OCD and Two Important Projects

by stuart miles freedigitalphotos.net

There have been events all over the country this past week in recognition of OCD Awareness Week. From live experiences such as the OCD Capital Walk, to every type of event you could imagine on social media, it has been an exciting and successful week for raising OCD awareness.

I’d just like to showcase two projects that began long before OCD Awareness Week 2017 that have now come to fruition.

Back in 2016, I wrote about Unstuck: An OCD Kids Movie, a documentary film about six children with obsessive-compulsive disorder who share their stories -including how they learned to face their fears, stop their rituals and regain control of their lives. The movie has touched many people and has received more accolades to mention. You can learn more about it here.

The second project is a book by John Green, the best-selling author of The Fault in our Stars. The main character in Mr. Green’s new novel, Turtles All the Way Down, has obsessive-compulsive disorder, a characteristic she shares with Mr. Green in real life. In this interview with ABC News chief anchor George Stephanopoulos, the author says:

One of the reasons I wanted to write this book was because I did feel very alone in that for a long time. I think that psychic pain can be tremendously isolating and that only compounds the hurt of it.

I haven’t read the book (it just came out) but I plan to, especially after reading this great article about him, and the book, in The New York Times.

As you can see, there is no shortage of incredibly talented and creative people helping to raise awareness of OCD. And that’s great! But let’s remember that even if we are not amazing filmmakers or widely-acclaimed authors, each and every one of us, as I mentioned in my last post, can advocate in our own ways, and truly make a difference. Not just during OCD Awareness Week, but every day of the year.




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OCD Awareness Week – 2017

by stuart miles freedigitalphotos.net

The ninth annual OCD Awareness Week begins today. It always takes place during the second week in October with the purpose of raising awareness and understanding of obsessive-compulsive disorder and related disorders, as well as the appropriate treatment. As many of you know, finding the right help is often one of the toughest battles in the fight against OCD and some estimates say it can take as long as 14-17 years from the onset of symptoms to get a correct diagnosis and treatment. Though my family didn’t realize it at the time, my son was one of the lucky ones – it took about two years after his diagnosis to get him the right help.

While that’s “not bad” in terms of OCD treatment, it is still much too long, in my opinion. It should have taken days, maybe weeks, but certainly not two years.

I started blogging in 2010, a year after OCD Awareness Week was launched. My goals have always been to spread the word that OCD, no matter how severe, is treatable, and that exposure and response prevention (ERP) therapy is the evidence-based psychological therapy for the disorder. My message continues to be one of hope – no matter how severe your (or your loved one’s) OCD is at this moment, you can recover and live a happy, fulfilling life.

But you need the right therapy.

So how are we doing with spreading the word about the right treatment?

Not great. I get five or six emails a week from those with OCD, or parents of those with OCD, who just don’t understand why they or their loved ones are not getting better, and often are in even worse condition than they were before therapy began. How could this be? They are doing everything the therapist advises, and then some. They want more than anything to be free from the clutches of OCD, but they are losing hope.

People are losing years of their lives – needlessly – to obsessive-compulsive disorder.

It’s not enough for those of us “in the know” to be spreading the word to those with OCD. Doctors, school counselors, and all professionals who might be the first point of contact need to be educated; they need to know there is a specific therapy (exposure and response prevention), that is used to fight OCD. There are actually therapists out there who are either not aware of ERP therapy, or choose not to use it. Indeed, it is sometimes the very people who are supposed to be helping us that steer us in the wrong direction, perhaps not maliciously, but due to ignorance.

While there are many ways to get involved in OCD Awareness Week, I think approaching these “experts” might be one of the most valuable things we can do. I think most professionals really want to help and would appreciate being educated. How great it would be if we could wipe out those unacceptable statistics, and get those with OCD the help they need and deserve – within days.

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ACT and ERP for OCD

freedigitalphotos.net by Stuart Miles

This week I’d like to share this post that was written in 2012…

As I’ve mentioned many times before, exposure and response prevention (ERP) therapy is the treatment of choice for OCD. However, a new acronym has recently made its way into the “OCD tool box.” Basically, ACT (Acceptance and Commitment Therapy) involves mindfulness and being able to accept your actions, as well as exploring your commitment to making changes. Think Serenity Prayer.

In a wonderful seminar at the 2012 IOCDF Conference, Dr. Jonathan Grayson discussed what is seen by many as competing therapies. He argued that the two therapies are really not at odds with one another, and that ACT is actually woven into ERP Therapy. Participating in an exposure involves acceptance. According to Dr. Grayson, the problem occurs when therapists use ACT without ERP.

ACT involves a top-down approach, where the sufferer works on changing his or her relationship with the whole world. While this therapy can certainly complement ERP Therapy, Dr. Grayson prefers starting with ERP Therapy, which is a bottom-up approach that specifically targets OCD. He used the analogy of an alcoholic working on his or her life’s problems while still drinking. It isn’t going to work. You’ve got to get the drinking under control and then you can move forward.

Surely, ACT can help those who suffer from OCD. For example, it can help with the acceptance of uncertainty, which is crucial in the treatment of the disorder. It can motivate sufferers who are engaging in ERP Therapy by helping them focus on their values, and what they want out of their lives. ACT has its place in the treatment of obsessive-compulsive disorder, and may even work as the main treatment for other mental health issues.

But OCD is unique, and the treatment for it is very specific. At this particular talk, and throughout the entire conference, this fact was stressed over and over: Exposure and response prevention (ERP) therapy is the accepted treatment for OCD, and when done correctly, it works. While other therapies may have benefits as well, if you want to rid yourself of OCD’s grip, ERP Therapy is the way to go. And while it’s not easy, I don’t know of anyone who has ever regretted committing themselves fully to it. The payback is huge…..freedom from OCD.

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OCD and Exhaustion

by graur codrin freedigitalphotos.net

When my son Dan’s OCD was severe, he was always exhausted. At first I attributed his lack of energy to the fact that he rarely slept well. But it soon became obvious, even when sleeping was not an issue, that he always felt tired.


I think there are many reasons why those with obsessive-compulsive disorder are often exhausted. Living with nonstop anxiety can be draining. Many people with OCD are also depressed, and depression and lack of energy often go hand in hand. Additionally, some medications used to treat OCD are known to cause fatigue.

And the very nature of OCD (left untreated) is exhausting just to think about, let alone live with. Relentless obsessions and compulsions – an endless cycle that takes up every ounce of your energy. And the pretending! So many people with OCD do whatever they can to hide their disorder – to keep up that facade of “normalcy.” I think it would be surprising not to be tired!

So what’s the best thing to do when you feel this overwhelming exhaustion related to obsessive-compulsive disorder? Sleep until you feel better? Wait for it to pass? After all, the way you feel now, you have no energy or motivation to do anything, especially exposure and response prevention (ERP) therapy which is exhausting in its own right.

As with so many things related to OCD, you should do the opposite of what you feel like doing.

I know it’s not easy. In fact it’s incredibly difficult. Mental and physical exhaustion take their toll in many ways, from physical ailments to depression to doubt in your ability to improve or change your life. Ah, that old word – doubt. Those with OCD often doubt their strength and ability to get through difficult times, but in fact they are just as capable, if not more so, than those without OCD.

Studies have shown that attitude plays a big part in overcoming adversity. If you’re so tired that you feel there’s no way you can fight your OCD, then you won’t fight it. However, if you acknowledge your exhaustion but still vow to move forward, even in small ways, then you will be one step closer to fighting your OCD. A good therapist who specializes in treating OCD can be helpful with setting goals.

So many of us wait to take action until we feel motivated, but sometimes we just need to do the opposite. We need to take action and eventually the motivation will follow.

If you are feeling exhausted, lethargic, and completely drained from your OCD, please don’t wait for it to pass. It won’t – OCD will just keep getting stronger. Take some steps to plow through the exhaustion and move forward to fight your OCD. The more you fight, the weaker your OCD will become, and slowly but surely, you will beat OCD and your exhaustion will give way to a renewed joy in life.




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Podcast on The Invisible Wheelchair

renjith krishnan

I recently had the pleasure of being interviewed by Donald Grothoff over at The Invisible Wheelchair.

If you’d like, you can listen to the podcast here:






A special thank you to Don for taking the time to speak with me!


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OCD and Shopping

by pong freedigitalphotos.net

By the time my son Dan entered a residential treatment center for OCD, he was barely functioning. Using exposure and response prevention (ERP) therapy he tackled his hierarchy and slowly but surely regained his life.

During his stay, one of his exposures was to go on shopping trips and make purchases. All types of shopping proved difficult for him – buying groceries and necessities, clothing, etc., but the more expensive purchases, particularly if they were for himself, seemed to be the most stressful.

But he did it. And he felt the overwhelming anxiety. And he refrained from doing compulsions. Over and over again until shopping was no longer an issue for him. At the time I thought this fear of shopping was an odd obsession, but I have since heard of others with OCD who, for whatever reason, have difficulty shopping. For some people it might be about having to make the “right” decision, others might have an issue with spending money, and still others might feel something tragic will happen if they make a particular purchase. The list of possibilities goes on, but no matter what the reasons are behind a fear of shopping in those with OCD, the treatment is the same – exposure and response prevention therapy.

But what about the opposite of being afraid to shop? Hoarding disorder is very real and can affect both those with obsessive-compulsive disorder and those without. While it is related to OCD, it is considered a distinct disorder, and a complex one at that. Those who hoard form very powerful attachments to objects and for many, having to dispose of possessions makes them feel as if they are losing a part of themselves. Cognitive Behavioral Therapy (CBT) has been shown to be effective in treating hoarding disorder.

As with most things related to OCD, it can get complicated. While my son Dan’s fear of shopping was tied into an obsession (and his compulsion before treatment was avoidance of shopping), for others with OCD, shopping might present as a compulsion. For example, a person with OCD might feel as if they have to buy a particular clock they saw in a store or something horrible would happen to someone they love. Or they might believe if they go ahead and buy the clock, something terrible might happen. In both cases, the obsession is something terrible happening, and the compulsion, which gives temporary relief, is buying (or not buying) the clock. Shopping as a compulsion might or might not be related to hoarding disorder as well. Yes, it can be confusing!

If you have OCD and deal with shopping (or fear of shopping) as an obsession or compulsion, I strongly suggest seeking good professional help with an OCD therapist. What it all comes down to, once again, is learning to not give in to OCD but instead accepting the uncertainty of life. Once this is accomplished, most people with OCD experience a level of freedom they never thought possible.

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Can Virtual Compulsions Help those with OCD?

by praisaeng freedigitalphotos.net

A recent study concluded that those with obsessive-compulsive disorder might get relief from watching someone else perform compulsions as opposed to having to do them on their own. The study involved ten participants with contamination OCD who were shown various “disgusting scenarios,” and some were asked to touch these “contaminated” objects. Each participant experienced significant relief just by watching a researcher wash his or her hands– even those participants who had touched the object themselves. More  trials with more participants are already underway.

While this is certainly an interesting study, is watching “virtual compulsions” something that could actually be helpful to those with OCD? Isn’t it just replacing one compulsion with another one? The premise behind exposure and response prevention (ERP) therapy is that the response (compulsion) should be prevented – not substituted with a different compulsion (watching someone else perform a compulsion). If someone’s compulsion is hand washing, they should work toward not washing their hands, not watching others was theirs.

But what if someone’s hand washing compulsion has left them with red, raw, painful hands? Wouldn’t it be better to watch a video of someone washing their hands than continue to hurt yourself while washing your own hands? I’m thinking it can be seen as more of a stepping stone to response prevention than as a substitute compulsion. The person with OCD could go from severe hand washing to watching someone else washing their hands and then to no hand washing compulsion at all. Those with OCD would still work toward embracing the uncertainty of life by not performing compulsions at all – it would just be a more gradual approach. For those who have skin-picking or hair-pulling compulsions, or any other self-harm compulsions, I think the use of virtual compulsions could be really helpful.

I’m not a therapist, and these are just my own thoughts. If someone is considering using virtual compulsions, I think it is really important to do so under the supervision of an experienced OCD therapist. You don’t want to get stuck just substituting one compulsion for another – you want to always have the end goal of not performing any compulsion.

I’d be interested to hear what those with OCD think of this new finding, and if you feel it might be helpful for some people with the disorder?

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