Obsessive-Compulsive Disorder (OCD)
Obsessive-Compulsive Disorder (OCD) is a neuropsychiatric condition characterized by persistent obsessions and compulsions, both of which contribute to significant anxiety (Singh et al., 2023). Obsessions are intrusive, unwanted, or distressing thoughts that provoke intense feelings of fear or unease (Liberman et al., 2023). To cope with this anxiety, individuals with OCD engage in compulsions/repetitive mental acts or behaviors that follow strict rules, in an attempt to neutralize or satisfy the obsessive thoughts (Singh et al., 2023). However, these compulsions ultimately reinforce the cycle, perpetuating the disorder over time.
OCD Subtypes
OCD subtypes can vary, however some of the most common ones revolve around fears of:
- Contamination: fear of germs, contamination others or contracting an illness
- Harm: Violent obsessions of violence towards self or others
- Perfectionism: repeat actions/behaviours until they feel ‘just right’
- Morality (scrupulosity): fear of acting ‘badly’ or violating one’s religion
- Existentialism: intrusive thoughts surrounding existential questions, such as the meaning
of life, our reality, personal identity, or the world
- Purely Obsessional: experiencing intrusive thoughts without the direct presentation of
compulsions (predominantly mental rituals) (Guazzini et al., 2022) (McGrath, 2023)
Exposure and Response Prevention Therapy (ERP)
ERP is a form of Cognitive Behavioural Therapy (CBT) that is used in the treatment of OCD. Treatment involves gradually exposing clients to the unwanted thoughts, images or situations that trigger a person’s anxiety (Hezel et al., 2019). Next, compulsions (responses) are prevented through distress tolerance activities. By not engaging in the compulsion, clients learn to sit with the uncomfortable feelings of anxiety and retrain their brain to no longer view situations as threatening (Hezel et al., 2019).
3 Tips for Managing Anxiety When Beginning ERP
1. Recognize and label the feeling – Reminding yourself “this is my OCD talking” can help reduce the anxiety by making the feeling a separate entity from ourselves (Penzel, 2014).
2. Practice relaxation techniques – Using coping skills such as progressive muscle relaxation or deep breathing can help to reduce feelings of anxiety when completing an exposure (Reis et al., 2024).
3. Talk to a loved one – Managing OCD on your own can feel scary! Talking to a loved one about how you are feeling can offer you extra support between therapy sessions (King & Zaboski, 2024).
4. Do NOT seek reassurance – OCD is sneaky and often tries to find reassurance from other people, places or things that will tell us everything will be okay. This only feeds the cycle! (Penzel, 2014).
The Role of a Therapist
Living with OCD can feel exhausting at times, and it is essential to have a therapist that is familiar with the disorder and its treatment. Finding a compassionate and supportive therapist ensures individuals can share their intrusive thoughts freely, without fear of judgment.
Additionally, therapists can work with clients to develop coping skills to use when engaging in exposure therapy. If you or a loved one is struggling with OCD, you are not alone. Reach out today and connect with one of our OCD-trained therapists at Vaughan Counselling and Psychotherapy.
References:
Guazzini, A., Gursesli, M. C., Serritella, E., Tani, M., & Duradoni, M. (2022). Obsessive compulsive disorder (OCD) types and social media: Are social media important and impactful for OCD people? European Journal of Investigation in Health, Psychology and Education, 12(8), 1108-1120. https://doi.org/10.3390/ejihpe12080078 Hezel, D. M., & Simpson, H. B. (2019). Exposure and response prevention for obsessive-compulsive disorder: A review and new directions. Indian Journal of Psychiatry, 61(1), S85–S92. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_516_18
King, K., Zaboski, B.A. (2024). Social support in obsessive-compulsive disorder: The relationships between social support and readiness to change. Bull Menninger Clin. 88(4):320-335. https://doi.org/10.1521/bumc.2024.88.4.320
Liberman, N., Lazarov, A., & Dar, R. (2023). Obsessive-compulsive disorder: The underlying role of diminished access to internal states. Current Directions in Psychological Science, 32(2), 118-124. https://doi.org/10.1177/09637214221128560
Penzel, F. (2014). 25 Tips for succeeding in your OCD treatment. International OCD Foundation https://iocdf.org/expert-opinions/25-tips-for-ocd-treatment/
Reis, A., Westhoff, M., Quintarelli, H., & Hofmann, S. G. (2024). Mindfulness as a therapeutic option for obsessive-compulsive disorder. Expert Review of Neurotherapeutics, 24(8), 735–741. https://doi.org/10.1080/14737175.2024.2365945 Singh, A., Anjankar, V. P., & Sapkale, B. (2023). Obsessive-compulsive disorder (OCD): A comprehensive review of diagnosis, comorbidities, and treatment approaches. Cureus, 15(11), e48960. https://doi.org/10.7759/cureus.48960