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Obsessive Compulsive Disorder

People with OCD experience repeated, unwelcome ideas, thoughts, images or impulses which cause them distress. In response to these thoughts (ie. obsessions), a person with OCD will feel compelled to subsequently perform a behavior or mental act (ie. compulsion) in an attempt to neutralize the thought or prevent a feared consequence of the thought from occurring. Often, the person will realize that the compulsions (also referred to as “rituals”) are senseless or excessive, yet they find it difficult to resist performing them. While compulsions may provide temporary relief from anxiety, they are time-consuming, interfere with a person’s functioning, and ultimately maintain the fear associated with the obsessive thoughts.


The content of obsessions varies greatly from person to person. Some common themes in OCD include fear of contamination, fear of harming oneself or others, taboo sexual thoughts, religious or moral concerns, the need for things to be “just right”, perfectionism and magical thinking. Common compulsions include checking, repeating tasks, re-reading, re-writing, avoidance, and reassurance seeking.


At its core, obsessive-compulsive disorder (OCD) is an intolerance of uncertainty. Everyone experiences unwanted thoughts from time to time; most people are able to dismiss these thoughts as irrational and go about their day. People with OCD cannot do this. Their intrusive thoughts become obsessions and take over their life. However, the intrusive thought is not the problem; the problem is your brain’s reaction to the thought! Overcoming OCD involves leaning into one’s fears and becoming okay with “not knowing for sure”. This is scary! A therapist trained in Exposure & Response Prevention (ERP) therapy can help. ERP is the gold standard, evidence-based treatment for OCD with a 75% response rate (Kozak et al., 2000). You can read more about ERP here.


At SPT, Jacqueline Caso, LMSW is trained to use ERP in the treatment of OCD. She also incorporates elements of Acceptance & Commitment Therapy (ACT) into exposure treatment when appropriate, or as an alternative to exposure when ERP is not possible. If you are interested in getting help with your OCD, email Jacqueline to request a consultation.

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