Obsessive-Compulsive Disorder

Video- “My OCD Story”

   My OCD Story by “Birdy” age 12   “Birdy” (her nickname) entered our Intensive Outpatient Program in April of 2014. When we met Birdy she was experiencing very severe OCD which made it difficult for her to walk, eat, go to school, and do most basic activities. Every moment of her day was filled with stomping, blinking, tapping, and other movements meant to ward off sickness. Not only was Birdy consumed by rituals, she was also fearful of hundreds of words that OCD associated with sickness.  This made it difficult to write, say or hear words such as ballerina blonde, nine, and blue.   Birdy had become trapped by her OCD and she was no longer the happy, vivacious kid she was before.  Birdy missed her old self and wanted to return to who she was before OCD. Every day that Birdy practiced ERP she got stronger and stronger. Some of her biggest early accomplishments were walking and getting in and out of the car without rituals. With each passing day she learned how to weaken her OCD by “bossing it back” and “messing up” her rituals.  What used to be an elaborate stomping ritual became a silly dance chosen by Birdy. OCD was no longer in charge!  Instead of returning to the girl she was before OCD, she transformed into a girl who was stronger and braver than we could have imagined. Birdy’s experience of overcoming OCD inspired her to become an OCD advocate. We are delighted to support this budding young film-maker share her inspiring story with others.  Here is “My OCD Story” directed and produced entirely by Birdy. Read “A Mother’s Story” by Birdy’s...

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Exposure and Response Prevention Therapy

Exposure and Response Prevention Therapy

What is Exposure and Response Prevention for OCD? If you or a family member recently received an OCD diagnosis you may have a lot of questions. Having a name for your symptoms may provide some amount of relief, but you need more answers. “I know I have OCD now, so why is it still so hard to stop my compulsions” “How can I get some real relief?” Let’s start with answering the first question—why is it so hard to stop compulsions? Well, to put it simply, your brain has learned that compulsions and avoidance work to reduce anxiety and discomfort!    It might be small and have taken some time to achieve relief, but at least it’s some relief. Logically, you might be fully aware that the compulsion is unnecessary and causing you more harm than good. However, it might be the ONLY thing that gives you any relief in the moment. There you have the battle that leaves so many with OCD feeling discouraged with themselves and trapped in compulsions they know full well they don’t need. If you are feeling trapped by Obsessive-Compulsive Disorder in this way, it is NOT because you have weak willpower or self-control. It’s just the way our brain are wired. Our brains are wired to avoid discomfort. The way it learns to avoid discomfort effectively is through something called negative reinforcement. Negative reinforcement may occur when something unpleasant is taken away. An example would be when we turn the faucet to cold when the water gets too hot; excuse ourselves from an awkward conversation; take an alternate route to work when we see construction ahead; or go inside when the weather is rough. However, in OCD, when we feel anxious the compulsion can take the feeling away. Every time we use the compulsion we are strengthening the habit and fuel the cycle. Every time you use a compulsion you add more fuel. This is why it’s so difficult to stop compulsions–they work in the short term.  But it isn’t in your long term best interest. Just like scratching an itch gives relief but aggravates the rash, compulsions relieve anxiety, but aggravate OCD. So are you doomed to be stuck in an endless loop of negative reinforcement? Absolutely not! However, beating your fears is a process of learning through addition, not subtraction. You can never fully erase fears from your brain, but each time you face a fear you have the opportunity to strengthen your brain, dampen those fears, and have them no longer control your behavior. This type of learning takes place when fearful expectations are not realized even in the face of what you fear. Let’s take the example of getting bit by a dog and developing a phobia of dogs. That association between dogs, danger, and an urge to escape may be very strong indeed. It’s likely to be an experience you’ll never forget. However, if you make a point to continue to interact with dogs and stay safe, that fear of being bitten “looses its teeth.” The benefits of facing your fears are achievable in OCD as well. The answer is in a treatment called Exposure and Response Prevention Therapy (ERP) for OCD. ERP is designed to help patients break free from the OCD trap. It consists of two components. The first is exposure to things that trigger OCD fears. This is the facing your fears element. The second part is response prevention and refers to preventing one’s self from performing compulsions. This keeps artificial relief from interrupting the process before it has a chance to start working. So...

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20/20 Episode on Childhood OCD

Watch this very important episode on treatment for childhood OCD. 20/20 Episode on Exposure and Response Prevention

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Client Story: OCD, teen

Client Story: OCD, teen

By “Beth” In retrospect my OCD began in childhood but the symptoms that brought me into therapy began out of the blue, years later. One day, I woke up and had the thought, “what if I molested a child?” I was horrified and shocked that I had even thought this, and immediately tried to get rid of the thought. I felt awful about it, but I literally couldn’t get the thought out of my mind. The harder I tried, the more it seemed to cement itself in my consciousness. Every day was a nightmare. I was flooded with anxiety constantly, and I couldn’t let myself relax or enjoy anything at all. I looked for ways to punish myself for having this intrusive thought; I thought I didn’t deserve happiness anymore. Eventually, it got so bad that I began having suicidal thoughts. This was the point where I realized that something was seriously wrong. I found a list online of intrusive thoughts common to people with OCD, and I was immediately flooded with relief and apprehension. If this was what I had, then it meant that I could be treated! However, I was also terrified that I didn’t have OCD, that I would go to a therapist and they would tell me that I was actually a pedophile or something. I was already suicidal, so I figured I had nothing to lose. I had also read online that the “gold-standard” for OCD treatment was called “Exposure and Response Prevention”, a type of cognitive behavioral therapy (CBT). I sought out a therapist who specialized in OCD and other spectrum disorders, because I wanted to treat both the intrusive thoughts I was having and my phobia of vomiting (emetophobia), that I’d dealt with since childhood. My only knowledge about going to therapy was from what I’d seen in the media, so I didn’t have much of an idea of what to expect. My therapist and I set goals for tackling my fears, strategized, and talked out whatever I happened to be going through. Inexplicably, the obsession that I was a child molester faded into the background as randomly as it had appeared. It was immediately replaced by the obsession that I was gay, then that was replaced by the concern that I was developing another mental illness, like bipolar disorder or schizophrenia. I realized that, this whole time I had been looking for reassurance for specific obsessions, but OCD will take any form it can to provoke anxiety. It didn’t matter what the content of the intrusive thought was, it all centered around the same core fears. Once I was officially diagnosed with OCD, the real work began. My therapist and I created fear hierarchies for my obsessions, as well as one for my phobia.  We began to complete the least anxiety-provoking items on the list and gradually worked our way up. Unfortunately, my anxiety was just too high and resilient for CBT to work on its own. I had to look for additional support to really be able to tackle this. I had been extremely reluctant to take any medication, but eventually I decided to try an SSRI. I was scared that it would change who I was as a person, or that I would have bad side effects, or that I would be dependent on it for life. Today, my only regret is that I didn’t try it sooner. My quality of life is so drastically improved that it sometimes feels like a miracle. I no longer have intrusive thoughts, and I don’t constantly worry about feeling sick. I went...

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