This post first appeared on my blog in May 2013:
When someone is diagnosed with obsessive-compulsive disorder, education is essential. Understanding what the disorder entails and how to best treat it are key components to recovery. As we know, however, OCD can be very sneaky, and sometimes this quest for knowledge can go awry. Sigh. Just when I thought OCD couldn’t get any more complicated…..
In this wonderfully written article by Stacey Kuhl Wochner, LCSW, Ms. Wochner explains that sometimes those with OCD (many who have had previous success with exposure and response prevention therapy) begin to feel that therapy is not helping as much as it used to. Why isn’t it working? Maybe they aren’t doing it right? Maybe they don’t truly understand everything about their OCD and treatment and need to learn more? What is happening is the uncertainty about keeping OCD in check is turning into an obsession. Those with the disorder believe they will never be able to beat OCD; their lives will be horrible.
So they begin a quest to research, learn and discuss everything there is to know about every aspect of OCD. Ms. Wochner calls this “the solving compulsion.” People with OCD might even attempt to engage in ERP therapy, but for the wrong reasons. Exposures now become a compulsion, a way to reduce anxiety, instead of the anxiety provoking act they are intended to be.
How is this type of OCD dealt with? As Ms. Wochner tells us: “Having unwanted thoughts and feelings about losing control of your OCD is not the problem. Your effort to rid yourself of your thoughts and feelings is the problem.” So really, it’s no different from other examples of the disorder. People need to feel the uncertainty about their OCD without allowing themselves to engage in any solving rituals. By doing this, they will be engaging in ERP Therapy in the right way and for the right reasons. Of course this will be anxiety provoking at first (which of course means you are doing it right) but eventually your OCD will lose its power.
I highly recommend reading her article as I’ve only touched upon some of the basics. What really became clear to me while reading this article is how crucial it is to have a therapist who truly understands OCD. My guess is there are plenty of health care providers who deal with patients with solving rituals (Ms. Wochner does a great job of describing a typical therapy session) and don’t even realize it. Therapy sessions with these providers will hurt, not help, those with obsessive-compulsive disorder.
So yes, OCD is complicated, but not so complicated that it can’t be outsmarted. If you’re armed with a competent therapist and a willingness to face and accept the uncertainty of life, OCD doesn’t stand a chance.