How to treat Obsessive Compulsive Disorder

The Hague Psychologist / Diagnosis  / How to treat Obsessive Compulsive Disorder

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What is Obsessive Compulsive Disorder? Obsessive Compulsive Disorder (OCD) is a mental illness that affects approximately 2% – 3% of the population. It is equally common in males and females and can occur in childhood, adolescence or early adulthood. Over the course of one’s lifetime, a person may have several episodes of OCD. OCD is characterized by the existence of obsessions and/or compulsions. Individuals with OCD recognize that their obsessions or compulsions are excessive or unreasonable but are unable to control them. The symptoms cause marked distress, are time consuming, and may cause significant interference to their daily lives.

What are obsessions? Obsessions are not simply worries about real-life problems. Obsessions are recurrent and persistent thoughts, impulses, or images that are intrusive, excessive, and inappropriate to the situation. They cause anxiety or distress and often interfere with a person’s ability to concentrate on daily tasks. Individuals with obsessions often try to ignore, suppress, or neutralize the obsessions, usually with little success. Common obsessions include: contamination worries (germs, dirt, etc.), aggressive thoughts or images (harm to self and others),  sexual thoughts or images, religious thoughts or images, thoughts about symmetry and order, recurring words, sentences, songs, numbers. 

What are Compulsions? Compulsions are rigid repetitive behaviors or mental acts that are done in response to an obsession. Compulsions are aimed at preventing or reducing distress but they are either not realistically connected to the obsessions or are clearly excessive. Common compulsions include: hand washing, ordering / arranging, checking, touching, repeating / reviewing, reassurance seeking. . .

How is OCD treated? The most effective psychological treatment for OCD is a form of cognitive-behavioral therapy called Exposure and Response Prevention. Exposure & Response Prevention involves exposing patients to the obsessions that create anxiety and preventing them from engaging in their compulsions. After repeated exposure without the compulsions, the patients learn that their anxiety is irrational and that their worst fears are not realized, and subsequently their anxiety decreases. Treatment for OCD typically begins with education about the disorder and the treatment. Then the patient and the therapist build an anxiety hierarchy, in which OCD symptoms and situations are identified and ranked from least to most anxiety provoking. Cognitive therapy is used to challenge those beliefs that maintain the OCD and to help the patient prepare for beginning ERP. With the therapist’s support, and at a pace that is comfortable for the patient, ERP begins and the patient is exposed to each situation on the anxiety hierarchy until that situation no longer provokes anxiety. Homework assignments including self-monitoring of symptom frequency and intensity and at-home ERP exercises are assigned to further facilitated symptom improvement.