Obsessive Compulsive Disorder 

OCD

What is OCD?


Obsessive-compulsive disorder (OCD) is characterized by two hallmark features: obsessions and compulsions. Those living with OCD have recurring, intrusive thoughts (obsessions) that trigger distressing feelings such as anxiety, and are often accompanied by a strong urge/ drive to do something repetitively in response to the obsession(compulsions).

The compulsions are intended to relieve the distressing feeling but unfortunately any relief is very temporary and ensures the person continues to engage in compulsions as their primary strategy to relieve anxiety, hence forming “the cycle” of obsessions and compulsions that those living with the disorder can become ‘stuck’ in.

OCD shows up very differently from person to person, the ranges of fears and variations in rituals are limited only by the human mind. Despite these differences, there is often one major feature shared, the fear of uncertainty.

Most people have some obsessive thoughts and/or compulsive behavior tendencies, however this does not necessarily mean they have OCD. You may hear others make use of OCD as an adjective “I’m so OCD right now” (cringe).

For a formal diagnosis of obsessive compulsive disorder to be made, this cycle of obsessions and compulsions becomes so extreme that it consumes a lot of time and gets in the way of important activities that the person values. The diagnosis must be given by a qualified professional such as your family doctor, a psychologist, psychiatrist, or Nurse Practitioner.


Common Obsessions in OCD:


OCD has a knack for “hitting you where it hurts” and creating fear and doubt about important aspects of your life. The particular content varies from person to person and this list is not exhaustive, but here are some examples of the “themes” of obsessions that often (but not always) show up for people…

Responsibility for harm or mistakes

Contamination

Order & Symmetry

Violence & Aggression

Sex

Religious & Morality (scrupulosity)

Somatic ( physical illness, disease, or an aspect of your appearance)

Miscellaneous

Common Compulsion in OCD:


Despite the differences in how rituals look for individuals, their main purpose is to make the person feel safe, certain, and in control. Most compulsive rituals generally fall into the following categories, however this list is simply an attempt to summarize common themes and it too is not exhaustive...

Reassurance Seeking (asking others, google)

Mental Rituals

Checking

Decontamination

Repeating

Ordering, Arranging & Counting

Who Gets OCD?


OCD does not discriminate, it equally affects all genders, races, ethnicities and backgrounds. OCD is estimated to affect approximately 1% of the population.


What Causes OCD?


While the exact cause remains unknown, research suggests that there is both a neurological and biological component to OCD. There is much to be learnt about this complex disorder, however another important component to the development and maintenance of OCD is found within learning theory. Learned responses can be very powerful and difficult to change, particularly when they are fueled by intense anxiety. These components have important implications to the treatment of this disorder.


How is OCD Diagnosed?


Most people have some obsessive thoughts and/or compulsive behavior tendencies, however this does not necessarily mean they have OCD. The word ‘obsession’ is often used quite casually in everyday conversation and can result in a minimization towards what this word means in terms of the disorder. In fact, being ‘obsessed’ with something in everyday terms is often equated to liking or being very interested in the thing you are describing. This can help us understand why you may even hear others using this diagnosis as an adjective, “I’m so OCD about…”. Although those statements often make those of us living with or treating the disorder cringe, more often than not it’s a lack of information and not meant to minimize the experience of those living with this incredibly impactful disorder.

For a formal diagnosis of obsessive compulsive disorder to be made, the cycle of obsessions and compulsions becomes so extreme that it consumes a lot of time and gets in the way of important activities that the person values. The diagnosis must be given by a qualified professional such as your family doctor, a psychologist, psychiatrist, or Nurse Practitioner.


How is OCD Treated?


OCD is commonly treated througha version of cognitive behavioural therapy called Exposure and Response Prevention or ERP.


Monitoring Outcomes


Alongside therapy, we use symptom monitoring tools designed to ensure therapy is heading in the right direction. The Y-BOCS, a 10-item scale, has become the most widely used rating scale for OCD. The Y-BOCS is designed to rate symptom severity, not to establish a diagnosis.

We will complete the Y-BOCS symptoms checklist at your first appointment and review it together to establish a starting point. We will repeat this scale several times throughout treatment to monitor your symptoms and how they are responding to the treatment.

Medications may be a helpful part of your treatment, we will encourage you to connect with your family physician or psychiatrist to have this conversation as we do not prescribe medication here at Lotus.


Managing OCD:


Unfortunately there is no cure for OCD and so the importance of developing long term management skills is a very important aspect to treatment. This therapy aims to help you identify when OCD is 'calling the shots' and unveil connections that you may or may not have noticed before so you can recognize them if they show up again in a different context in the future. Simply put - by eliminating behaviours that 'OCD' (not you) designed to keep you safe, you are able to test their value and make choices based on your values  instead of being bossed around.


We are thrilled to offer ‘WeOCD’, a therapeutic support group open to clients who are completing or have completed ERP. This group is designed to augment therapy, offer supportive connections to others living with the disorder and become a source of ongoing support after treatment.