OCD is a miserable, often private battle. Most clients describe feeling “stuck”, “ trapped”, or like “a prisoner” in their own mind. Unwanted, intrusive thoughts or images cause significant distress and our natural reaction is to turn that off as fast as possible, so we do various mental or behavioral “gymnastics” to achieve temporary relief…until the next trigger.

I’ve specialized in treating OCD for most of my career as a therapist. I personally suffered with full-blown symptoms in both high school and early college, so when I encountered my first client with OCD after graduate school, I immediately knew what was going on. Like many clients with OCD, this client had been misdiagnosed with Generalized Anxiety Disorder (GAD), and was starting therapy over because their symptoms had worsened. That’s because traditional Cognitive Behavior Therapy (which is great for treating GAD) often becomes compulsive for someone with OCD, as it had for this client.

subtypes

While OCD has the same basic cycle and pattern for everyone, the content varies from person to person. Below are some examples of OCD subtypes:

• Checking OCD

• Contamination OCD

• Counting OCD

• Emotional Contamination OCD

• Existential OCD

• False Memory OCD

• Harm OCD

• Hit and Run OCD

• Hoarding OCD

• Illness OCD

• “Just Right” OCD

• Magical Thinking OCD

• Mental Illness OCD

• Ordering OCD

• Pedophilia OCD

• Perfectionism OCD

• Perinatal OCD / Postpartum OCD

• Purely Obsessional OCD (Pure-O)

• Real Events OCD

• Relationship OCD

• Scrupulosity (Moral) OCD

• Sensorimotor OCD

• Sexual Orientation OCD

• Suicidal Ideation OCD

• Symmetry OCD

That’s a lot I know! It’s not uncommon to identify with several subtypes. But I believe there is power in an accurate label when fighting back against OCD. If we don’t have an accurate label, it’s much easier to internalize the thought as our own, which makes it easier to overestimate the threat or overestimate the personal responsibility in the situation or trigger.

I remember how miserable it was to be plagued by intense thoughts and images that immediately made my anxiety skyrocket, only to be followed by intensely distressful compulsions to avoid or neutralize the fears. It finally got bad enough that I was late to class or work in college because I “had” to go back home to make sure the stove was off or the door was locked. I also ended up in a cardiologist’s office, convinced I was having heart problems. He was wise enough to ask me a few trick questions, and then diagnose me with OCD after a short interview. Everything began to change for me that day. What I thought and felt were threats based in reality I quickly realized were only magnified because my behavior supported the belief in those thoughts. I immediately began stopping any of the compulsions that I could and noticed that the associated intrusive thoughts all of a sudden didn’t seem so meaningful. Therapy helped me with the rest! Fifteen years later, it’s pretty rare that I experience an OCD “flare up”. The skills I learned (and now teach) still work to keep it in check, and I move on with life again. That’s why I’m so passionate about helping others achieve the same long lasting relief. I’m so glad I invested in the work when I did, because I can’t imagine suffering all this time with a treatable issue.

TREATMENT

Exposure and Response Prevention (ERP) is the gold standard treatment approach for OCD. Acceptance and Commitment Therapy (a form of CBT) and Mindfulness is also useful in treating OCD and OCD related disorders. For OCD triggers that have a trauma, or intense shame or disgust based component, EMDR and IMTT are also useful treatments.

Readiness

OCD is unfortunately a “progressive” disorder, meaning that in most cases, if left unchecked, OCD will tend to worsen and morph and grow. Folks often mistakenly believe that their OCD “went away”, only to learn later in therapy that they didn’t realize their OCD had morphed into focusing on another content area that was less distressing (or even an area they thought was helpful for them, like keeping a clean house). And when stressful circumstances reoccur in their lives, so do their full-blown symptoms. OCD never really “goes away”, but it can be well managed with the right therapy. I share this to help motivate you if you are considering treatment for OCD or OCD-like symptoms. As with anything, therapy incorporates motivation building, so you’re definitely not alone in getting “ready”!