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How to Control OCD

W. Nate Upshaw, MD

W. Nate Upshaw, MD

Dr. William Nathan Upshaw is the Medical Director of NeuroSpa TMS®. Since receiving training from the inventor of TMS Therapy nearly a decade ago, Dr. Upshaw has been a pioneer, champion and outspoken advocate of TMS Therapy. Dr. Upshaw’s holistic experience in the field has transformed him into Florida’s leading advocate for widespread accessibility to TMS Therapy.

About Dr. Upshaw

One of the more common myths about Obsessive-Compulsive Disorder (OCD) is that everyone is “a little bit OCD.” Obsessive-Compulsive Disorder takes over a person’s life completely and is not a quirk of personality. Instead, OCD is a common, often severe psychological disorder that affects about 2.3 million adults in the United States.  OCD is known for producing intrusive, disturbing and repetitive thoughts (obsessions), coupled with compulsive, ritualistic behaviors. Performing these behaviors temporarily relieves the intense, unbearable anxiety that the obsessions cause.

OCD is a chronic, life-long condition that cannot be cured. However, it responds well to treatment, which can greatly reduce its impact on a person’s life. Treatment for OCD involves psychotherapy, medication, or alternative therapies such as transcranial magnetic stimulation. 

How to Stop OCD’s Obsessive Thoughts

Treating OCD is a challenge, in part because OCD is a system of disordered control. Attempting to control OCD directly runs a high risk of fueling the very system that generates OCD itself. Consider obsessional thinking. You can’t prevent those thoughts. By their nature, they’re unpredictable and irrational. You can’t argue with them by presenting rational information. With treatment and practice, you can learn to resist performing a compulsive behavior, but you cannot un-think obsessive thoughts. Studies have shown over and over that thought suppression not only fails but generates more anxiety and more compulsive behavior.

Professional Treatment for OCD

Psychotherapy alone is often enough for a person to learn how to break OCD habits. It involves meeting with a mental healthcare professional weekly. One of the best forms of therapy for OCD is cognitive-behavioral therapy (CBT), which helps people learn how their thoughts and emotions shape their behavior. Unlike psychodynamic and other forms of therapy, CBT is focused on getting results and reducing symptoms. It works considerably faster than medication treatment, taking weeks to months, not years.  One of the best benefits of CBT is that you learn how to be your own therapist. You can take the techniques you use anywhere.

In particular, a form of cognitive-behavioral therapy called Exposure and Response Prevention Therapy (ERP) is ideal for treating OCD. ERP helps people break OCD habits. Compulsive behaviors follow intrusive thoughts, which trigger anxiety that something terrible, something catastrophic will happen unless certain compulsive behaviors are carried out. People perform these behaviors to relieve the anxiety that comes from the fear of these disasters. Although people understand their behavior is illogical, they feel compelled to perform compulsions in order to prevent the imagined disaster from happening. OCD behavior, in that sense, becomes habitual and people get stuck in the OCD cycle. 

The feelings of anxiety, even terror, that something terrible is going to happen, are quite real. A person with OCD understands this logically, but that doesn’t help reduce the fear or anxiety. Although compulsive behaviors temporarily remove anxiety, in fact, performing those behaviors reinforces the neurological basis of OCD itself. Compulsive behaviors feed energy into the whole fixed routine, so breaking OCD habits is essential for controlling your OCD.

ERP focuses on habituation; that is, repeated exposure to a stress-producing stimulus causes an incremental decrease in that amount of anxiety the stressor provokes. For example, if a person feels compelled to wash their hands repeatedly for fear of being contaminated after touching a doorknob, a therapist would ask a client to touch a doorknob and refrain from washing their hands. 

That’s a simplified example. After all, if the client could refrain from excessive washing, they would. The difference is that in ERP the therapist is present with the client, helping them process their emotions, particularly the anxiety. Exposure is gradually scaled up. At first, the client would work with the therapist in the office but would scale up to going to places like a store with the therapist. The therapist helps the client in each setting to tolerate the stress. Over time, the client learns to resist the urge to perform compulsive behavior on their own.

Controlling OCD is absolutely reliant on gradually eliminating compulsive behaviors. There are many techniques therapists teach clients to tolerate anxiety, including self-distraction. Distracting one’s self allows time to intervene between the emergence of the distressing thought and performing one’s particular compulsion. Anxiety peaks and then drops off, allowing a person to avoid OCD counting, checking, hand washing, and all the other various kinds of rituals.

Transcranial magnetic stimulation (TMS) is a newer therapy recently cleared by the FDA for treating OCD and depression. TMS uses powerful magnetic fields to stimulate over-active areas of the brain that lead to obsessive, “stuck” thinking. This leads to a reduction in overall OCD symptoms. The best part of TMS is that it’s pain and side effect free, making it an excellent option for those seeking an effective and hassle-free treatment. 

This blog post is meant to be educational in nature and does not replace the advice of a medical professional. See full disclaimer. 

Works Cited

Camprodon-Gimenez, J. (n.d.). Transcranial Magnetic Stimulation (TMS) for Obsessive Compulsive Disorder (OCD). Retrieved April 5, 2020, from https://iocdf.org/expert-opinions/transcranial-magnetic-stimulation-tms-for-obsessive-compulsive-disorder-ocd/

Hezel, D. M., & Simpson, H. B. (2019, January). Exposure and response prevention for obsessive-compulsive disorder: A review and new directions. Retrieved April 5, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6343408

Obsessive-Compulsive Disorder (OCD). (n.d.). Retrieved April 5, 2020, from https://www.nimh.nih.gov/health/statistics/obsessive-compulsive-disorder-ocd.shtml

Penzel, F. (n.d.). 25 Tips for Succeeding in Your OCD Treatment. Retrieved April 5, 2020, from https://iocdf.org/expert-opinions/25-tips-for-ocd-treatment/

Penzel, F. (n.d.). Ten Things You Need To Know To Overcome OCD. Retrieved from https://beyondocd.org/expert-perspectives/articles/ten-things-you-need-to-know-to-overcome-ocd

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