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OCD and OCD-Related Problems
Common obsessions and compulsions in OCD:
Hair Pulling (Trichotillomania)
Getting things "just so"; Perfectionism
Body Dysmorphic Disorder
What Is it?
People with OCD have a problem with stress-inducing, repetitive, recurring thoughts (obsessions) and corresponding actions or thoughts (compulsions) which reduce the stress of the obsessions. Often, the compulsion causes a person to feel more certain, safe from harm, or safe from hurting someone else, at least temporarily. Sometimes the compulsion causes a feeling that things are "right" or "just so". Because the compulsion feels effective, it unfortunately actually reinforces the obsessions, and the obsessions come back. A simple example is checking several times to make sure a door is locked. One check would be sufficient, but just to make sure, a person checks several times, perhaps building up in his mind that the danger in having an unlocked door justifies the multiple checks. The compulsion may bring temporary relief, but it is an illusory relief, and the obsession comes back, over and over. Some obsessions and compulsions are just annoying (e.g., checking alarm settings multiple times), and it takes just brief psychological work to reduce those symptoms.
Some obsessions though are so heinous or dark that a person can hardly admit they think these things. They can spend a lot of time every day trying to stop these thoughts, distracting their attention away from things they want to do, interfering with their ability to live freely.
Cognitive and behavior therapies are often useful in the treatment of OCD as well as some of the OCD-related disorders, not only with the mild symptoms, but also with the more serious and time consuming. Using these therapies, people can learn to decrease their obsessions and compulsions. Using cognitive therapy, people can confront the illogical content of the obsessions and learn to live with everyday uncertainties. This type of understanding makes the next treatment steps (such as exposure and response prevention, and habit reversal) go smoother.
Using a combined cognitive/behavior therapy called “exposure and response prevention”, people learn to expose themselves to the obsessions and at the same time, prevent themselves from doing the compulsion. This will break the bond between the obsession and the compulsion, which will cause the obsession to lose power.
For compulsive behaviors that are habits (such as hair pulling and skin picking), habit reversal techniques can be used. The person learns better Stress reduction techniques. Alternate responses are developed to replace the habits.
I am very aware that there can be great stress involved in beating OCD and related disorders because the power of the obsessions is so great. We can go at a gradual pace, whatever the person is comfortable with. Or in contrast, some people may want to try an intensive treatment over a short amount of time. I can work within either paradigm. If a person requests, I can refer them for medical treatment of OCD. I am a member of the Obsessive Compulsive Foundation and have completed their Advanced Behavior Therapy Institute. In 2010, I did an online interview about OCD that is published at "Associated Content" called "Interview with Dr. Eleanor Criswell".