OCD Treatment Vancouver

Counselling & Therapy for OCD

What is OCD?

Obsessive-compulsive disorder (OCD) is an anxiety disorder characterized by intrusive and repetitive thoughts (obsessions) that make a person feel compelled to perform behaviours repeatedly or in a ritualized manner (compulsions).

Obsessions are persistent thoughts, urges, images, sensations, or impulses. People with OCD experience these thoughts as unwanted, distracting, and usually disturbing. For most people, undesirable thoughts come and go; everyone has them sometimes. For people with OCD, the obsessions do not go away – they are all-consuming and cause great distress.

Compulsions are the behaviours & mental acts that people with OCD feel they must do in response to their obsessions. People follow compulsions according to strict rules and specific patterns to try and reduce anxiety caused by obsessions, or to prevent a feared event from happening. It is these attempts at containing, suppressing, and reducing the obsessions, that keep OCD alive.

For example, a person who has a fear of contamination may have persistent thoughts about getting seriously sick or contracting a fatal disease (obsession). To prevent contamination, they will wash excessively (compulsion) and steer clear of threatening places (e.g. public washrooms).

It is these attempts at containing and suppressing the obsessions that keep OCD alive.

Common Subtypes & Obsessions

Contamination: People with this subtype clean their surroundings or wash themselves to cope with fear around germs, dirt, or contaminating chemicals. For example, they might worry that they’ve been infected with a disease after touching poles on public transit.

Doubt/Harm: People with this subtype have anxiety about putting themselves or others in danger because of their carelessness. For example, they might imagine their house on fire because they worry they didn’t turn off the stove.

Symmetry/ Arranging: People with this subtype feel the intense need to arrange objects symmetrically or in a particular order until they are “just right”. Disorganized items and messy environments can be stressful and uncomfortable until they correct them.

Religious: People with religion-themed OCD are preoccupied with obsessive religious doubts and sinful or blasphemous thoughts, images, and urges. Compulsions can include religious rituals (e.g. constant praying) and seeking moral reassurance (e.g. asking others if they are doing the “right” thing).

Sexual: This subtype features intrusive, disturbing, and unwanted sexual thoughts, sometimes about children, sexual orientation, family members, or animals.  People find these thoughts to be immoral and shameful.

Obsessions without compulsions: Also known as Pure-O, this type of OCD features obsessions without any observable or physical compulsions. Instead, Pure-O compulsions take the form of “hidden” mental rituals, for example: replaying memories, repeating words, or even mental avoidance. The obsessions usually have themes of social, moral, or religious deviance. People with Pure-O feel alarmed by their thoughts and react by trying to neutralize or suppress them. Unfortunately, attempts to control them only reinforce the thoughts and worsen the distress and anxiety.

Treatment for OCD

It is often said that the only way to get past OCD is to go through it. In other words, trying to avoid the obsessions and intrusive thoughts only serves to strengthen them. Instead, treatment must focus on two things: a) challenging the core beliefs behind the obsessions/ compulsions, and b) learning to disengage from the compulsions. The good news is that OCD usually responds well to therapy.

Cognitive Behavioural Therapy (CBT) is considered the treatment of choice for OCD. Treatment begins by identifying the triggers that provoke the obsessions and compulsions. With your therapist’s guidance, you will gradually expose yourself to the anxiety-inducing thoughts, objects, and situations, and learn to resist the compulsions.

This is known as Exposure and Response Prevention (ERP). With gentle support, you will slowly learn to tolerate the distress of your obsessions, and your anxiety levels will start to drop. Eventually the anxiety should dissipate completely and you will no longer feel a need to perform the compulsions. This process is called habituation, and treatment usually takes between 12-16 sessions total.

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