Could It Be OCD? Here’s What You Need to Know about Therapy for OCD

Could it be OCD?

By Angela Leonardo and Jenna Mayhew

Could It Be OCD? Here’s What You Need to Know

Obsessive-Compulsive Disorder (OCD) isn’t about being tidy or liking things a certain way. It’s a serious mental health condition that can feel exhausting and overwhelming for those living with it. Imagine being stuck in a repeating cycle of distressing thoughts and rituals that you feel you can't escape. That's the reality for many individuals with OCD. 

OCD has two core features:

1. Obsessions: Distressing, intrusive thoughts that won’t go away

2. Compulsions: Repetitive behaviors done to ease the anxiety those thoughts bring

For example, 

 “Did I leave the stove on?” (obsession)  →  Repeatedly checking the stove to feel safe (compulsion).  However the relief is temporary. The thoughts come back, and the cycle continues.

Common Forms of OCD

Here are a few common patterns:

• Contamination fears: Excessive cleaning, handwashing, or disinfecting

• Order & symmetry: Needing things “just right,” repeating actions, counting, evening things out

• Harm obsessions: Fears of accidentally hurting someone, leading to mental reviewing or avoidance

• Other themes: Religion, relationships, sexual orientation – all can become obsessive focus areas

OCD can show up in different ways across a person’s life, so the OCD may be focused on hygiene for a period of time but then shift to an harm obsession at another time. 

OCD vs. Anxiety 

OCD doesn’t exist in a vacuum—and sometimes, it can look a lot like other mental health concerns. Conditions like generalized anxiety, eating disorders, autism spectrum disorder, tic disorders, and obsessive-compulsive personality disorder (OCPD) can all share overlapping traits. But despite the similarities, each has important differences.

Sorting this out is part art, part science—and it’s one of the most important roles a therapist plays: looking past the surface to understand what’s really going on.

Take Generalized Anxiety Disorder (GAD), for example. It can be especially tricky to distinguish from OCD. Both involve repetitive thoughts (or rumination) and mental discomfort. In both, people might rehearse things in their minds, seek reassurance from others and struggle to “let go” of a thought. However some key differences are that with GAD the concerns are typically more grounded  in real-life concerns (e.g. work, finances, family health), and there’s usually no compulsive ritual involved.

Therapy for OCD: ERP

The most effective and evidence based treatment for OCD is Exposure and Response Prevention (ERP), a form of Cognitive Behavioral Therapy (CBT) endorsed by the American Psychological Association and the American Psychiatric Association.

• Exposure: Gradually facing fears with support of a therapist. The gradual approach is crucial; too much exposure too quickly can be overwhelming.

• Response Prevention: Resisting the urge to do the compulsive behavior. 

So that might be turning the stove off, walking away, and not allowing oneself to recheck it. ERP helps retrain the brain to tolerate uncertainty, which is often the root issue in OCD.

OCD can feel like a never-ending cycle—but recovery is absolutely possible. In fact, one review of 16 separate studies showed that 76% of people who complete ERP maintain their progress long-term. Mind you, like most psychological studies, latinos are overwhelmingly underrepresented in clinical studies for OCD, including those on the use of ERP. Therefore we have to be cautious about our assumptions of the effectiveness of ERP for a latino population, and make adaptions as necessary during evaluation, planning and roll out of therapy.

Nonetheless, with the right support and individualised treatment, individuals can manage their symptoms and lead fulfilling lives.

Here at Hola Therapy, we offer ERP treatment for OCD. If you’d like to learn more, please send us an email here.

References

Chad T. Wetterneck, Tannah E. Little, Kimberly L. Rinehart, Maritza E. Cervantes, Emma Hyde, Monnica Williams, Latinos with obsessive-compulsive disorder: Mental healthcare utilization and inclusion in clinical trials, Journal of Obsessive-Compulsive and Related Disorders, Volume 1, Issue 2, 2012, Pages 85-97.