What is OCD?
When a person suffers from OBSESSIVE-COMPULSIVE DISORDER (OCD), they experience obsessions and compulsions. What are obsessions? Obsessions are recurrent, unwanted, and highly distressing thoughts that urge feelings or images. And what are compulsions? Compulsions are repetitive behaviors or mental acts, commonly known as rituals, that are aimed at reducing or undoing the emotional terror that is triggered by the obsessions. While rituals may provide short-term relief and respite, they will most often backfire because rituals to OCD are like fuel to fire -they keep OCD alive.
Although all forms of OCD have symptoms in common, the way these symptoms present themselves in daily life differs from person to person. OCD often fixates around one or more themes, some of these include contamination, harm, checking, and perfection. People with OCD may have more than one subtype that may change over time.
According to the INTERNATIONAL OCD FOUNDATION about 1 in 100 adults — or between 2 to 3 million adults in the United States — currently have some form of OCD.
Is it OCD or Just Anxiety?
Distinguishing between obsessive-compulsive disorder (OCD) and generalized anxiety can be challenging due to their overlapping symptoms, yet understanding the nuances is crucial for effective diagnosis and treatment. While both conditions involve excessive worry, individuals with OCD often experience intrusive and distressing thoughts that drive compulsive rituals. These rituals serve as a way to alleviate the anxiety associated with obsessive thoughts. In contrast, general anxiety tends to manifest as pervasive worry about various aspects of life without the specific compulsive behaviors seen in OCD. It's important to recognize that OCD is a distinct mental health disorder with its own diagnostic criteria. Seeking professional guidance from mental health professionals can help individuals gain clarity on their symptoms, leading to a more accurate diagnosis and tailored treatment plan.
Signs You May Be Struggling with OCD
Intrusive Thoughts: Persistent and distressing intrusive thoughts or mental images that cause anxiety.
Compulsive Behaviors: Engaging in repetitive and ritualistic behaviors as an attempt to alleviate anxiety or prevent a feared event.
Excessive Doubt: Constantly questioning one's actions or worrying about potential harm, even when there is no realistic threat.
Time-Consuming Rituals: Spending a significant amount of time on rituals or compulsive behaviors, which may interfere with daily activities and responsibilities.
Fear of Consequences: An intense fear that something terrible will happen if specific rituals or compulsions are not performed.
Impact on Daily Life: Experiencing significant distress or impairment in social, occupational, or other important areas of functioning due to obsessive thoughts and compulsive behaviors.
Exposure and Response Prevention Therapy (EXRP) for OCD
This form of therapy involves specifically targeting the source of a person’s obsessions by directly exposing them to it in the safety of the therapeutic relationship. In some cases, people find that EXRP helps to eradicate their fears in their entirety. EXRP therapy is an active form of treatment that requires client engagement when participating in exposures, client willingness to experience discomfort, and client transparency around their obsessions, and compulsions. EXRP encourages weekly participation in order to see its clinical benefits. EXRP therapy has a proven track record of helping people with OCD. About 80% of clients with OCD experience positive results, and the majority of clients experience these results within 12 to 25 sessions.
EXRP Therapy provides intentional and graduated exposure to situations that provoke obsessive thoughts and the resulting distress for the individual while helping to prevent their compulsive responses. Although discomfort is inevitable, this is done in the safety of a strong therapeutic alliance. It also provides opportunities to learn new patterns of behavior without avoidance of the feared situation or thought. This functions to increase the individual’s distress tolerance and allows for them to learn more adaptive ways to cope.
Common OCD Subtypes
OCD can take many forms and symptoms may look different person to person. An OCD specialist can help you identify which subtype of OCD you may be struggling with and create a customized treatment plan accordingly.
Harm OCD
Harm OCD causes people to be deeply disturbed by violent thoughts that most people experience. However, whilst most people are able to shrug these thoughts away, those with harm OCD may feel completely overcome by them. Harm OCD may look like self-doubting thoughts about one’s inclination towards violence. A harmful OCD obsession might look like this: “I could use this kitchen knife to hurt my partner right now.” A harmful OCD compulsion might look like complete avoidance of knives altogether.
Sexual Orientation OCD (SO-OCD)
SO-OCD involves obsessions about one’s sexuality. This may look like constant questioning about one’s sexuality and its expression. A SO-OCD obsession might look like this: “I think that man is handsome. That must mean I am gay”. An S-OCD compulsion might look like avoidance of gay men.
Pedophilia OCD (P-OCD)
P-OCD is particularly prone to stigma because of how strong people’s feelings are about the matter. However, all types of OCD obsessions do not equate to desire. Obsessions are often antithetical to one’s actual values. A P-OCD obsession might look like this: “what if I molested a child and just can’t recall it happening”. A P-OCD compulsion might look like ensuring that all people you find attractive are of age.
Relationship OCD (R-OCD)
R-OCD leaves people completely unable to tolerate the experience of uncertainty in their relationships giving them obsessions about what a “healthy” or “perfect” relationship is supposed to look like - making them either question the security of their relationship, their feelings for their partner, or their partner’s feelings for them. An R-OCD obsession might look like this: “do I actually love my wife?”. An R-OCD compulsion might look like looking through old videos to gauge whether or not they actually looked happy and in love.
“Just Right” OCD
“Just Right” OCD is a little different from the aforementioned subtypes, in that it’s difficult to identify a specific fear that may be triggering it. Instead, it’s usually more like a strong “sense” that something isn’t “right” when things are not set up in a certain way. A “just right” obsession might look like: folding laundry, and it just not feeling right. A “just right” compulsion might look like folding your clothes over and over again till it feels right.
Contamination OCD (C-OCD)
C-OCD is the most commonly stereotyped form of OCD, particularly in the media. People with this subtype are afraid of getting sick, falling ill, or infecting someone they care about after being in contact with some type of bacteria. A C-OCD obsession might look like this: “this person sneezed near me, I must have contracted something”. A C-OCD compulsion might look like: repeatedly washing your hands, and face.
Pure-O OCD
Pure O OCD is one of the harder-to-understand subtypes of OCD. The idea is that people with Pure-O have obsessions without “visible” compulsions or behaviors. The obsessions can be about sex, sexuality, religion, harm, personal health, romance, and others. A Pure O Obsession could look like: How am I even meant to know that life is worth living? A Pure O Compulsion could look like: constant pressure to find meaning in everything you do.
Scrupulosity OCD
This is characterized by obsessions and compulsions around violating religious, moral, or ethical beliefs that one tries to live by. A person’s OCD may center around fears related to going against these beliefs by sinning, cursing, benign actions, etc. A compulsion of Scrupulosity OCD might be repeated prayer whenever one feels like they have erred.
Perinatal OCD
With Perinatal OCD, you may have had OCD before getting pregnant, and noticed exacerbated symptoms during your pregnancy. For others, OCD symptoms may arise during fertility challenges, pregnancy, or the postpartum period for up to 2 years. Most people have had OCD symptoms at another time in their life; but either the severity of symptoms or diagnosis becomes apparent during this time of major transition for a new parent. Perinatal OCD may present itself as any of the aforementioned subtypes, however, it typically focuses on obsessions around the safety of the baby. Obsessions may look like intrusive thoughts about your child’s safety while they are asleep in the other room. A Compulsion may look like repeatedly waking up to check on your child through the night. If this sounds like you, check out our Maternal Wellness Page, and work with our Maternal Wellness Specialists.
Childhood-Onset OCD
Obsessive-compulsive disorder is said to be childhood-onset if obsessions and compulsions occur before a child reaches puberty. Children with OCD have less insight into their obsessions than adults do and hence do not have the capacity to understand the irrational nature of their thoughts. This, combined with limited verbal ability, can make it difficult to determine a diagnosis that is appropriate. Common obsessions may look like: disturbing thoughts about harming others, preoccupation with order, need to have things be only “one way”. Compulsions may look like: repeatedly counting things over and over again, excessive repetition of words or sounds, ordering or rearranging things frequently, frequent reassurance seeking from family. If you suspect your child has symptoms of childhood-onset OCD and want support, check out our Therapy for Teens & Therapy for Parents page to learn more about Repose’s offerings for children, parents, and families.
Is OCD Treatment in New York, New Jersey, and Connecticut What You Are Looking For?
Somatic Therapy for OCD
Somatic therapy, an integrative approach that recognizes the intricate connection between the mind and body, can be a valuable method in treating Obsessive-Compulsive Disorder (OCD). In the context of OCD, somatic therapy emphasizes the exploration and release of tension stored in the body, often arising from the anxiety and compulsive behaviors associated with the disorder.
Therapists employing somatic techniques may encourage individuals with OCD to become more attuned to bodily sensations, helping them identify and understand the physical manifestations of stress and anxiety. Through practices such as breathwork, mindfulness, and gentle movement, individuals can learn to regulate their nervous system, fostering a sense of calm and control.
Additionally, somatic therapy can assist individuals in breaking the cycle of obsessive thoughts and compulsive actions by redirecting their focus to the present moment and bodily experiences. By incorporating somatic approaches into the treatment of OCD, therapists provide clients with a holistic and personalized path towards symptom relief and improved overall well-being.
Finding an OCD Therapist Near You
Finding a therapist who specializes in Obsessive-Compulsive Disorder (OCD) is a crucial step towards effective treatment and support for individuals grappling with this mental health condition. OCD presents unique challenges that require specialized understanding and therapeutic approaches. Consider researching therapists who have a background in Cognitive Behavioral Therapy (CBT), as this approach has proven effective for many individuals with OCD. Additionally, therapists who utilize Exposure and Response Prevention therapy (EXRP) have specialized training in OCD treatment. Your OCD therapist can provide a safe and compassionate space for you to explore and manage your obsessive thoughts and compulsive behaviors, fostering a path towards improved mental well-being and a higher quality of life.
Get Support for OCD Today
Obsessive Compulsive Disorder (OCD) does not have to dictate your life. Repose therapists work with clients in New York, New Jersey, Connecticut, and abroad. We also offer virtual and in-person herapy out of our Westchester, New York office. Our therapists specialize in a variety of mental health issues, including OCD, and are trained in CBT, EXRP, EMDR, and somatic therapies — all of which can help you manage OCD symptoms.
