Fear of judgment, barriers to accessibility, uncertainty about therapy, and lack of access are just a few of the reasons why people don’t seek therapy for OCD. However, OCD is manageable, and exposure and response prevention (ERP) therapy can help you learn to break the cycle of symptoms.
If you have obsessive-compulsive disorder (OCD), you likely know how exhausting and time-consuming the condition can be. Dealing with what can feel like a constant loop of unwanted, distressing thoughts can be debilitating if left untreated. While OCD is manageable with specialized therapy, taking that first step toward getting help isn’t always easy.
If something is holding you back from seeking care, know you’re not alone. In this article, we’ll explore some of the most common reasons people don’t reach out for therapy, and how overcoming these challenges can help you get your life back from OCD.
1. Lack of awareness and misdiagnosis
There’s a common misconception that OCD is just about germs, cleaning, and organizing, but that’s not the case. The condition is really about unrelenting, often shameful, intrusive thoughts that cause a lot of distress—even if they aren’t visible to others. OCD can show up in many different ways, from thoughts of self-harm to a fear of becoming a pedophile. But, it’s crucial to know that people with OCD are extremely unlikely to act on these thoughts. Just because you have these thoughts doesn’t mean they have anything to do with who you are.
When OCD symptoms are left untreated, misdiagnosed, or are approached with general therapy, your condition can worsen, says Tracie Ibrahim, LMFT, CST, NOCD’s Chief Compliance Officer. In fact, it can take 14 to 17 years on average to get effective treatment after you begin experiencing symptoms.
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2. Guilt and shame
Obsessions—whether intrusive thoughts, images, urges, feelings, or sensations—often include upsetting content. Because of this, you may worry that your therapist will judge you for your unwanted thoughts. “People with OCD think that they’ll be arrested, that their kids will be taken away, or that somebody will leave them,” says Ibrahim. “There’s a lot of shame and guilt with OCD, and it shouldn’t be there.”
There’s a lot of shame and guilt with OCD, and it shouldn’t be there.
Tracie Ibrahim, LMFT, CST
No matter how “bad” you believe your obsessions are, a therapist who specializes in OCD will be compassionate to what you’re dealing with—and likely won’t be surprised by anything you have to share. They know that these thoughts don’t align with your personal values, and that’s exactly why you want to get rid of them. “We aren’t going to be shocked,” says Ibrahim. “We’re going to help you feel comfortable. We’re here to support and treat you.”
3. Difficulty getting proper care
Because OCD requires a special type of treatment, it can be hard to find a trained therapist who really understands the condition. In fact, as little as ten years ago, people with OCD had to spend hours weeding out professionals who didn’t know how to assess and diagnose it, or who might suggest incorrect types of therapy that could worsen your symptoms.
Unfortunately, it’s still the case that some therapists claim to treat OCD, but haven’t received the specialty training necessary to provide proper care. It’s crucial to work with an OCD specialist who knows how to diagnose and treat the condition with the most effective treatments. The best approach for treating OCD is exposure and response prevention (ERP) therapy, a specialized form of cognitive behavioral therapy (CBT) that teaches you how to respond differently to your intrusive thoughts, so you feel less distress and can focus on other aspects of your life.
Although ERP has been proven to significantly reduce distress from intrusive thoughts, Ibrahim says it has historically been hard to access due to issues with insurance coverage. OCD has long been misunderstood and misdiagnosed, which means some insurance companies haven’t even known their policy-holders have OCD—or what the best treatment approach is. ERP can be expensive, costing about $350 per hour without insurance coverage. Plus, there was often a shortage of therapists, leaving people stuck on waiting lists, or traveling long distances for care.
Fortunately, awareness is growing. Now, through NOCD, over 155 million Americans can access ERP therapy using their health insurance benefits. And since we have over 650 specialty-trained therapists in our network, you can get started in therapy within a week—without wasting time sifting through directories of therapists who may or may not know about the condition.
4. Anxiety about therapy
ERP therapy teaches you how to sit with the uncertainty and discomfort of your obsessions, and that might feel intimidating at first. “It sounds anxiety-inducing to say that we’re going to face our fears,” says Ibrahim. This is especially true, she says, if you perform compulsions because you think these behaviors keep you safe.
“Just imagining that you’re going to have to sit and talk about the thing that is haunting you feels like an uphill battle,” says Ibrahim. But, if you stick with therapy, the challenge will get easier with time. Your therapist will work with you every step of the way to make sure you’re ready for each new exercise, and the results will be worth it.
Just imagining that you’re going to have to sit and talk about the thing that is haunting you feels like an uphill battle.
Tracie Ibrahim, LMFT, CST
5. Fear of getting better
As time-consuming and exhausting as OCD symptoms can be, you may feel like some of the things you’re doing help quiet the noise from your intrusive thoughts and anxiety. Sometimes, the condition can make you think that your compulsions are protecting you or your loved ones from harm. This can make it feel really scary to consider the possibility of trying to stop those behaviors, even if you know therapy might help. Ibrahim says these fears are common, especially if your OCD has led you to believe you’re responsible for other people’s safety.
But, in order to find relief and get back to doing the things you enjoy, you’ll have to let go of those behaviors. Even gradual steps can help. Compulsions only reinforce fears, teaching you that you can’t withstand any negative emotions without engaging in ritualistic or repetitive acts. The point of ERP therapy is to understand that both safety and uncertainty coexist in life, notes Ibrahim. “You have no control over either one by doing compulsions,” she says. ERP therapy helps you learn that you can handle whatever life throws at you—and over time, you’ll likely find that life feels a lot more manageable.
Freedom from OCD is possible—here’s where to start
Seeking therapy for OCD can seem overwhelming, but remember that this isn’t a journey you have to face alone. While fear of judgment, uncertainty about treatment, and other barriers may be holding you back, effective treatment can be life-changing. Taking that first step toward ERP therapy can lead to long-term relief. When you’re ready to start your treatment journey, help is here.
Key takeaways
- If obsessive-compulsive disorder (OCD) is left unmanaged, symptoms can worsen over time, leaving you stuck in a cycle of obsessions and compulsions.
- While effective OCD therapy is available, many avoid it out of fear of judgment, concerns about treatment, and lack of access to OCD specialists.
- ERP therapy is the most effective form of treatment for OCD, helping you release compulsions and regain control of your life.