OCD is a potentially debilitating condition that can severely interfere with your ability to live your life and can have serious implications for your quality of life.  It can be particularly distressing for people because sufferers know that their fears and behaviours are not making sense in the current circumstances.  Features of OCD are generally worse during times of heightened life stress or crisis.

OCD is characterized by obsessions (unwanted, repeated, intrusive thoughts) and compulsions (repeated acts or rituals), which the sufferer uses as an attempt to lower the anxiety surrounding their obsessions.  This works in the short-term but over the long-term has the unfortunate result of entrenching and escalating obsessional thoughts, and the anxiety that results from them.

Common obsessions include germs/hygiene, safety/security and blasphemous thoughts usually centring around sex, violence or religious themes.  Blasphemous thoughts are typically very upsetting as they are not in harmony with the sufferer’s wishes or intent.

“These kinds of obsessions are particularly unwanted and people with them would never want to act on them. Having them DOES NOT mean you are crazy, dangerous, or evil deep down inside!”—Anxiety Canada.

Common compulsions include hand washing, checking, counting, ordering, cleaning, hoarding, repeatedly “confessing,” ritualized praying and the need for excessive reassurance, especially among children.

Typically sufferers experience both obsessions and compulsions, although less commonly, a person may experience “OCD with primary obsessions,” also known more commonly as “Pure O.” In other words, disturbing obsessions dominate with minimal corresponding compulsions.  This does not mean that the individual’s suffering is less.  It is just different.

Help for OCD

Cognitive Behavioural Therapy (CBT) is often a treatment of choice for OCD. In a nutshell, treatment consists of:

• Challenging the obsessional thoughts causing acute distress and anxiety. Here, the therapist may help you explore the underlying beliefs/fears, gather evidence to test whether your beliefs are reasonable, provide information about the obsessions and OCD in general, and identify “thinking traps” or cognitive distortions.
• Graduated Exposure/Response Prevention – Gradually facing the situations that trigger your obsessions and then refraining from acting out the compulsions.  Healthy relaxation and self-soothing strategies are learned and used in place of the compulsions.

Mindfulness strategies, for those who are interested, can pair very well managing the distress surrounding OCD.

In more recent years, I’ve been influenced by many of the principles of Internal Family Systems therapy, which offers a validating, de-pathologizing lens for working with OCD.

I firmly believe that all treatment must be trauma-informed and neurodiversity-affirming.

While not a choice for everyone, many people also benefit from medication to help reduce or eliminate obsessional thoughts.

Participating in therapy for OCD is hard work but with your determination, it can be very effective!  It is normal to need a lot of support and understanding as you go through this journey.  A therapist experienced in OCD can effectively guide you through the process, help you understand what to expect, and provide you with encouragement to keep going. I welcome you to call or email me with your questions, or to book an appointment.