Hi docs, I’m having a tough time combating obsessive compulsive disorder. It’s not the physical kind that manifests with things like tapping or hand washing. I primarily experience intrusive thoughts, these thoughts cause distress, and then I try neutralize that distress by doing various mental gymnastics (again, all in my head, no physical compulsions).
Sometimes my brain even “tags” objects with an irrelevant thought - like “if I buy this pair of shoes, a bad thing will happen.”
Despite a solid understanding that these notions are all ridiculous, the false alarms are really hard to ignore. Do you have any pointers for getting help? My current therapist understands OCD extremely well, but I’m just not progressing.
Thanks for any pointers!
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I’m sorry to hear about this. Unfortunately this is outside my area of expertise to provide management recommendations, though.
I’d recommend seeking out a psychiatrist, as well as potentially seeking an alternative / second opinion from a different psychotherapist with specific experience in this area.
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It sounds like you’re doing quite a bit to work on this, and intrusive thoughts like this are VERY challenging. It sounds like what you’re describing is the “obsessive” or intrusive thought pattern of OCD, more than the compulsive or repetitive behaviors that people often think of when they hear OCD. (Those with OCD often have both obsessions and compulsions.)
In therapy, it could be helpful to know what type of treatment is being used as there could be other options as well. For example, I would certainly suggest exploring ERP therapy as that is a very evidence-based therapy treatment. Other potential options include Inference Based Cognitive Behavioral Therapy and the inclusion of ACT.
Like Austin said, a psychiatrist would also be able to address potential pharmacological treatment, as this could be used in conjunction with therapy.
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Just wanted to chime in as I was diagnosed with OCD a few years ago. I started taking Zoloft (Sertraline) 150mg for about a year back in college, but dropped it to 50mg as I felt “better”. I also didn’t want to deal with some of the side effects (very vivid dreams). Recently however, a lot of the ruminations came back, resulting in me bumping up the medication dosage. Its been about 2 months since I upped the dose from 50mg to 100mg, and I can confidently say that it is dramatically easier to function. If you work with a psychiatrist, it’ll probably take some time to experiment, especially since SSRIs are known for taking a while to “kick in”. I’ve also heard Fluoxetine & Prozac are common alternatives, so definitely work with your doctor to see what works best for you.
I also echo Leah’s point to try out ERP - whenever a painful obsession manifests I tell myself to “sit with it” for a few minutes. Exposure and Response Prevention, as Leah mentioned, is currently the most evidence-based, gold standard treatment for OCD. By focusing on the behavior (response) aspect, we can weaken the reinforcement pathway between the obsession and its corresponding response. Therapists who specifically practice ERP exist, but the methods are readily available online as well. @Right_Field
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Many thanks for all the responses, everyone. I appreciate the suggestions and the kind words. The current treatment does include ERP - mainly using index cards and pictures that depict common obsessions. Doc says I need to do these more often each day and start to ramp up the intensity of the exposures.
Nikantaheri, I haven’t tried medication yet. I know that’s a possible tool in the toolkit if CBT/ERP doesn’t cause sufficient symptom relief. Good to hear that you’ve dialed in to something that works for you.
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