Obsessive-Compulsive Disorder (OCD)

Obsessive-compulsive disorder is an anxiety disorder in which people have recurring, unwanted thoughts, ideas, or sensations (obsessions) that make them feel driven to do something repetitively (compulsions). Many people with OCD know or suspect their obsessions are not true; others may think they could be true. Even if they know their obsessions are not true, people with OCD have a hard time keeping their focus off the obsessions or stopping the compulsions. Body Dysmorphic Disorder, characterized by “imagined ugliness” is related to OCD. CHH offers Exposure and Response Prevention (EXRP), which is undoubtedly the gold-standard psychotherapy treatment for OCD due to the wealth of scientific evidence to support its efficacy.

Obsessions

Obsessions are recurrent and persistent thoughts, impulses, or images that cause distressing emotions such as anxiety or disgust. Many people with OCD recognize that the thoughts, impulses, or images are a product of their mind and are excessive or unreasonable. Yet these intrusive thoughts cannot be settled by logic or reasoning. Most people with OCD try to ignore or suppress such obsessions or offset them with some other thought or action. Typical obsessions include excessive concerns about contamination or harm, the need for symmetry or exactness, or forbidden sexual or religious thoughts.

Compulsions

Compulsions are repetitive behaviors or mental acts (e.g., washing/grooming rituals, avoidance, seeking reassurance from others, checking, mental reviewing, ordering and arranging, etc.) that a person feels driven to perform in response to an obsession. The behaviors are aimed at preventing or reducing distress or a feared situation. Although the compulsion may bring some relief to the worry, the obsession returns and the cycle repeats over and over.

Avoidance

In addition to obsessions and compulsions, many with OCD also find themselves engaging in a fair amount of avoidance. Avoidance is primarily associated with people, places, objects, and situations that elicit obsessional thinking and produce anxiety. As compulsions can be time consuming, exhausting, and impairing, avoidance often functions as an alternative to compulsions to make life easier. While avoidance may ease anxiety in the short-term, it is ultimately worsening the OCD cycle.

Body Dysmorphic Disorder (BDD):

Body Dysmorphic Disorder, a related disorder of OCD, is characterized by an “imagined ugliness.” A person experiencing BDD is preoccupied with one or more perceived defects or flaws in their physical appearance. Important to note is that these perceived defects or flaws are not observable to others. The preoccupation experienced in BDD can become incredibly overpowering, leading to harmful coping strategies. Such strategies could include repetitive behaviors (e.g., mirror checking, skin picking, excessive grooming behaviors, seeking assurance from others, etc.) or repetitive mental acts (e.g., intensely comparing his/her appearance to others) as a means of self-soothing or self-assurance. The treatment offered at CHH for BDD is Cognitive-Behavioral Therapy (CBT).