Obsessive-compulsive disorder (OCD) involves a pattern of unwanted thoughts, feelings, sensations or urges (obsessions) that lead you to do repetitive behaviors (compulsions). These obsessions and compulsions interfere with daily life and cause significant distress.
OCD is largely misunderstood due to the media’s portrayal of the disorder. Here we see OCD misrepresented as a love of cleaning and organization or a quirky personality trait. “I’m soooo OCD!” We commonly hear people saying they are “obsessed” with something (“I’m obsessed with this show”, “I’m obsessed with your shirt”, etc.). Someone suffering from OCD does not like their obsessions or compulsions. OCD is ego-dystonic, meaning the obsessions and compulsions are distressing and go against the person’s values.
The media and movies would also have you believe that OCD is all about contamination, hand washing and checking. While contamination fears do exist as do physical compulsions like hand washing, checking and repeating, compulsions can be mental as well. These are things like: mental review of the past, rumination, self-reassurance, counting and replacing “bad” thoughts with “good” thoughts. “Pure O” (Pure obsessional or Thought-based OCD) is a term that describes OCD without any noticeable physical compulsions. Other covert compulsions include reassurance seeking and avoidance.
Mental compulsions, reassurance seeking and avoidance often go undetected in regular talk therapy because it can appear the sufferer is simply “analyzing” feelings and thoughts. A therapist may unknowingly be providing reassurance on obsessive themes (“You would never do that”, “That won’t happen to you”) which only feeds into the obsessive-compulsive cycle.
In our work together, I will help you identify your obsessions and compulsions. We will do cognitive restructuring to challenge distorted thoughts. We will gradually begin ERP (Exposure and Response Prevention) to expose you to your fears and obsessions while learning to disengage with compulsions. Reducing and/or eliminating compulsions will turn down the volume and intensity of obsessions. We will focus on your values so that you can co-exist with the anxiety unwanted thoughts bring while living a full and meaningful life.
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