OCD is tough.

It can have a horrific impact on people’s lives, taking up hours of a day in compulsions, or ripping apart their internal world with intrusive thoughts.  The public discourse about it can be even worse. I can’t count the number of patients who have described the hurt when a friend casually mentions, “I’m so OCD” for wanting something clean, while they are struggling to accomplish the basics because of the impact of their disorder.

OCD isn’t a personality trait. It isn’t a fun quirk.  It is a persistent pattern of behavioural avoidance, rooted in mappable, understandable cognitive and neurological mechanisms.  It is a self re-enforcing pattern of behaviour that, if not interrupted, can consume a life. Because of this, it is treatable. OCD treatment, specifically Exposure Response Prevention (ERP’s are the gold standard of OCD treatment) is among the most difficult psychological therapies to follow through with. When it is followed through with however, it works. 

It works by identifying compulsive behaviours and internal thoughts that fall within the OCD loops and systematically interrupting them.  This means engaging in ‘exposures’ multiple times a day - short exercises designed to interrupt the behavioural cycle that feed and maintains OCD. We build these gradually, starting easy, building confidence and skills, and progressively moving forwards until the compulsions are gone.  We layer in additional practices such as mindfulness, value based narratives, and self compassion practices - these have been proven to speed up the treatment process and lessen the distress of doing ERP’s.  When targeting intrusive and compulsive thoughts, we lean heavily on mindfulness - learning to hold the thoughts lightly, rapidly identify what is an intrusive thought and what isn’t, refocusing on the present moment, and focusing on behaviours that we actually care about. Little by little, the intensity of intrusive thoughts go from a vice grip to something gradually quieter until they are just occasional noises in the distance.  We address shame that often comes up directly - with love and care, without letting it take over.

OCD therapy is verry different than regular therapy. We don’t need to talk about childhood, we don’t need to explore everything in life (although sometimes this is helpful for understanding and acceptance).  My goal with OCD patients is to equip them with the understanding, tools, and techniques for them to be able to treat their OCD in the future if and when relapses occur - the goal is not to be in therapy for ever!

Seeing a therapist for OCD can be incredibly scary. Especially when subtypes such as morality, harm, religious, or POCD are present.  Sometimes thoughts of suicide and self harm can be incredibly vivid and intense.  With my background and ongoing work as a paramedic, experience in crisis intervention, and 150+ patients with OCD I’ve worked with - you can trust that I’ve heard it before.  Most people with OCD have tried to get better on their own first. Some succeed, most don’t.  It’s simply too confusing sometimes - the OCD patterns have too many tricks to play, and it’s hard to know up from down.  The point of therapy here is to have a guide to whom you’re accountable to. Who will follow up, over and over, encourage you when you fail to keep trying, and be removed enough from the situation to be able to clearly tell you when you’re off track.

Personally - I work with OCD patients because when they dedicate themselves to their recovery, they get better. There aren’t many other types of therapy that I can say this for.  If you’re struggling and this approach sounds like it might be a fit, reach out for a 15 min consult.