Obsessive Compulsive Disorder
Diagnosing OCD
One of the biggest misconceptions is that OCD is about needing things to be symmetrical or in a specific order. However OCD has many manifestations and more research is coming out along with a longer modified Y-BOCS to better assess how someone’s OCD might represent. In order to properly diagnose someone with OCD it’s important to know how to weed out what is and isn’t OCD as other diagnoses can look almost identical symptomatic-wise.
Unfortunately many professionals are not trained in being able to assess and diagnose for OCD. This often causes them to misdiagnose individuals not realizing that their symptoms could more closely represent a different diagnosis such as ASD or PTSD. And individuals who suspect they have OCD are unable to complete a Y-BOCS by themselves as they might view their obsessions/compulsions as normative. Therefore it’s my job to teach you how to sniff out your OCD and help teach you how to do exposures to them. I’m able to do this using ERP or Exposure and Response/Ritual Prevention. One of the first things I like to review with my clients are the definitions of each so that you have a better understanding of what OCD is.
Definitions & Examples
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Obsessions
Obsessions are unwelcome and distressing ideas, thoughts, images or impulses that repeatedly enter your mind. They may seem to occur against your will. They may be repugnant to you, you may recognize them as senseless, and they may not fit your personality or value system.
An example of an obsession is:
The recurrent thought you might be responsible for making a loved one ill because you weren’t careful enough about washing your hands.
The recurrent thought that you might have ran someone over with your car because you’re unsure if you checked your rear view mirror enough times after stopping at a stop sign.
The recurrent thought that you might go to hell because you forgot to confess a sin at church one time.
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Compulsions/Rituals
Compulsions, on the other hand, are behaviors or mental acts that you feel driven to perform although you may recognize them as senseless or excessive. At times, you may try to resist doing them but this may prove difficult. You may experience anxiety that does not diminish until the behavior or mental act is completed. Sometimes compulsions are also referred to as rituals.
An example of a compulsion is: the need to repeatedly check appliances, water faucets, and the lock on the front door before you can leave the house.
While most compulsions are observable behaviors, some are unobservable mental acts, such as silent checking or having to recite nonsense phrases to yourself each time you have a bad thought. These mental compulsions are different from obsessions, which are unwelcome and senseless ideas that enter your mind against your will.
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Avoidance & Reassurance
Avoidance of feared situations is often used in addition to or in place of compulsions in order to prevent contact with triggers to OCD. An example would be not reading or listening to the news out of concern that some stories will spark obsessions.
Seeking reassurance is another form of a compulsion that often times is over looked because it can be seen as someone looking for validation. However, seeking reassurance that you didn’t hit someone with your car by calling your friend on face-time to check for you only temporarily reduces the anxiety because it doesn’t address the true obsessive fear.
Exposure and Response/Ritual Prevention (ERP)
This treatment might sound scary however I promise you it’s not. One of the biggest aspects of this treatment is that you structure your exposures and we do them together. And I would never ask my client to do an exposure that I wouldn’t do myself. This is the gold standard for treating OCD with 60-80% effectiveness. So please know that this treatment was created to help you feel liberated from your OCD not tied down by it. If you’re curious and want to learn more about about ERP or if you think you have OCD and believe this might be a good fit, schedule a screening call or contact me to ask any questions you might have.