The image of therapy you have in your mind may look like the stereotypical portrayal you’ve seen in movies or on TV: someone sitting in an office with a therapist every single week for many years – maybe even for the rest of their lives – focusing on the same issues over and over again.
The truth is, therapy doesn’t have to look like that at all. Although our team at NOCD specializes in providing evidence-based treatment for people living with obsessive-compulsive disorder (OCD) and related conditions, we believe that it’s critical to let the community know when specialized therapy for OCD isn’t needed to the level that one might think.
In fact, our goal is for you to gain skills that will help you rely less on your therapist over time. This might sound counterintuitive: Why would a for-profit service that’s focused on offering OCD treatment highlight not continuing to get therapy for as long as possible?
It’s because of our company values. Our first value at NOCD is “Members first,” meaning everything we do each day is for the people with OCD we serve and their families. Our goal is for people to say no to OCD suffering, and yes to a life free of the tyranny of OCD.
Part of this includes utilizing the skills you learn during Exposure and Response Prevention (ERP) therapy – the gold standard OCD treatment – on a daily basis. While a therapist will be more involved in treatment at the beginning, you’ll eventually be better equipped to handle the things OCD throws your way without them. At that point, your therapist will transition to providing you support and will check in with you regularly, or as often as you need or want.
After you start treatment, here are two ways to recognize when you can rely on your therapist less:
OCD symptoms are causing you less distress.
People with OCD have specific fears called obsessions, which can come in the form of thoughts, images, or urges. The fears are recurring and ego-dystonic in nature, meaning that they’re the opposite of the person’s core values and character.
To make the fears and associated distress dissipate, people with OCD do specific actions called compulsions. Even though these actions might reduce anxiety caused by the fear in the short term, they typically make the OCD fear more severe and frequent in the long run.
It’s important to understand that compulsive actions are proven to make OCD fears worse. During OCD treatment, your therapist will purposefully trigger your fears and then teach you how to respond to them by accepting uncertainty, rather than by doing compulsive actions.
If you’re finding that any recurring unwanted thoughts, images, or urges aren’t causing significant distress or interfering with your life, then you may be at a point where you can reduce treatment. However, if another issue – such as anxiety or depression – is still affecting you, keep in mind that therapy for OCD can help with this, too.
Additionally, there are also many great organizations that work with anxiety that can assist you, such as the Association for Behavioral and Cognitive Therapies (www.abct.org) and the Anxiety and Depression Association of America (www.adaa.org).
You’ve become your own therapist and have the ERP-based tools to effectively self-manage.
As mentioned earlier, the goal of OCD treatment isn’t to lean on a therapist for life. It’s to eventually learn how to “become your own therapist” – a point when you’re so skilled at doing ERP that you can manage an OCD episode.
After seeing a significant reduction in OCD severity, your therapist should help you sustain results while slowly reducing the frequency at which they see you. For some people, this might take a few months. For others, it might take a few years. For everyone, the goal is the same: to be autonomous and fully functional in society without needing a therapist every week.
Despite this concept, many people with OCD who have achieved significant reductions in severity and improvement in quality of life stay in therapy for longer than they need. In some cases, they even compulsively avoid fully immersing themselves out of fear of the possibility that their OCD will return with vengeance. This behavior typically prevents the person from fully conquering their OCD and living life with confidence, since it creates a scenario that depends on their therapist.
If you are reading this and feel that you have gotten better but are staying in treatment as a compulsion, here is some encouragement. Think about the empowering feeling of knowing you can finally function independently. You can travel the world, have a relationship, play team sports, and even start a family because you know that you’ll be able to manage when OCD strikes.
And, if you are reading this and are newly looking for a treatment option that will be best for you, know that NOCD Therapy is designed to give you the support that you need, as you need it. We try to provide therapy more intensively at the beginning when you are first getting started, and we will lead you to eventually become your own therapist over time.
We also made it easy to receive additional support through the free NOCD app. The app enables people in our peer community to learn about OCD, give and receive support, and self-manage, all in one place. We built the community to help people learn from their peers to better understand their OCD symptoms. We also built tools with the functionality to empower people to manage OCD on their own when their therapist isn’t available, or when they get to a point where they don’t need to rely on their therapist as much as they did before.
Check it out by downloading the free app on the Apple App Store or Google Play. Or, if you’re early in your journey and could benefit from starting ERP therapy with one of our specialists, we invite you to book a free 15-min call with our team.