Obsessive Compulsive Disorder (OCD) is a form of anxiety, which are often rooted in a fear of contamination, overwhelming feelings of self-doubt about something like a person’s sexual orientation, excessive worrying about having done something wrong, amongst other things. This can be incredibly debilitating and feel as though it’s taking over your life. You can, however, learn to better understand and manage your symptoms to enable you to live a life in line with your values and goals.
WHAT IS OBSESSIVE COMPULSIVE DISORDER?
OCD is more common than people realise, with 1 in 50 people suffering from this at some point in life (that works out to be roughly over 1 million people in the UK alone). It is characterised by obsessions and compulsions. Obsessions may be better understood or described as unwanted, intrusive thoughts that pop into our mind and activate feelings of anxiety and panic. Compulsions are better described as repetitive behaviours that people use in response to their obsessions, to make them go away or to obtain a feeling of “just right”. Some people report not having compulsions, maybe even describing themselves as “Pure O”. These look different for every person but may involve washing, ordering, checking, counting, etc. They can take up a lot of time in a day, with the amount of time getting bigger, and can have a big impact on your ability to carry out day to day tasks. We have seen people avoiding parks, gyms, public transport and even human contact as a result of these difficulties.
Just like anxiety disorders, there are multiple forms of OCD, where the obsessions and compulsions relate to a specific theme. Examples include:
1. Contamination OCD
2. Harm OCD
3. Relationship OCD
4. Just Right OCD
5. Sexual Orientation OCD
Signs of OCD
In our experience, people suffering with OCD tend to be very aware of their experiences and do a lot of research into their symptoms before seeking help. It is however important to remember that a lot of information on the internet is not accurate and so it is very important to avoid sites that are not created or monitored by healthcare professionals.
That being said, common symptoms reported by our clients include:
1. Doubting: For example: doubting if you have locked the door, doubting the certainty of your own thoughts and finding it hard to tolerate the uncertainty of this, this may result in checking, i.e. checking the door is locked, trying to recall thoughts/memories to check your understanding.
2. Unwanted intrusive thoughts, or images, popping into your mind despite the fact you do not want or find them to be in line with who you are as a person.
3. Wanting things to be in a specific order or symmetrical, perhaps finding yourself rearranging things a number of times until it feels “just right”.
4. Handwashing and cleaning to an excessive degree, this could be washing your hands, showering or cleaning your house.
5. Feeling intense anxiety or distress when experiencing obsessions, even more so if you don’t or are unable to complete your compulsions.
TREATMENT
There are a number of treatment options for OCD, including:
1. Cognitive Behavioural Therapy (CBT). This is considered the gold standard treatment for Obsessive Compulsive Disorder as per NICE guidelines. CBT for OCD focuses on helping you to identify and challenging negative thoughts and beliefs associated with your obsessions, and learning new coping strategies to manage anxiety and reduce compulsive behaviours that can serve to maintain the problem.
2. Exposure and Response Prevention (ERP): ERP is a specific type of CBT that involves gradually exposing individuals to anxiety provoking situations/places/people/thoughts whilst actively preventing you from engaging with the compulsive behaviours. This is a “small steps over time” approach and helps you learn that your feared outcomes are unlikely to occur, leading to a reduction in anxiety and compulsive behaviours.
3. Medication: Selective serotonin reuptake inhibitors (SSRIs) are commonly also prescribed to help reduce symptoms. These can be helpful in reducing the overall intensity of obsessions and compulsions, often used side by side with therapy to achieve positive results.
4. EMDR therapy: EMDR can also be used with OCD in cases where other methods have not achieved the desired outcome/result. To learn more about EMDR, check out the ‘What is EMDR?’ page.
HOW TO OVERCOME OCD WITH CBT
As mentioned above, CBT has been proven to be highly effective in treating OCD, with the evidence base highlighting a marked reduction in symptoms and improvement in ability to function on a day-to-day basis. CBT adopts a formulation focused approach that targets your individual symptoms and acts as the foundation for breaking the current unhelpful cycle and developing more adaptive, healthier strategies for managing difficult thoughts and emotions.
We recognise that there is a lot of jargon and psychological concepts described so lets break it down. CBT firstly identifies a specific goal to work towards and uses the below steps:
1. Psychoeducation: Effectively learning more about OCD, signs and symptoms and what treatment involves. The more we understand a problem, the more distance we can develop between it and ourselves.
2. Formulation: Think of this as a map or blueprint for the problem. A formulation combines cognitive and behavioural theory and your individual experiences of OCD. A formulation is completed in collaboration between a therapist and client, and maps out triggers and maintenance factors for the problem.
3. CBT Techniques and Strategies: Of which there are many! Your therapist will identify the most helpful for your presenting problem and support you to learn and apply these both in and out of session. These are designed to manage obsessions and compulsions.
4. Relapse Prevention Planning: A lot of clients can find the idea of ending therapy tough, and yet this is something we have to do. This phase of therapy helps you continue to work towards your goal, maintain your progress and develop a strategy for potential obstacles you may face following ending therapy.
LEARN MORE
If you would like to learn more, please get in touch and arrange an initial consultation to discuss your view of the reason for seeking therapy and we can decide together on what steps to take next.
You can reach us via email (matthew@meettocope.co.uk AND kirsty@meettocope.co.uk), telephone (0161 524 1703) or using our contact us page on our website (www.meettocope.co.uk).
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