Highly Effective Therapy for OCD
What is Obsessive Compulsive Disorder?
Obsessive-Compulsive Disorder (OCD) is a mental health condition characterized by persistent, unwanted thoughts (obsessions) and repetitive behaviors or mental acts (compulsions) that individuals feel driven to perform. These obsessions and compulsions can significantly interfere with daily functioning and lead to psychosocial distress. OCD is driven by anxiety and atypical difficulty with uncertainty. It is maintained by ritualistic behavior, including mental rumination.
The OCD Spectrum
OCD has several related disorders that can be thought of as part of an OCD spectrum. Although OCD was formally given it’s own category and removed from the Anxiety Disorders section of the DSM (Diagnostic and Statistical Manual of Mental Disorders) in 2013, many experts consider anxiety disorders as existing along the OCD spectrum due to the prevalence of intense fears often combined with compulsive avoidance behavior.
Some of OCD’s related conditions don’t necessarily include obsessive thoughts, anxious distress, or fears, but rather are weighed more heavily on the repetitive or ritualistic behavior side of the OCD spectrum. Body-Focused Repetitive Behaviors (BFRB), such as Trichotillomania and Excoriation Disorder fall into this category, as does compulsive overconsumption of digital media or what some call “internet addiction,” although not a formal diagnosis recognized in the DSM at this time.
Common ways OCD manifests
Common obsessions include fears of contamination, fears of harming oneself or others, fears of losing control, or worries about symmetry and orderliness. Compulsions often manifest as repeated hand washing, checking behaviors, arranging items in a particular manner, or mental rituals such as counting or praying.
What causes OCD?
The exact cause of OCD is not fully understood, but it is believed to be a combination of genetic, neurological, and environmental factors. Individuals may have a history of anxiety or mood disorders like depression, which can exacerbate OCD symptoms.
Effective treatment for OCD
Treatment for OCD typically involves a combination of therapy and, in some cases, medication. Exposure and Response Prevention (ERP), a form of cognitive-behavioral therapy, is considered the gold standard for treating OCD. ERP helps individuals confront their fears in a controlled manner, decreasing the anxiety triggered by obsessions and reducing the need to engage in compulsive behaviors.
Recovery from OCD with professional help
If anxiety and compulsions cause distress and decrease your quality of life, it may be time for professional help. Anxiety and OCD has a way of making our lives small and robbing us of deeper social relationships and experiences. Compulsions are a short term solution and over time serve to maintain and increase the discomfort we’re trying to avoid.
You might fear your loved ones will be harmed or you’ll lose something of deep importance to you. You might fear you’ll accidentally do something awful or that you’re a horrible, immoral person. You might try to get things just right, but it’s never enough. No matter how many times you do the ritual or avoid the thing or the place, the peace doesn’t last.
I (Teva) offer evidence-based treatment tailored to meet the unique needs of each person struggling with OCD. I see clients in person primarily in Ventura, CA or via Telehealth for online therapy throughout the state. My compassionate approach helps you feel supported and understood as you work towards starting a new chapter.
Therapy can help with a range of common OCD themes:
Moral scrupulosity or religious OCD
Just right OCD and symmetry OCD
Sensorimotor OCD or somatically-focused OCD
Sexual orientation and identity-based OCD
Relationship OCD
Harm OCD
Taboo OCD
Contamination OCD
Fear of going crazy OCD
Health anxiety and OCD
Perinatal / Postpartum OCD
Body-Focused Repetitive Behavior (BFRB)
Body-focused repetitive behavior (BFRB) refers to a distinct group of disorders that are characterized by the recurrent, compulsive behaviors that specifically target your own body. Some of the most common examples of BFRBs include hair pulling, known as trichotillomania, skin picking, which is referred to as excoriation disorder, and nail biting, technically called onychophagia.
Coping Mechanisms for Anxiety, Boredom, Stress
BFRBs often serve as a coping mechanism to manage underlying issues such as anxiety, stress, or other forms of emotional discomfort. Individuals experiencing BFRBs may find that engaging in these actions provides them with temporary relief or distraction from negative emotions, momentarily easing their psychological burden. However, over time, such actions can lead to significant physical, emotional, and social repercussions, including visible physical injury, heightened emotional distress, and impaired functioning in daily life.
Evidence-Based Treatment Options
Effective treatment options for BFRBs often include cognitive-behavioral strategies that emphasize understanding individual triggers and developing healthier coping mechanisms. Techniques like Habit Reversal Training (HRT) can assist individuals in recognizing their urges and developing competing responses that deter the unwanted behaviors. Additionally, mindfulness practices can also be quite beneficial, as they promote awareness of body sensations and emotions, allowing individuals to experience them without judgment.
Therapy can support managing BFRBs through personalized treatment plans that incorporate a variety of evidence-based practices tailored to your unique needs, along with planning for relapse prevention. As with any behavioral issue, early intervention combined with a supportive therapeutic environment can lead to more effective and favorable outcomes.
Trichotillomania
Trichotillomania, which is commonly known as hair pulling disorder, is a complex mental health condition characterized by an overwhelming and often irresistible urge to pull out one's hair, which ultimately leads to noticeable hair loss and significant emotional distress. This compulsive behavior can impact various areas of the body, including the scalp, eyebrows, and eyelashes, and frequently results in not only physical damage but also emotional challenges such as heightened anxiety and low self-esteem. Many individuals who struggle with this disorder experience temporary feelings of relief or gratification during the act of hair pulling, which can serve to perpetuate the cycle of behavior and make it increasingly difficult to stop.
Treatment for trichotillomania typically involves a combination of therapeutic approaches, including Cognitive Behavioral Therapy (CBT) and Habit Reversal Training, to aid individuals in managing their urges and developing healthier coping strategies that promote overall well-being.
FAQs
Do you have in person availability for OCD treatment?
Yes, I have in person in availability in the beach town of Ventura, California, near Camarillo, Santa Barbara, Ojai, and Thousand Oaks. Online therapy is provided via HIPAA compliant Zoom and I see clients all over the state of California, including Los Angeles and the Bay Area.
What is your approach to treating OCD?
I use exposure and values-based modalities that have strong empirical support for recovery from OCD and anxiety disorders. My approach centers client’s culture and sense of agency. I primarily utilize:
Exposure and Response/Ritual Prevention (ERP)
SPACE (Supportive Parenting for Anxious Childhood Emotions)
Acceptance and Commitment Therapy (ACT) principles
Is Exposure-based therapy for OCD trauma-informed or trauma-sensitive?
Yes, the consent-based, gradual, and flexible nature of ERP where exposure pacing is determined by the client’s comfort level, may be suitable for clients with a trauma history. Current studies suggest OCD and PTSD may be treated concurrently using ERP and Prolonged Exposure (PE). The American Psychological Association (APA) has designated Cognitive Behavioral Therapy and Exposure-based therapy, specifically Prolonged Exposure, as the first line treatment for trauma.
While in therapy for OCD, will I have to engage in exposures that are against my religious beliefs?
No. As an ERP therapist who strives to practice cultural humility and cultural competence, I would not intentionally ask you to do anything that was against your religion or deeply held beliefs. Since treatment planning is collaborative, you will help design exposures aligned with your values. I work with many people of faith and respect the diverse beliefs and practices of my clients.
Can I keep my other therapist to process my trauma history or weekly challenges while in treatment with you for OCD?
Yes. You can keep your existing therapist to talk through weekly difficulties and to process other issues like developmental trauma and adverse childhood experiences. I would see you for OCD/anxiety ERP treatment only if you had another therapist. To provide the best care, I may request to consult with your other therapist about your treatment (with an appropriate release).
How many therapy sessions will I need for OCD recovery?
Recovery is a highly individualized process. The length of time for a successful course of treatment depends on variables like severity of symptoms, cooccurring mental health conditions, life stressors, commitment to change, and our working alliance. The structured modalities I use are about 20-24 sessions and can extend longer based on your individual needs.
Do you see children and adults for OCD treatment?
Yes. I treat child and teen anxiety, OCD, and compulsive screen with evidence-based therapeutic modalities. I treat children and teens whose parents are able to commit to collaborative treatment.
“So even if the hot loneliness is there, and for 1.6 seconds we sit with that restlessness when yesterday we couldn't sit for even one, that's the journey of the warrior.”
— Pema Chodron
