Obsessive Compulsive Disorder
Obsessive-Compulsive Disorder (OCD) is a condition that involves unwanted thoughts and repetitive behaviors that feel impossible to deny. While many people with OCD experience a decrease in symptoms over time, others find their symptoms worsening.
Understanding what causes OCD to get worse can help people manage the condition and seek the right treatment. Let us dive into some of the main factors that can make OCD more challenging.
1. Increased Stress and Anxiety
Stress and anxiety are key triggers that can make OCD worse. When life becomes more stressful, people with OCD may find themselves experiencing stronger or more frequent obsessions. These stressful events could include major life changes, relationship issues, or work pressure.
Stress can make it harder to manage the compulsions and obsessive thoughts that come with OCD, causing them to take up more time and energy. For example, if a person with OCD is going through a stressful period, their need to perform rituals may intensify as a way to cope with the heightened anxiety.
2. Avoidance Behaviors
Many people with OCD try to reduce their anxiety by avoiding situations or places that might trigger their obsessive thoughts. However, avoidance may offer temporary relief, but it can actually make the disorder worse in the long run.
Avoiding triggers can prevent the person from learning that their fears are often irrational. This reinforces the idea that they need to perform compulsive behaviors to feel safe. Over time, the cycle of avoidance can grow, and the OCD symptoms can become more deeply ingrained.
3. Lack of Treatment or Inconsistent Treatment
When OCD is not properly treated, symptoms can get worse. Some individuals may not receive the right treatment at all, while others may stop treatment before they see improvement. OCD is best managed with a combination of Cognitive Behavioral Therapy (CBT), specifically Exposure and Response Prevention (ERP), and sometimes medication.
ERP helps people face their fears without engaging in compulsive behaviors. Without consistent treatment or the right interventions, symptoms can snowball, causing the person to feel trapped in their cycle of obsessions and compulsions.
4. Negative Thought Patterns
People with OCD often struggle with negative thought patterns that can intensify their symptoms. These thoughts include things like “I must be in control” or “If I do not do this, something bad will happen.”
These patterns of thinking make the person feel compelled to perform rituals or checks to prevent harm. When a person becomes more consumed by these thoughts, they may engage in behaviors that reinforce the cycle. The more they give in to the obsession, the more likely it is that the OCD will worsen.
5. Social Isolation
OCD can be an isolating condition. Those suffering from OCD often feel embarrassed or ashamed of their symptoms, which can lead to avoiding social situations or even relationships. This isolation can contribute to worsening symptoms because the individual is left alone with their intrusive thoughts.
Being around others can provide support and distraction from the compulsions. When that support is missing, the obsessions can become more overwhelming, leading to greater distress and a higher intensity of compulsive behaviors.
6. Comorbid Conditions
OCD often co-occurs with other mental health conditions, such as depression or generalized anxiety disorder. These conditions can worsen OCD symptoms by adding additional layers of stress and emotional distress.
For example, if a person with OCD is also dealing with depression, they may feel more hopeless and less motivated to fight the obsessive thoughts. This can make it even harder to break free from the compulsive cycle.
Conclusion
OCD can become more challenging when stress, avoidance, or untreated symptoms come into play. By understanding the factors that contribute to the worsening of OCD, individuals can work with their therapist to develop coping strategies and treatments that target the root causes of their condition.
Seeking OCD treatment and staying committed to treatment can prevent the symptoms from escalating and help those affected by OCD lead more balanced and manageable lives.
Obsessive Compulsive Disorder
Existential OCD (obsessive-compulsive disorder) is a form of OCD that involves persistent and distressing thoughts about big life questions. Unlike traditional OCD, which is often focused on fears related to contamination or harm, existential OCD revolves around deep philosophical uncertainties. These obsessive thoughts can lead to compulsive behaviors as individuals try to gain certainty or control.
For people with existential OCD, existential questions are not just theoretical. They are often tied to intense emotional distress and the feeling that life is meaningless or that something is wrong with their sense of self. The result is an ongoing battle to find answers to questions that may not have any clear answers.
Examples of Existential OCD
No two people dealing with existential OCD will have the exact same struggles, but their thoughts can feel like a never-ending cycle of worry. Below are some of the types of thoughts people with this type of OCD often struggle with:
- The fear of being disconnected from reality: constant worry that their life is just an illusion or that they are not truly living.
- Obsessive questioning of personal identity: doubting who they really are, their purpose, or their place in the world.
- Fear of death or the unknown: intense preoccupation with what happens after death or how they will cease to exist.
- Philosophical rumination: repeatedly analyzing the meaning of existence or grappling with the concept of time, space, and the universe.
How ERP and ACT Can Help
While existential OCD may seem different from traditional forms of OCD, effective treatments like exposure and response prevention (ERP) and acceptance and commitment therapy (ACT) can help manage the symptoms and reduce the impact on daily life. Let’s learn more about these two effective treatment options.
Exposure and Response Prevention (ERP)
ERP is a treatment I utilize for OCD that involves slowly exposing individuals to their fears in a controlled way. For those with existential OCD, this might mean confronting the very thoughts and questions they are trying to avoid. Rather than engaging in compulsive behaviors to “neutralize” the thought, ERP encourages individuals to sit with the discomfort and uncertainty.
For example, a person may be asked to spend time thinking about the fear of death or existential meaninglessness without attempting to find answers. Over time, this can help reduce the anxiety associated with these thoughts and prevent them from controlling the person’s life. The goal is not to find answers but to tolerate the distress that comes with uncertainty.
Acceptance and Commitment Therapy (ACT)
ACT is another powerful tool that can help people with existential OCD learn how to accept their thoughts and feelings without being consumed by them. Rather than trying to eliminate obsessive thoughts, ACT focuses on accepting them and taking action based on personal values.
A person struggling with questions about the meaning of life may never find a definitive answer. But ACT can help them focus on what is meaningful to them, such as relationships, personal growth, or contributing to a cause. By aligning actions with values, people can find a greater sense of purpose and acceptance of the unknown.
Combining ERP and ACT
Combining ERP and ACT can be especially effective for those with existential OCD. While ERP addresses the need to confront and accept distressing thoughts, ACT helps individuals embrace those thoughts without being controlled by them. This combination allows people to define their lives by their values and goals rather than obsessive questioning.
Help Is Available
Existential OCD is a challenging condition that can make life feel confusing and uncertain. Fortunately, treatments like ERP and ACT offer powerful ways to manage the disorder. If you or someone you know is struggling with existential OCD, remember that OCD therapists are here to help. Looking for help navigating your existential OCD? Visit my contact page for more information on scheduling an in-person or virtual appointment.
Obsessive Compulsive Disorder
There are many different approaches to treating and managing panic disorder and obsessive compulsive disorder (OCD).
While these two conditions are not the same, there are some similarities in commonly prescribed treatments. One such method that therapists can utilize for both conditions is exposure therapy and response prevention (ERP).
Exposure therapy may sound like an oxymoron. After all, how can exposing yourself to the things you fear most actually be an effective therapeutic treatment for a mental health condition? While it may sound contradictory, this method is actually quite sound.
Here’s how using exposure therapy under the guidance of a qualified therapist can help people with panic disorder and OCD.
The Basis of Exposure Therapy with Response Prevention
So, what is the basic principle behind exposure therapy? In general, people with OCD or panic disorder do their best to avoid the situations that trigger their fears. This is a completely rational response to fear. And in the short term, it is the easiest way to protect yourself from what you’re afraid of.
Exposure therapy, however, aims to eliminate that urge to avoid certain situations. Throughout the course of treatment, you will ideally learn that the thing you were fearing doesn’t pose a real threat or danger after all. And, if you’re dealing with OCD, you also will slowly let go of your compulsive need for certain rituals before facing specific situations. By choosing to stop the compulsions (i.e. prevent the responses), you will learn to habituate to the anxiety feelings and decrease the intensity and frequency of the obsessive thoughts. The ERP approach allows you to break free from the vicious cycle of anxiety.
What’s Wrong With Avoidance?
We all go out of our way to avoid things that make us feel anxious or afraid sometimes. So, if we all do it occasionally, how bad can avoidance really be?
When avoidance becomes your sole strategy for dealing with a particular fear, and it begins to interfere with your everyday life and holds you back from doing what you love, another approach is necessary. Avoidance is a form of temporary relief, but it does not actually improve your overall quality of life in the long term. Eventually, it can lead to the development of other harmful behavior patterns. Over time, avoiding the fear or participating in compulsive thoughts or rituals actually increases your anxiety and may lead to extreme responses such as never leaving the house.
Getting Started
How can you begin exposure therapy sessions? It starts with the therapist working closely together with you to establish a trusting relationship and identify exactly what you fear. They will also discuss what you may view as your “worst-case scenario.”
Essentially, the goal of this collaboration is to target exactly what you’re most afraid of happening. To prepare for the treatment phase, the therapist will use everything they’ve gathered to put together a careful, step-by-step plan (also called hierarchy of fears) for gradual exposure.
How It Works
Over time, the therapist will slowly expose you to what you fear. This may include imaginal (thinking about your fears) or in-vivo (in real life). The in-vivo exposure will take place in a completely safe environment with the support and company of the therapist. You will never have to enter a chaotic situation during treatment where you have to face your triggers with no support. The idea is to start with less distressing fears and gradually move up to more fearful situations as you gain confidence to face your anxiety.
In these scenarios, you’re not supposed to make any efforts to avoid or minimize your exposure to the trigger. Of course, this can be very difficult. But with their therapist’s support it can get easier. And that’s exactly why they’re there.
Ultimate Goal
By the end of the treatment course, the ultimate goal of exposure therapy is to ensure that you no longer feel the need to avoid the trigger. Alternatively, if you have OCD, you will recognize that you will be safe without performing rituals and mental compulsions or responses. Through consistent exposure therapy followed by response prevention, you can begin to see that the situation you thought was so dangerous is not the threat that your mind built it up to be.
Ideally, you will slowly stop practicing avoidance in your daily life.
Exposure therapy is not a method of erasing memories of traumatic events or telling a person that their fears don’t matter. To the contrary, proving to them that they are capable of facing these triggers without being harmed is the ultimate goal.
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Do you suffer from panic disorder or OCD? Are you interested in trying exposure therapy and response prevention (ERP) to see if this approach can help you in your healing journey? As a trained CBT and ERP psychologist, I can help you decide if ERP would be helpful for you. Learn more about OCD treatment, or feel free to contact me to discuss the benefits of exposure therapy and next steps.
Obsessive Compulsive Disorder
In our digitized world of multiplying memes, the letters OCD are often misrepresented. Obsessive-compulsive disorder (OCD) is a far more complex, nuanced, and varied condition than you might imagine based on its pop-culture portrayals. It is not the same as being a so-called “neat freak.”
Sometimes, you might have moments or topics or people that bring out the obsessive thoughts in you. Just as often, you may temporarily behave compulsively to cope with anxiety. However, the D in OCD is for “disorder,” and that is what shifts things into the diagnosable range.
OCD is not a quirk, and it’s not a phase. It is a mental health condition, and like any other mental health condition, it will have an impact on your relationships.
This disorder can impact your relationship in many ways:
- Secrecy: Feeling a need to hide your symptoms
- Detachment: Depression is common with OCD, and this can make it challenging to connect with others
- Intimacy: OCD symptoms can make sexual relations a challenge
- Dependency: Relying on your partner to reassure you to reduce your OCD anxiety
- Relationship OCD: This is when a partner becomes the focus of a person’s OCD — to the point of obsession
Educate Yourself and Your Partner
The more you understand OCD and its agenda, the easier it will be to identify and response effectively to OCD thoughts and compulsion. Self-education is key to gaining this knowledge and understanding. If a healthcare professional diagnosed you with OCD, an excellent approach is to do the work to understand your diagnosis. Since OCD manifests differently in each person, this effort will require a blend of comprehensive research and personal monitoring.
If you are in a committed relationship, your self-education will need to morph into a collaborative effort for the health of the relationship. Your partner also needs to understand OCD and how it works in you to be able to support your treatment. This approach is not about lecturing or “schooling” them. Instead, you will need a teamwork approach to lay a foundation for understanding and adjusting expectations. Often, OCD works to undermine your relationships with yourself and others. Many partners find themselves at the mercy of their partner’s OCD compulsive behaviors and offer reassurance in an effort to “help” their partner reduce anxiety. These well-intentioned efforts can do more harm than good. Your psychologist or therapist can play a significant role in this process. They may encourage your partner to sit in on some sessions to help ensure smooth progress and offer more effective tools for handling OCD together.
Commit to Healthy Communication
Consider this your foundation. Healthy communication is direct, respectful, compassionate, and done face-to-face regularly. It involves strong listening skills and a willingness to learn. Healthy communication is where trust is built. As that bond develops, solutions and resolution become more attainable.
Manage Your Symptoms
Sure, this is easier said than done. Even so, it is non-negotiable. Throughout your treatment for OCD, you are encouraged to stay in steady contact with your physicians, therapists, etc. to stay on top of developments in your symptoms and treatment goals. Treatment strategies can and will evolve throughout the recovery process.
Keep Your Partner Involved (and up to date)
To avoid shame and secrecy, both partners must lean in and remain fully engaged. Once the lines of communication are open, as discussed above, it is important to keep your partner updated on treatment goals or changes, so they can be supportive in the recovery process.
Participate in Individual or Group Therapy
You will see more consistent gains in your recovery if you actively participate in therapy and follow-through on the individualized treatment plan. Your partner can support your commitment to treatment and even attend some sessions (see below). In some cases, the non-OCD partner may choose to seek their own individual counseling to better manage their feelings, reactions, and expectations.
Call in the Experts
Individuals struggling with OCD usually need some professional help in the form of counseling and specialized treatment targeting OCD. Your sessions — in-person or via video chat — are a safe space in which sensitive topics can be discussed openly and productively without shame or embarrassment.
Neither you nor your partner should expect yourselves to figure out everything at once. Having the benefit of a skilled guide can be a significant game-changer in terms of keeping your bond secure and growing and not allowing OCD to negatively impact your relationship. Please reach out to me if you’re ready to begin your journey toward OCD treatment and recovery.
