THERAPY FOR OBSESSIVE-COMPULSIVE DISORDER (OCD) AND ANXIETY

Obsessive-compulsive disorder used to be classified as an Anxiety disorder, but more recently, OCD has been separated into its own category. However, the treatment for OCD and anxiety disorders shares many common aspects.

OCD has been named the doubting disorder.  The presentation of OCD can be variable, can change over time, and can attack the things that are most valuable to you. Common types of obsessions include fear of harming self or others, sexual obsessions (including pedophilic OCD), contamination (e.g. Covid, bodily fluids, dirt, etc.), symmetry/ordering and "just right" feelings, perfectionism, concerns with sensorimotor / automatic bodily functions (e.g breathing, heart beat, etc.), superstitious or magical thinking, and religious or scrupulosity. Pure obsessional OCD, also known as "pure O" is a type of OCD where people have disturbing intrusive thoughts, but there are no apparent behavioral compulsions. However, when we look carefully, we find a range of metal compulsions (e.g. rumination, worry, looking for evidence, reviewing, etc.) and avoidance of objects, situations, places or people. Exposure and Response Prevention (ERP), the evidence based treatment for OCD, is effective for behavioral and mental compulsions, as well as for avoidance behaviors. Other adjunctive treatments for OCD, such as mindfulness and acceptance and commitment therapy may be added as needed, but ERP remains the most active agent of change for OCD.

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Anxiety disorders, such as generalized anxiety, panic disorder, social phobia and specific phobias all share common aspects of treatment that include cognitive-behavioral therapy, mindfulness, and acceptance and commitment therapy. Some people don’t necessarily meet criteria for an anxiety disorder but may have a propensity to worry, lack the support they need to face challenges, or have difficulties problem solving under stressful circumstances, and therefore my also experience considerable anxiety and may benefit from therapy.

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There is evidence that suggests that online ERP for OCD is just as effective as in person ERP. In fact, online therapy for OCD has many advantages given that it allows us to challenge rituals at home, where they often develop.

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Besides specializing in OCD and anxiety, I am also an experienced and integrative therapist, and can help you deal with other issues that are related or contributing to these problems. Often times, after some extensive work with ERP, and once compulsions are more under control and a person regains at least some of their functioning, emotion focused therapy techniques can be very useful at addressing the core fears that underlie some OCD behaviors (e.g. trauma, unresolved grief, maladaptive guilt, fear of loss and abandonment, fear of inadequacy).

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If you believe you may have any of these issues and are interested in learning more about treatment, feel free to call me for a 15 min free consultation.