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Counseling for OCD

Obsessive-Compulsive Disorder can be a debilitating condition that knows no boundaries and affects people of all ages, genders, and backgrounds.

Have you ever heard of the phrase “Oh my god… I am so OCD…” or “There goes my OCD…” when describing a person as particularly organized, cleanly, and neat?

Sayings like these downplays the struggles that the clinical condition OCD brings and is belittling to those who truly live with it. It’s a common misconception that OCD is simply being perfectionistic, neat or clean, or frequent hand washing.

What Is Obsessive-Compulsive Disorder (OCD)?

OCD can be a debilitating condition that knows no boundaries and affects people of all ages, genders, and backgrounds. OCD belongs under the categorical umbrella of anxiety disorders and is marked by excessive or unreasonable fear.

What makes OCD unique in comparison to other anxiety disorders is that it consists of two important factors that connect to anxiety: obsessions and compulsions.

Let’s break down the definition of these two terms.

What Are The Signs and Symptoms of OCD?

Obsessions are unwanted intrusive thoughts, ideas, or images that bring worry, anxiety, distress, or discomfort.

Before you start to freak out, let’s be clear: humans are thought-making machines– unwanted thoughts and worries occur as a normal part of life.

Studies show no differences in the content of bizarre, immoral, senseless thoughts people living with OCD and non-OCD have!

Compulsions are the behavior (internal: mental acts or external: physical actions) one does in response to the obsessions.

For a more wonderful and specific metaphor on how mental compulsions operate, take a look at this podcast. The main purpose of using compulsions is to escape the situation one believes to be threatening.

What Is The Difference Between Worries and Obsessions?

Worrying is a natural part of life, while uncomfortable, it does not automatically mean you have a mental health disorder. Thought-related worries tend to be more future-oriented, short-lived, and can be an indication to use problem-solving if the worry is warranted.

The real difference between worrisome thoughts and obsessions is that while everyone worries, obsessions will take their thoughts to the next level.

Obsessions feel intrusive and invasive and are very repetitive in nature. Obsessions do not have to be intrusive thoughts; they can also be experienced as unwanted feelings, sensations, images, and/or urges.

People with OCD feel like they are going out of control and need to get rid of, out-think, or fix the obsession. Let’s take a real-world example to illustrate the difference between the two:

Imagine if you have a presentation tomorrow and you find yourself thinking about it frequently, figuring out what you will say, how long you have to talk, and how many people will attend. This worry is something you can actively prepare for, and once the presentation is over; the worrying tends to decrease.

A person with OCD, on the other hand, might continually worry that this presentation needs to “feel” perfect. For instance, when prepping for the presentation, someone with OCD (specifically “just right” OCD) may feel compelled to adjust, rearrange and organize their presentation notes or what they say in a certain order until the sensation of everything feels perfect for them. (This may look like a number of certain words need to be on a slide… or the bullet points on the slide have to be in exact symmetry with one another…)

This desire for exact precision and a particular structure can be time and energy consuming to the point one may start over because the notes felt wrong or off, despite knowing that the presentation will unlikely ever be perfect to one’s liking.

However, it will likely feel like they can’t stop from trying to get themselves to finish the presentation with these “imperfections” which can lead to incompletion or even avoiding the presentation altogether.

It is also important to note that this is just one of the many possible examples that can occur with a person living with OCD, but OCD is tricky in the sense that one will not exactly experience obsessions or compulsions the same way as other people with OCD might.

To normalize, wanting to escape from a potentially distressing/threatening situation is a natural response, OCD, on the other hand, will take that natural response and tie it with intentionally performing a mental act or behavior to eliminate or lower the chance of that harm happening.

The 5 Steps Of The Obsessive-Compulsive Disorder (OCD) Cycle

Obsessions and compulsions will operate together and create the obsessive-compulsive cycle. The cycle usually involves five parts:

1. A normal unwanted, intrusive thought, sensation or situation will occur in the beginning of the cycle.

2. The most powerful part of the obsessive-compulsive cycle is how the OCD part of the brain will misread this thought/sensation as dangerous and threatening.

3. This thought/sensation tends to be experienced as an obsession, which triggers anxiety or emotional distress. The obsession is usually tied to a particular fear or worry, and this fear causes the individual to become increasingly anxious.

4. In order to get rid of the anxiety or discomfort, there will be a need to either avoid, perform an excessive action (ritualize) or behavior to attempt to undue or neutralize the danger (safety behavior). When the ritual and safety behavior becomes involuntary and repetitive becomes the compulsion.

5. There is an experience of feeling immediate relief or decrease from the anxiety, which tells one’s brain that you have prevented/escaped from the danger. The OCD part of your brain goes: See! You were able to prevent/get rid of X…because you did Y… you now have to keep doing that in order to keep the threat/discomfort from happening or becoming worse.

Take this cycle…rinse…repeat…repeat again…and again…and again…The OCD monster becomes even stronger when we add these factors into the mix:

Safety behaviors: When you attempt to neutralize or reduce the anxiety with short-term relief strategies
Avoidance: Making attempts to keep away or not do something in order to prevent perceived danger
Rituals: Engaging in habits or mental exercises that can be repetitive, or superstitious in order to alleviate distress.
You can see how this can create such a disturbance in one’s life. So what can you do about it if you realize you have been stuck in this cycle for too long?

The simple answer is to break the OCD cycle. And the great news is that breaking the cycle to OCD recovery can be done through Exposure and Response Prevention (ERP) therapy.

What Is Exposure and Response Prevention (ERP) Therapy?

Exposure and Response Prevention (ERP) therapy is a highly effective type of therapy that is based on Cognitive Behavioral Therapy (CBT) concepts.

The goal is to have the individual face distressful and uncomfortable (NOT harmful) situations, scenarios, and thoughts that relate to their obsessions (the exposure piece) and use strategies to help the individual inhibit using their go-to compulsions that keep feeding the cycle (the response prevention piece).

How Is ERP Therapy Helpful for People Struggling with OCD?

OCD will teach a person that the anxiety will never go away unless you engage in a specific (usually repetitive) action. The ultimate goal of ERP is to teach and retrain the brain that not doing what your OCD tells you to do will still result in an eventual decrease and recovery from one’s anxiety.

When you face your identified fears and recover, the OCD monster becomes smaller, and the intensity of that fear shrinks or even goes away over time. This process is a fancy term that we like to call habituation! You eventually become desensitized to unwanted thoughts, feelings, and urges, leaving room to do the things that matter to you.

OCD Styles

We Offer Results-Driven OCD Counseling in Charlotte, NC

Now, you might be asking yourself “But how do I know it’s OCD and not just me having inappropriate/taboo/shameful thoughts or simply I am just a bad person?”

Let the experts be the judge of that! If you have made it this far on this page and feel like what you read has resonated with you, then it could be time to follow up with a therapist to assess whether or not you have OCD.

If you are stuck on a fear that brings you such distress, disgust, and worry because it goes against the core of who you are, and it feels like you would never do it (e.g., immoral or harmful acts), then there is a good chance it could be OCD.

If we went through every theme of OCD that feels inappropriate, weird, or taboo, this page would never end (so here is a list of OCD subtypes for reference).

Your thoughts DOES NOT equal your core sense of self. Here at ChangeWell Psych, we have highly trained and compassionate therapists who provide a nonjudgement space to collaborate and explore these thoughts as well as help you overcome the taboo and stigma of what you are going through.

Together, we can personalize what you want to overcome, change your relationship to anxiety, and recover from the fear.

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