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Writer's pictureDr. Rachel Kutner, Psy.D.

OCD 101: The Basics of Diagnosis and Treatment


OCD 101: The Basics of Diagnosis and Treatment


In a room full of people, there are likely a couple who are suffering from Obsessive Compulsive Disorder, or OCD. OCD can cause extreme distress and disability, and it often makes life feel overwhelming or downright impossible.


An individual suffering from OCD experiences repeated unwanted and distressing thoughts or images. Compulsions are then performed in an attempt to control the anxiety or fear that comes along with those thoughts and images. Compulsions can be physical, such as checking a stove or washing hands, or they can be mental, such as ruminating or seeking reassurance.


OCD has a way of convincing people that they must engage in compulsions in order to be okay. The problem is that with time compulsions start feeling mandatory. The sufferer believes that they need to follow these compulsions, or “rules,” in order to be safe. Compulsions may temporarily ease anxiety, but they are detrimental in the long-term, as the sufferer feels obligated towards OCD and it becomes more and more difficult to live beyond it’s tight grip and strict regulations.


This is where Exposure and Response Prevention, or ERP, comes in. ERP is an evidence-based treatment aimed to loosen the hold of OCD on one’s life. Exposure involves facing a feared thought, object, image, or situation. Response prevention involves a decision to not comply with OCD’s rules and to stop engaging in compulsions. OCD wants you to see something normative as something terrible. The goal is to be able to see something exactly as it is and not as what OCD tells you it is. For example, a doorknob is something you turn to enter a room, not a representation of disease and demise. ERP is all about relating to things as they, and not as the terrible thing OCD tells you they are.


OCD screams that these rules are so important and that they cannot be broken, or else something terrible will happen. The more you practice ERP, the more you break OCD’s rules and instead live a life filled with your own values, and not OCD’s values, the less important these “rules” will feel and the freer you will feel.

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