Obsessive-Compulsive Disorder

Obsessive-Compulsive Disorder is an underdiagnosed set of symptoms that can otherwise be dismissed as untreatable anxiety and depression or post-traumatic stress, extreme pickiness or people-pleasing, and simply having a personality characterized by rigid thinking and obsession with control. 

This is complicated by masking - by the time adults are diagnosed with OCD, it’s usually after a lifetime of finding clever ways to hide all the extreme thoughts and fears and compulsive behaviors that make them feel safe, because they’re not socially acceptable.

In truth, OCD is a difficult tolerating the pain of uncertainty.

We find great strategies that we use to generate certainty and safety, and then feeling anxious because we’re convinced all the time that we can’t live without those strategies - and, because we keep finding out we can’t maintain the hit from our last dose of reassurance and certainty! This process is miserable, confusing, shame-filled, deeply impacts our work and social lives, and is deeply isolating. 

I practice the gold-standard treatment for OCD, Exposure and Response Prevention (ERP).

This is a cognitive-behavioral treatment where you and I can work on how you can tolerate uncertainty, exposing yourself to the things that OCD tells you will end you, and learning together whether your extreme fears are:

  1. As likely as OCD tells you they are

  2. As awful-feeling as OCD tells you they are if they do occur

  3. As unsurvivable as OCD tells you they are if they do occur.

The end goal of ERP is not having total certainty and reassurance and safety. It is being able to tolerate human existence as it is - full of impermanence, unpredictable change, beauty, limited control, and unpredictable suffering and difficulty - and live the lives we want to live because we have the right coping tools for our OCD thoughts and urges.

Note: I refer out for moderate-to-severe substance use disorders and disordered eating, bipolar disorder, and schizophrenia and other psychotic disorders, in order to help clients move toward care from clinicians who have years of training and experience in these presentations.