Obsessive-Compulsive Disorder (OCD)
Obsessive-compulsive disorder (OCD) is distinguished from the other anxiety disorders in that the person is usually overwhelmed with repugnant or fearful thoughts, impulses or images (the obsession). The person attempts to suppress or neutralize these events by performing some sort of senseless behavior or mental act (the compulsion). The person reports that these compulsions somehow gives the relief from the obsessions. However, the relief tends to be short-lived, and the person is driven to repeat the rituals once again. Any attempt to stop the compulsion by the person usually results in a rapid increase in the obsession, driving the person to repeat the ritual.
The obsessions and compulsions take many forms, but most cases tend to center around issues such as:
- Fear of contamination – leading to excessive washing
- Fear of hurting others – leading to checking to see if someone was hurt
- Fear of repugnant thoughts – with attempts to control thinking
- Need to keep things excessively neat – wasting many hours
- Need to hoard unnecessary items – such as newspapers or clothes
People can spend hours checking locks, stoves, filing cabinets, scrubbing themselves raw in the shower, repeating a prayer hundreds of times until it feels right, filling their homes with garbage rather than taking the risk of throwing anything out that is valuable, or undergoing other compulsive behaviors which they see as ridiculous, but necessary, in order to escape the anxiety.
Cognitive behavioral therapy (CBT) alone greatly helps the majority of OCD patients and allows them to return to a normal pattern of living. The treatment involves a systematic, graded exposure of the obsessions, along with teaching the patient a series of behavioral responses that are incompatible with the compulsions. For instance, the patient would be taught how to tolerate being mildly contaminated, and resist the desire to wash. The treatment involves a careful exposure to ever-increasing disturbing obsessions, with the patient practicing responses which are more in keeping with normal behavior.
Treatment length varies, with the average length being approximately six months. Relapse rate is very low after a patient has undergone successful CBT, with only about 10% of the patients relapsing over the next year. If, after several months, a patient is not improving sufficiently with the CBT approach, medication may be suggested. The combination may increase the chances of the patient being able to escape from the disorder.
During the initial consultation at Behavioral Associates the diagnosis will be made and you will be matched to a staff therapist who will devise a treatment plan to help relieve your symptoms of OCD. Behavioral Associates also has a psychiatrist on staff if it is decided that CBT would be more effective in combination with medication.
Contact us or call our office at (212) 860-8500 to schedule your initial consultation.