WHAT IS THE TREATMENT FOR OCD?
OCD is a very treatable condition and, in many cases, medication might not be necessary. Hundreds of research studies agree that the best treatment for OCD is a form of cognitive behavioral psychotherapy known as "exposure response-prevention" (ERP), which I practice. ERP helps OCD sufferers overcome their fears and reduce their compulsive behaviors gradually, at a pace they're comfortable with. While results are gradual, ERP does not require long term traditional psychotherapy. Results occur in months not years. ERP has been shown more effective in the long run (in terms of curing and preventing later relapses) than either medication or other therapies. For details see the tab, "Describe Treatment."
WILL I NEED MEDICATION?
Medication helps many people reduce their symptoms, but the symptoms bounce right back once you stop the meds. ERP, by contrast, provides OCD sufferers with a skill or technique to "boss back" the OCD and reclaim their lives. This gives them a skill to prevent relapses. The majority of my OCD clients, and I've seen many severe cases, benefit from therapy with no medication at all. And those who are on meds, can even be weaned off of them after ERP therapy is concluded.
Having said that, I have recommended medication to some people if they are in an emergency (potential job loss or divorce) or if they are too severe to even engage in therapy, but I usually save it as a last resort. I usually recommend to others that they start with the therapy first and see how far they can go without meds. You can always add them later if needed. However, if you are on meds now, I would not drop them until your condition has largely been stabilized by ERP, and I would only recommend weaning off them while you continue with the ERP therapist for some months after, while eliminating any leftover symptoms the medication was masking .
There are at least a dozen medications used for OCD, but usually an SSRI or fast acting anxiolytic medication is used. This is not an exhaustive list. Different things work for different people and it sometimes involves some trial and error before the right medication is found for each individual. So if one medication doesn't work, don't give up on meds entirely. Each person's chemistry is different, and usually there is some medication that will work for you.
HOW CAN I FIND AN OCD THERAPIST?
I practice in Manhattan, NY City and northern NJ. I would be happy to arrange an appointment at 212-726-2390. You can also request a free consultation by email or can book an appointment online. If you're out of the NY area, you can also find a therapist in your area by visiting the OCD Foundation web site (www.ocfoundation.org).
If you're considering another therapist, THERE ARE 2 "TEST QUESTIONS" YOU MUST ASK A THERAPIST before you make an appointment:
(1) Is ERP their main technique? If not, don't make an appointment. ERP is the only therapy endorsed by the OC Foundation.
(2) How many people have they SUCCESSFULLY treated for OCD? By "successfully" I mean that by the end of therapy, the person is not on any medication, and is almost if not completely free of all obsessions, compulsions, and excessive anxiety. They should be able to tell you they did this with at least SEVERAL DOZEN people if you are in a major metropolitan area (NY, LA, Chicago, Boston) or at least several people in other areas or countries.
WHY DO SOME PEOPLE HESITATE TO SEEK TREATMENT?
On some level every OCD sufferer knows something is wrong, but it's scary to accept it. Sometimes reading about OCD can help the sufferer realize they're not alone, and that OCD isn't the worst thing, even though it may currently be interfering greatly in their life.
Many OCD sufferers arrive in my office after years, in some cases decades, of refusing to get treatment. The reasons they hesitated differ with each individual. Some common reasons are they think they're the only one going through this. Some people don't know OCD can be treated. It's a lot harder to seek help if you think it's untreatable. Many others think the therapist will force them to face their worst fears (a false assumptom I might add), which is too intimidating to them. Others fear therapy will actually make the problem worse. Some can't even leave their homes on time to go to an appointment, or can't leave home at all, because of their elaborate compulsions or avoidant behaviors. Others are simply too embarrassed by their behavior to share it with others (even though I've heard just about everything hundreds of times). Finally, many OCD sufferers worry that they are "going crazy" and in very extreme cases can become very depressed, anxious or in extremely rare cases actually hallucinate, and they might fear a therapist will tell them it's something worse than OCD, like schizophrenia, etc. (which it's not).
HOW CAN FAMILY AND FRIENDS HELP?
The most important advice I can give to the family and friends of an OCD sufferer is to empathize with what the OCD sufferer is going through. Don't let him feel blamed, he is a victim, as indeed the whole family is being victimized by OCD. It is OCD that is the enemy, not person suffering with it. He cannot stop it himself. It is important for family and friends to unite with the sufferer against the true enemy, OCD.
At the same time, family and friends should not accomodate the OCD. That would merely reinforce the problem. It's not a problem for the sufferer if everyone goes along with it. So while you shouldn't scold him, you also should not perform these compulsive behaviors for him. Don't take care of chores he avoids, or allow yourself to be delayed for events and appointments. You might have to leave for appointments without him and have him join you later (or not at all).
Most importantly, don't try to persuade an OCD sufferer that his worries are irrational. That will just make him worry more. It's like telling someone not to think about a white elephant. It just makes them think about it more. I can't emphasize this enough.
It may also help to let the sufferer know that OCD is highly treatable, and that it's not the worst thing. It's a lot easier to accept they have OCD if they know it can be treated. The other good news is that it doesn't require long term psychotherapy and might not require medication. Emphasize that therapy is not scary and they will never be asked to do anything they feel uncomfortable about. Finally, encourage the OCD sufferer to read some books about OCD and to view this website.
WHAT ARE SOME GOOD BOOKS OR MOVIES ABOUT OCD?
There are many books about OCD. One that I recommend is "Confronting the Bully of OCD," by my former client, Linda Maran. It is one of the few books written by someone who actually had OCD, instead of by a professional. It is available on Amazon.com.
Two others that I recommend are:
When Once Is Not Enough (by Gail Steketee) and Stop Obsessing (by Edna Foa)
The cable TV shows "Obsessed," "Hoarders," and "Monk" and the movies, "The Aviator" and "As Good As It Gets," also depict the lives of OCD sufferers.