Fifteen Years of Helping People with OCD

Obsessive-Compulsive Disorder (OCD) is a challenging condition characterized by distressing, intrusive thoughts and/or repetitive, compulsive physical or mental actions. Helping people with this condition has been extremely rewarding. Here are some of the things I’ve learned over the past 15 years.

• People with OCD have a hard time finding effective, OCD-specific treatment. A supportive counselling relationship and general relaxation strategies can be beneficial but are unlikely to improve OCD symptoms.
• Proper diagnosis is important. A professional with OCD-specific training and experience should be able to differentiate among OCD obsessions, “what if…” worrying of Generalized Anxiety Disorder (GAD), failure and loss themed rumination in depression, and the perfectionism and rigidity of Obsessive-Compulsive Personality Disorder.
• Though we now talk more freely about OCD, which is positive, people sometimes trivialize and over-use the term. This can minimize the profoundly unfortunate impact of OCD.
• OCD symptoms can interfere with intimacy, closeness, and being fully present in relationships, and can create conflict when loved ones are exhausted by the cycle of reassurance-seeking and being expected to accommodate to the OCD. As well, the “doubting disease” can even target relationships. For many reasons, it can be beneficial to have loved ones be a part of therapy.
• OCD remains a shameful, isolating, and secretive condition for many. People with OCD expect that others won’t understand and, unfortunately, others may, in fact, find it strange or over-react. Most experience great relief in sharing details about it in therapy.
• Patience and motivation is key. After all, what ultimately helps people with OCD – learning to tolerate anxiety or the “not quite right” feeling without neutralizing it - runs counter to their instincts and what they have been doing for a long time and may trigger a sense of loss of control.
• The focus of OCD is slippery and tends to move around over time. The specific content of obsessive thoughts is less important than developing a different response to one’s thoughts and feelings.
• Therapy often involves coming to terms with the idea that OCD can’t be eliminated but can be well managed.
• Anger (at the condition) and humour can be helpful resources in treating OCD.
• Individuals with OCD are often kind, thoughtful, responsible (often overly so), and imaginative. Therapy can help a person reclaim these strengths.

Want to know more?

Learn about Dr. Jeffrey Schwartz's four steps for OCD relief.