OCD/CBT

Obsessive Compulsive Disorder (OCD) is one of the anxiety disorders. It affects children and adults, men and women. OCD is unique in that persons who suffer from it feel compelled to perform ritualistic behaviors as a means of neutralizing their anxiety about specific situations, objects, or persons. People with OCD perform these behaviors even though they are aware that they (the behaviors) may be ridiculous, make no sense, and may cause social embarrassment.

Common obsessions involve contamination issues, the need for symmetry, checking, religiosity, magical numbers, and sexual obsessions. Hair pulling (trichotillomania), skin-picking disorder, hoarding, and body dysmorphic disorder (BDD) are other associated anxiety disorders.

Treatment for OCD involves a special type of psychotherapy called Cognitive Behavioral Therapy (CBT). This form of therapy stresses the relationship between faulty thinking, mood, and behavior. Successful treatment depends upon the nature of the relationship between therapist and patient, adherence to the principles of CBT including firm, but collaborative, therapist directives, and compliance on the part of the patient in completing "homework" assignments. Intensive, weekly, therapy is usually necessary for remission. CBT may be done successfully with children as young as five years old.

Persons with OCD may live happy and productive lives if they are learn the tools to keep their anxiety and rituals under control. Hard work is necessary, as is vigilance and mindfulness as to the degree of their current impairment.

ERP

Exposure-Response Prevention, or ERP, refers to a major tool used by CBT therapists. ERP is used after the therapist has aided the patient in successfully restructuring any faulty thoughts (enough to reduce anxiety about a particular situation). This technique involves exposing the patient to the very thing that causes him/her anxiety, and preventing the "OCD response" to neutralize this anxiety. ERP is highly effective in attenuating OCD ritualistic behaviors. However, it must be used correctly and carefully, with the assistance of a trained CBT therapist. As I tell my patients, "You must be willing to practice being anxious for your anxiety to go away".

Medication

Medication may be helpful as an adjunct to CBT therapy for OCD. However, research has shown that CBT, if done correctly, is just as effective (if not more so) than medication. Medication may be required in the early phases of CBT to help a person with OCD assimilate therapy if their anxiety is preventing them from making adequate progress.

As is the case with all behavioral disorders, it is crucial that screening be done for other co-existing conditions that commonly exist.

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