OCD Treatment Tips
Hi Everyone,
Hope everything is good in your part of the world. This is a revised and updated version of a previous blog post. Even though I’ve done this type of work for over 35 years, I am still learning and as I learn I will from time to time go back and update/revise (and hopefully improve) some of my earlier posts.
Over the years I have gathered a number of tips/techniques that my clients have generally found helpful when seeking to better understand and manage their OCD. Listed below are some of what I believe to be the most useful ones:
1. Uncertainty is at the core of all types of OCD. To move forward you must accept the uncertainty and act anyway.
2. As hard as it is to believe, the contents of your obsessions are irrelevant. The issue is uncertainty.
3. Exposure and response prevention (ERP or “exposures” for short) is the best treatment for OCD. Exposures are not easy (in fact if the exposure is easy you’re probably not doing it properly), but the more you do exposures, the more you are taking back control of your life.
4. Deliberate planned exposures are generally easier to follow through with than unplanned spontaneous exposure that catch you off guard. You should seek to do deliberate planned exposure every day.
5. Don't overthink or over analyze your worries/thoughts - just do the exposures and trust the process. Sometimes the exposure assignment may feel impossible or like the worst thing in the world, but do it anyway. If your exposure feels hard, you’re probably doing it correctly.
6. The goal of exposures is not to feel better in the moment, but to challenge the OCD and accept uncertainty. Feeling better is a bonus and will come later.
7. When you first start treatment expect to feel worse because you’re confronting and challenging the OCD and this will likely result in an increase in your anxiety in the short run.
8. OCD tries to control your thoughts and everyday life activities. When you do exposures and start moving forward with your treatment, it will try to find many ways to get you to stop. It will want to confuse you and trick you. Don't let this happen. Do not question it - if it gives you intrusive thoughts, tell it "OK", if it tells you to do the compulsion say, "NO." If it tells you something bad will happen, say, "OK." Don't ever question it, accept what it tells you, live with the uncertainty and keep moving forward.
9. Don't reassure yourself to make the compulsion/thought, etc. seem ok. Just accept the thought and move on with your life.
10. When you are having a difficult time with the treatment. Remember how much OCD has stopped you from having fun, how much it has impacted your relationships with family, friends and significant others and how it has prevented you from living a normal life. The years of listening and obeying your OCD have hurt you far more than the exposures will hurt you. Manage your OCD and "Drive the bus, don't be a passenger."
11. Allow the thoughts to happen and don't take them seriously. The thoughts are just noise. Don’t get caught trying to analyze or in any way figure out what a particular thought means. Engaging your OCD thoughts is like getting caught in quicksand – the more you (struggle) think, the deeper you sink.
12. Make note of your successes. No matter if you think the success is small, it's a step towards improvement and you should reward yourself.
13. Be self-compassionate. You are human and make mistakes. No one is perfect. Just aim to do your best.
14. Remember thoughts are meaningless. They don't matter (I know I’m repeating myself, but this is such an important point it is worth mentioning several times).
15. Don't worry if you can't do an exposure. Some days will be harder than others. And if you can’t completely stop the ritual, can you modify it in some way, can you do it with just one finger rather than your whole hand, can you do it slower, can you do it backwards, etc.? Any way you can change the ritual is a win. Everyone with OCD struggles at times to do exposures. Don’t put yourself down, relax and if you can’t do it today come back and try again tomorrow.
16. Don't give up. No matter how hard the OCD treatment may feel, you can do it!
As always, let me know if I can be of any help and I’m happy to answer any questions you might have. This post isn’t meant as a substitute for therapy and so if you’re struggling with anxiety/OCD please consult a qualified therapist.
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If you’re struggling with OCD then you might want to consider attending the annual International Obsessive Compulsive Disorders annual conference this summer in Denver, CO. I’ve attended many conferences and this one is hard to beat.
Stay safe,
Dr Bob
