Naming Obsessive Compulsive Disorder (OCD)can be an enlightening moment for a client, putting some language to a verydistressing experience that can be very difficult to understand. OCD is acomplex mental health condition, but effective psychological treatments areavailable. In this post, we’ll cover what OCD is, how it can affect people, andhow OCD treatment works.
What Is OCD?
OCD is characterised by obsessions andsometimes (but not always) compulsions.
Obsessionsare repeated, unwanted thoughts, images, or urges (e.g., imagining in vividdetail harming the ones we love, worrying about getting sick, even worrying wemay have run someone over in our car on the way to work). Compulsionsare repetitive behaviours or mental acts performed to reduce the distress ofobsessions (e.g., handwashing, checking, or counting to a certain number in ourhead). Compulsions make us feel safe from the threat of obsessive thoughts,although this works only temporarily. Over time, engaging in compulsions is oneof the primary factors maintaining fearful thoughts or obsessions.
OCD often hits us where it hurts. Manyclients experience obsessions that they find so shameful that it takes a verylong time to seek help. For example, it is also a common obsession to worrythat we might be some sort of terrible deviant (e.g., a murderer orpaedophile). On the other hand, obsessions can be more subtle and hard toidentify (e.g., worrying that we made a catastrophic mistake in a work documentdespite checking multiple times).
How Does It Impact People?
OCD can affect people in different ways.Obsessions often trigger anxiety, guilt, or shame. Compulsions and avoidancebehaviours can take hours each day (e.g., excessive handwashing to avoiduncertainty about whether why may become ill). Loved ones may become frustratedwith our time-consuming checking behaviours, or excessive reassurance-seeking. Unintentionally,the same loved ones may reinforce OCD by participating in reassurance orencouraging avoidance behaviours. In some cases, OCD can severely interrupt ourability to work, go to school, maintain relationships, and live a meaningfullife. Although engaging in compulsions can make us feel temporarily better,they unfortunately strengthen obsessive thoughts. Over time, we can becomehopeless and depressed, perhaps not even knowing that the core of ourdifficulties is OCD.
It is important to note that, in somecontexts, obsessions and compulsions might be seen to be harmless or evenhelpful. Treatment is only considered when they cause a great deal of distressor interrupt our lives.
What Is ERP?
Exposure and Response Prevention (ERP) is atype of Cognitive Behavioural Therapy (CBT) and the most effective treatmentfor OCD. It focuses on:
• Exposure: Gradually facing fearsor triggers (e.g., touching a “contaminated” surface).
• Response Prevention: Resistingcompulsive behaviours (e.g., refraining from doing excessive handwashing aftertouching something).
ERP works by helping the brain “unlearn”the fear-response cycle, reducing the distress caused by obsessions and theneed for compulsions.
What Does ERP Look Like?
1. Assessment: Understanding theperson’s unique OCD symptoms and triggers.
2. Creating a Fear Hierarchy:Listing fears from least to most distressing.
3. Gradual Exposures: Starting withmanageable challenges, the client practices facing triggers without performingcompulsions.
4. Building Resilience: Over time,anxiety reduces, and the client learns to tolerate uncertainty. Clients oftennotice that, when they spend less time and energy on compulsions they are freeto engage in more of what makes their life meaningful and enjoyable.
ERP is a collaborative process where thetherapist provides guidance and support every step of the way. Concrete emotionregulation skills are taught to clients to ensure that they face these gradualchallenges in a way that feels supported.
Take the Next Step
OCD can feel overwhelming, but recovery ispossible with the right treatment. If you or someone you know is strugglingwith OCD, our experienced clinicians at Canopy can help. Contact us today tolearn more about ERP and begin your journey toward a healthier, more fulfillinglife.
Suggested Resources
1. Book – “The Joy Thief: How OCDSteals Your Happiness and How to Get it Back” by Penny Moodie.
2. Podcast – “Obsessive-compulsivedisorder and how Penny loosened its anxiety-inducing grip”, ABCConversations.
3. Self Help Guide – “Obsessionsand Compulsions Explained”, This Way Up, St Vincent’s Hospital, Sydney.
Disclaimer: This information is foreducational purposes only. Please seek professional advice for your specificsituation.
Henry Austin
Principal Clinical Psychologist
