Counseling for Obsessive Compulsive Disorder

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Obsessive Compulsive Disorder (OCD) is a complex neuropsychiatric disorder. It is characterized by persistent, intrusive thoughts called “obsessions” and/or urges to perform certain repetitive strange seeming behaviors called “compulsions.” OCD is not simply a single, identifiable disorder. It is frequently a ‘masked’ disorder, mixed with other symptoms. One can suffer from thoughts alone, the behaviors alone, or both.

Obsessions are 

  • Recurrent and persistent thoughts, impulses, or images that are experienced, at some time during the disturbance, as intrusive and inappropriate and that cause marked anxiety or distress.
  • The thoughts, impulses, or images are not simply excessive worries about real-life problems.
  • The person attempts to ignore or suppress such thoughts, impulses, or images, or to neutralize them with some other thought or action.
  • The person recognizes that the obsessional thoughts, impulses, or images are a product of his or her own mind (not imposed from without as in thought insertion). In other words, the individual does not truly believe in the thought, but is unable to erase it from his/her mind.

Compulsions are:

  • Repetitive “motor” behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the person feels driven to perform in response to an obsession, or according to rules that must be applied rigidly. Mental compulsions are more discreet because they are invisible.
  • The behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviors or mental acts either are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive.

The Following are Some Common Types of Obsessions:

  • Aggressive (e.g. urge to stab, push someone onto railroad tracks)
  • Morbid (e.g. urge to harm oneself or others, thoughts of death, disease, tragedies)
  • Religious (e.g. Blasphemous thoughts against God, being possessed by the devil)
  • Sexual (e.g. believing one is homosexual, thoughts of having sex with animals)
  • Reviewing of conversations (e.g. trying to recall exactly what was said in a discussion)
  • Need to know (e.g. pondering over questions that intrude into the mind and are of no relevance to the present functioning of the person)
  • Somatic (e.g. being overly concerned with having an illness such as AIDS)
  • Right and wrong (e.g. a need to know when thoughts are right, and if they are wrong, the need to stop doing other activities until one gets the right thought)
  • Obsessionality with place (e.g. difficulty recognizing where one is, e.g., one may not know whether he is awake or asleep)
  • Obsessionality with light (e.g. focusing attention on luminous objects such as chandeliers, bulbs, the sun)

What Are the Most Effective Treatments for OCD?

The International OCD Foundation advises:

The most effective treatments for OCD are Cognitive Behavior Therapy (CBT) and/or medication. [1] More specifically, the most effective treatments are a type of CBT called Exposure and Response Prevention (ERP), which has the strongest evidence supporting its use in the treatment of OCD, and/or a class of medications called serotonin reuptake inhibitors, or SRIs.

Exposure and Response Prevention is typically done by a licensed mental health professional (such as a psychologist, social worker, or mental health counselor) in an outpatient setting. I have been trained by the International OCD Foundation / Behavior Therapy Training Institute in treatment for Obsessive Compulsive Disorder, including Exposure and Response Prevention.

Medications can only be prescribed by a licensed medical professionals (such as your physician or a psychiatrist), who would ideally work together with your therapist to develop a treatment plan. Click here to learn more about medications for OCD.

I look forward to discussing your specific concerns and developing an appropriate treatment plan with you.

To learn more about Obsessive Compulsive Disorder, visit the International OCD Foundation