We recently launched our new Intensive CBT Program for Anxiety and OCD.  We thought we could take some time to explain more about OCD below.

We’ve all heard people casually throwing around the phrase, “I’m so OCD!” when they are being overly clean, orderly, or perfectionistic.  But what does having clinically diagnosed OCD actually mean?  And what does it look like?

OCD is defined as having unwanted and intrusive thoughts, urges, or images that cause intense distress, often with efforts to get rid of these thoughts by pushing them away or performing a ritual.  What may be confusing is that OCD can look so different among different people.  Commonly known types of OCD include fears of contamination leading to cleaning rituals, or doubts about appliances being on or doors being locked leading to checking behaviors.  However, did you know that OCD can often take the form of unwanted sexual taboo thoughts/images (e.g., unwanted sexual images of someone to whom one is not attracted), doubts about one’s sexuality or gender (e.g., doubts about being gay despite knowing one is straight or being transgender despite feeling confident one is cisgender), intrusive aggressive urges or thoughts (e.g., unwanted and distressing worries that they may harm a loved one despite not wanting to), or accidental harm to others (e.g., fears of unknowingly hitting someone when driving)?  Additionally, OCD rituals do not have to be observable, they can also be internal rituals such as mentally reviewing past events, reassuring oneself, or internally scanning one’s body.  If you are experiencing any of these symptoms, please know that you are not alone!

An interesting research study (Purdon & Clark, 1993) found that 99% of college students have “OCD-like” thoughts such as running one’s car off the road, harming a family member, or having sex with unacceptable people.  However, OCD only has a prevalence rate of 2% (Ruscio, Stein, Chiu, & Kessler, 2010).  So how come so many people can have these thoughts and be completely fine, while others have these same thoughts and go on to develop OCD?  Here is a diagram to explain what may be happening:

OCD Thought Pattern

For folks without OCD, they may have an intrusive thought such as, “I could push this stranger onto the subway tracks.”  They would then just shrug the thought off, dismissing it as a weird and unimportant thought, and the thought dissipates.  But for folks with OCD, this thought may be interpreted as, “EXTREMELY IMPORTANT!  DANGEROUS!  I MUST DO SOMETHING TO PREVENT THIS FROM HAPPENING!!”  This thought then sticks around, causes much distress, and leads the person to stand far from the subway tracks or avoid taking the subway altogether.  Once the OCD cycle starts, it is tough to break out of it because it involves taking a risk to drop the rituals to learn what actually would happen.  

The good news is that OCD can be treated!  The gold standard treatment is cognitive behavioral therapy (CBT), and when it is applied to OCD, it is called exposure and response prevention (ERP).  Treatment involves taking those risks to stop the rituals to break out of the OCD cycle, changing one’s interpretation about the meaning and importance of thoughts, and moving towards living a values-based life.  Of course, this is all easier said than done, and a specially trained OCD clinician can be invaluable in this journey.  If you live in Massachusetts, our clinic has immediate openings for both individual weekly therapy or our 2-week Intensive CBT program, and we would love to help you out!

Written by Beth Shikatani, PhD, a clinical psychologist at Cambridge Psychology Group who specializes in treating OCD and anxiety.  She is the director of the Intensive CBT Program for Anxiety and OCD, a 2-week accelerated program that provides individual CBT and exposure therapy to adults and adolescents (age 16+) with difficulties with OCD, social anxiety, panic disorder, agoraphobia, and specific phobias.  Dr. Shikatani is also available to give presentations to mental health professionals and the community on OCD, anxiety, perfectionism, cognitive behavioral therapy, and mental health skills.