For treatment of OCD to be effective, it is necessary to fully understand the nature of its symptoms. OCD can most easily be understood as a condition in which an individual experiences recurrent obsessions and/or compulsions. Obsessions in OCD are defined as repetitive thoughts, ideas, mental images, or impulses that an individual experiences as intrusive, unwanted, and/or inappropriate. Compulsions in OCD are defined as repetitive behaviors that an individual feels compelled to perform in an effort to avoid or decrease the anxiety created by obsessions.
In OCD, obsessional symptoms are not just exaggerated fears about real-life situations, and usually are not directly connected to commonplace problems such as normal relationship, academic, or financial concerns. In fact, individuals with OCD are quite often very distressed precisely because they recognize that their unwanted thoughts are excessive, irrational and/or inappropriate. OCD compulsions may appear in various forms, including recurrent observable behaviors such as hand washing, repetitive "mental compulsions" such as praying or counting rituals, repeated reassurance seeking, and/or avoidant behaviors that have an almost phobic quality.
For individuals suffering with OCD, their obsessions and compulsions are often a source of considerable shame and embarrassment, leading them to go to great lengths to hide their symptoms. OCD obsessions and compulsions can be extremely time-consuming, often taking up many hours of a person's day. As a result, OCD frequently causes significant emotional distress, and may greatly interfere with academic and professional functioning, as well as interpersonal relationships.
Traditionally, OCD was thought to be quite rare, and was frequently misdiagnosed by psychotherapists who didn't understand the disorder. However, research over the past twenty years has resulted in an improved understanding of OCD, along with a much better idea of just how prevalent this disorder actually is. It is now estimated that OCD affects roughly 2-3% of the population. This finding suggests that over six million Americans will experience OCD in their lifetimes.
Symptoms of OCD
Obsessions seen in OCD vary widely from person to person. Some examples of common OCD obsessions are:
- exaggerated fears of contamination from contact with people or everyday items
- nagging doubts about having locked the windows or the doors to the home, car, or garage
- excessive concerns about having turned off the stove, hair dryer, coffee pot, or other household appliances
- overwhelming urges to arrange items in a particular order so that they are "just right"
- fears of accidentally or purposefully committing an act which one considers to be violent of harmful (sometimes called "Harm OCD")
- repeated thoughts of acting in a manner that one considers sexually inappropriate or incongruent with their true sexuality
- excessive fears of acting or thinking in a manner that one believe to be sinful, immoral, or sacrilegious (sometime called "Scrupulosity")
As with obsessions, the compulsions seen in OCD vary from person to person. Some examples of common OCD compulsions are:
- repeatedly washing hands or showering, or excessively using anti-bacterial cleaning products in an effort to eradicate potential contaminants
- avoiding contact with everyday objects such as sinks, toilets, doorknobs, money, or virtually anything that an individual could construe as being contaminated
- frequently checking door locks, windows, stove knobs, light switches, electrical outlets, etc.
- unnecessarily arranging the contents of one's desk, closets, cabinets, bookshelves, etc., or straightening household objects such as window blinds or rugs
- avoiding exposure to situations in which one fears the onset of unwanted thoughts, feelings, sensations or urges
- repeatedly saying prayers to ensure that one has not or will not commit an unacceptable, inappropriate, or immoral action
- continually seeking assurance from others that one has not or will not commit an act they consider to be unacceptable, inappropriate, sinful, or immoral
Pure Obsessional OCD
Some individuals with OCD may suffer from what is commonly called "pure obsessional" OCD (or "Pure O") in which they report experiencing obsessions without observable compulsions. These obsessions often manifest as intrusive, unwanted thoughts, impulses, or "mental images" of committing an act they consider to be harmful, violent, immoral, sexually inappropriate, or sacrilegious. Click here to learn more about pure obsessional OCD.
The Obsessive-Compulsive Cycle
Perhaps the most salient characteristic of OCD is the cyclical process by which the symptoms intensify. Initially, individuals with OCD perform compulsive and/or avoidant behaviors in an effort to reduce the anxiety caused by their obsessions. Unfortunately, while performing these behaviors may at first reduce the anxiety and obsessions, it actually reinforces and worsens both in the long-term. This in turn leads to an increase in compulsions, which leads to even more obsessions and more anxiety.
While the specific thoughts and behaviors of OCD may vary with each individual, this process, called the Obsessive-Compulsive Cycle, is identical. In the course of going through this cyclical process, the individual becomes emotionally "sensitized" to specific thoughts, objects, or situations. In other words, they develop a "learned response" in which they automatically become anxious in reaction to these thoughts, objects or situations. For those with OCD, this can become a near-constant cycle of obsessive thoughts and compulsive behaviors. Click here to learn more about the Obsessive-Compulsive Cycle.
OCD is a widespread disorder with extremely challenging symptoms, and for many years, it was considered to be extremely difficult to treat. Fortunately, OCD treatment has improved dramatically over the past twenty years, and it is now recognized as a very treatable condition. Advances in the field of Cognitive-Behavioral Therapy (CBT) have led to the development of a therapeutic approach that is remarkably effective in treating OCD. This treatment, called Exposure and Response Prevention (ERP), or "exposure therapy", has dramatically altered the therapeutic management of OCD. ERP is far more proactive and less time-consuming than psychoanalysis and other "talk therapies", and has consistently been found by researchers to be the most effective treatment for OCD.
Additionally, a variant of ERP, sometimes called "imaginal exposure," is frequently used in the treatment of OCD, OC Spectrum Disorders, and related anxiety disorders. Imaginal exposure involves using short stories based on the client's obsessions. These stories are audiotaped and then used as ERP tools, allowing the client to experience exposure to their fearful thoughts. This form of exposure therapy is particularly beneficial for obsessions that cannot be experienced through traditional ERP (e.g., killing one's spouse or molesting a child). When combined with standard ERP, and other cognitive-behavioral techniques, this type of imaginal exposure treatment can help to greatly reduce the frequency and magnitude of these intrusive obsessions, as well as the individual's sensitivity to unwanted thoughts and mental images.
One of the most effective CBT developments for the treatment of Obsessive-Compulsive Disorder (OCD) and related conditions is Mindfulness-Based Cognitive-Behavioral Therapy. The primary goal of Mindfulness-Based CBT is to learn to non-judgmentally accept uncomfortable psychological experiences. From a mindfulness perspective, much of our psychological distress is the result of trying to control and eliminate the discomfort of unwanted thoughts, feelings, sensations, and urges. In other words, our discomfort is not the problem - our attempt to control and eliminate our discomfort is the problem. For an individual with OCD or a related anxiety-based condition, the ultimate goal of mindfulness is to develop the ability to more willingly experience their uncomfortable thoughts, feelings, sensations, and urges, without responding with compulsions, avoidance behaviors, reassurance seeking, and/or mental rituals. If you would like to learn more about Cognitive Behavioral Therapy for the treatment of OCD and related anxiety-based conditions, click here.
Individual Therapy for the Treatment of OCD
The OCD Center of Los Angeles offers individual therapy for treatment for adults, children, and adolescents with OCD, with a strong emphasis on Cognitive Behavioral Therapy (CBT). We have eight therapists on staff, and our offices are open six days a week, including evening and Saturday appointments. If you would like to discuss treatment options at the OCD Center of Los Angeles, please call one of our client coordinators at (310) 824-5200 (ext. 0), or click here to email us.
Low-Fee Group Therapy for the Treatment of OCD
In addition to providing individual Cognitive Behavioral Therapy (CBT), the OCD Center of Los Angeles also offers five weekly, low-fee therapy / support groups for adults with Obsessive Compulsive Disorder (OCD) and related anxiety based conditions. Numerous research studies have shown that group CBT is extremely effective for the treatment of OCD and these related conditions. All groups at the OCD Center of Los Angeles are led by our professional staff therapists, and use the same CBT treatment protocol as our individual therapy program. Please note that all of our groups require an assessment prior to participation, and are open only to adults over the age of 18 with OCD and related anxiety based conditions. Please note that we currently have openings in our Tuesday evening and Saturday morning low fee groups for adults with OCD. If you would like more information on our weekly therapy/support groups for adults, click here.
Telephone and Online Therapy for the Treatment of OCD
The OCD Center of Los Angeles also offers webcam based online therapy and telephone therapy to clients around the world struggling with OCD and anxiety. Telephone and online therapy are cost-effective options for clients who have physical and/or psychological limitations that restrict their ability to come to our office, and for those in remote areas who cannot find specialized OCD and anxiety treatment close to their home. Telephone and internet therapy have repeatedly been found to be safe and effective in numerous research studies, and have been legal in California since 1997. If you would like to learn more about our telephone and online therapy program for Obsessive Compulsive Disorder (OCD) and related anxiety-based conditions, please click here.
Intensive Treatment for OCD
We also offer intensive OCD treatment for adults, adolescents, and children. This program is designed to meet the needs of those for whom standard outpatient OCD treatment is either unavailable or insufficient. Our intensive outpatient program is ideal for clients from other states or countries who cannot find effective treatment near to their homes, and for those whose symptoms require a more rigorous treatment protocol. To learn more about our intensive outpatient treatment for OCD, click here.
If you are experiencing any of the above OCD symptoms, and would like to discuss treatment options at the OCD Center of Los Angeles, please call one of our client coordinators at (310) 824-5200 (ext. 0), or click here to email us.