Obsessive-compulsive disorder, or OCD, is characterized by frequent and intrusive thoughts, images, or urges known as obsessions that can cause intense anxiety, distress, and fear. In an attempt to get rid of this distress and anxiety, people with OCD then perform compulsions, which can look like anything from repetitive physical actions to mental rumination. Not only can these compulsions take up hours of each day for people with OCD, but they actually make OCD worse over time.
This cycle of intrusive thoughts and time-consuming compulsions can be completely debilitating for many people with OCD and impacts all areas of life, including their health, work life, and relationships.
Despite having been listed in the past by the World Health Organization as one of the 10 most disabling mental illnesses, OCD is actually highly manageable with the proper treatment. In fact, the process of learning to manage OCD can be summarized in three steps:
Step 1: Identify all of your compulsive behaviors
This first step may seem simple: all you have to do is make a list, right?
Unfortunately, OCD makes things more complicated. While many compulsions may be obvious to someone suffering from OCD, taking up hours of their lives every day, others can be hard to notice, and may be difficult to distinguish from healthy behaviors. Seemingly innocuous habits like seeking reassurance from a partner or searching for advice online can be compulsions when done in response to the anxiety caused by obsessions, and even commonplace behaviors like these can make OCD worse over time.
Try to identify everything you do in response to intrusive thoughts, feelings, and urges. What makes the anxiety from your obsessions seem to subside? What behaviors do you regularly rely on to feel “better” when anxiety spikes? These may be compulsive responses to your obsessions—in order to manage OCD long-term, you first need to become the expert on all of these behaviors.
Step 2: Learn how to resist compulsions and sit with uncertainty
Recognizing your compulsions is an important first step, but in order to learn to manage OCD, you actually have to resist doing them.
Naturally, this is not easy. OCD may tell you that your compulsions are what keep you or your loved ones safe. You may feel that your compulsions are what allow you to get through the day, even if they take up countless hours of your time and drain your energy.
The more you do compulsions, the more your brain believes that compulsions are necessary to manage the “threat” caused by your obsessions. The problem is that your obsessions don’t actually pose a threat at all—it’s as if the alarm system in your brain is broken, and you need to re-train it. When you resist doing compulsions, and instead sit with uncertainty and anxiety, your brain learns that your compulsions do nothing to manage a real threat, but rather feed OCD and make it worse in the long run.
Step 3: Continue to practice response prevention over time
Recovering from OCD takes knowledge, courage, discipline, and, often, support. Once you learn how to resist doing compulsions, you have to master the skill in the long term.
The more you continue resisting compulsive responses, the more successfully you will be able to sit with the anxiety and uncertainty that comes from intrusive thoughts, feelings, and urges. This process is called habituation, and it’s the key mechanism to life-long OCD management. By habituating to uncertainty, you can finally regain parts of your life that you lost to compulsions, and your obsessions will cause you less anxiety as a result.
The best way to learn how to manage OCD
Together, these 3 steps to manage OCD are found in a form of therapy called exposure and response prevention (ERP). ERP is the gold-standard treatment for all forms of OCD, backed by years of clinical research.
Some people may try to do ERP on their own in order to recover from OCD, but ERP is often challenging at the start. Without first receiving guidance from an ERP-trained professional, they run the risk of not recognizing key compulsive behaviors, derailing their progress with exposures they’re not ready for, or finding themselves unprepared for setbacks along the way.
The best way to learn to manage OCD is to start ERP therapy with a licensed therapist who has specialty training in using ERP to treat OCD. A specialty-trained therapist will have the experience necessary to uncover all of your compulsions, teach you the techniques you need to master response prevention and sit with uncertainty, and keep you safe, motivated, and on track as you continue to manage OCD in the long term. By working with an OCD specialist to start, you’ll eventually be equipped to be your own therapist and will be able to handle when OCD strikes on your own.
No matter where you are in your OCD recovery journey, there is hope. At NOCD we understand from personal experience that OCD may feel debilitating and inescapable at times, but we also know that it’s highly treatable. You can take steps to manage OCD long-term, and get back to living the life you want to live.
At NOCD, all of our therapists are licensed and specialty-trained in treating OCD with ERP, and can help you master the skills needed to manage OCD. You can book a free 15-minute call with our team to get matched with a NOCD Therapist who is licensed in your region and get started with OCD treatment.