVE working with clients using this modality as well as incorporating other tools mentioned. Here is some information about what to expect if you are interested in ERP with me:

1. ADMINISTER Y-BOCS: First, I will assess the level of severity of your OCD and determine if you are a good candidate for ERP. I will ask you questions about your specific obsessions and compulsions, as well as the amount of time/energy you spend thinking about the obsessions and engaging in compulsions to determine the severity. I use a questionnaire called the Y-BOCS (Yale-Brown Obsessive Compulsive Scale) which typically takes one therapy session to complete.

2. REVIEW RESULTS OF Y-BOCS/DISCUSS POTENTIAL EXPOSURES: During the next session, we will review your Y-BOCS score and then determine which themes are most prevalent that we want to target. I will explain the rationale for taking part in exposure and response prevention therapy, and answer any questions you may have. We will create a “ladder” of exposures—rating things that cause low, medium and high levels of anxiety. From here, we will decide together on a starting point and will begin a time/place (ideally during session if possible!) to begin exposing you to the fears you have, while practicing response prevention (which means NOT engaging in the compulsive behaviors that keep you stuck in the OCD cycle).

3. PRACTICE EXPOSURE AND RESPONSE PREVENTION: For the next several sessions as well as between sessions, the goal will be for you to engage in exposures on purpose (thinking about or doing the scary thing) WITHOUT engaging in the compulsive behavior. The idea is that we want to start with an exposure on the lower/middle rungs of your ladder/hierarchy, something that is “difficult but tolerable” and build up from there. I will explain this in more detail during our sessions.

4. PRACTICE, PRACTICE, PRACTICE! Since OCD is sneaky and presents itself in different and ever changing ways, known sometimes as the whack-a-mole disorder (where one obsession goes away and another pops up), you have to continue to do exposures to the obsessive thoughts while resisting the compulsions. Although engaging in compulsions temporarily brings anxiety down, over the long term, it feeds the OCD cycle and keeps you stuck. There are many nuances in therapy for OCD and MANY different techniques that I provide along the way. You will continue to use ERP skills, even after therapy has ended, and once the skills are learned, you will know what to in order to lessen the severity of OCD and take back your power!

For more information on OCD and ERP, reach out. I am happy to answer any questions. Additionally, I am happy to provide ERP as an adjunct offering for people who currently have established care with another therapist/professional who is not trained in ERP but have recommended it.