Selecting The Right OCD Therapist
Across the nation, and here in northeast Florida, the OCD community is underserved by our healthcare providers. Many patients are mislabeled, misunderstood, and misdiagnosed by competent, well-meaning clinicians. In 2004, Dr. Michael Jenike, noted psychiatrist and anxiety disorder specialist, reported in the New England Journal of Medicine, that most people with OCD will spend an average of nine years seeking treatment for their symptoms before getting a correct diagnosis. Many will see up to four healthcare providers during this same time period. The fact is most of us do not recognize OCD, even mental health professionals. Selecting the right OCD therapist is crucial to a successful treatment outcome.
Many of my patients have told me that their previous counselors had no understanding of OCD or assumed that the etiology of their symptoms could be traced back to childhood trauma, control issues, and family of origin. What usually followed was a frustrating course of relationship oriented counseling that produced no positive results. This is, unfortunately, an all too common experience for many with OCD.
The International Obsessive Compulsive Foundation published a pamphlet in 2006 entitled “How Do I Know If My Therapist Can Treat Obsessive Compulsive Disorder?” It was written to help those with OCD to address the problem of selecting the right OCD therapist. It contains questions for interviewing a prospective therapist to determine whether or not there is a correct understanding of what is required to adequately treat OCD. The essential component to good OCD treatment is Exposure and Response Prevention (ERP).
The scientific community established definitively during the 1990’s that OCD is a biological disorder of the limbic system or feeling brain. Traditional talk therapy, which emphasizes examining underlying psychodynamic processes, is ineffective in treating OCD. The reason for this is that obsessions and intrusive thoughts, and the fear that accompanies them, are caused by a brain circuit problem, not unresolved conflicts. ERP, a form of behavior therapy, is the only research validated treatment for OCD. Cognitive Behavior Therapy (CBT), which focuses on modifying dysfunctional thinking, is also showing promise in treating OCD. The right OCD therapist will know how to use ERP.
The purpose of ERP is to extinguish anxiety by preventing patients from performing compulsions which are triggered by their obsessive thoughts. Patients are repeatedly exposed to their obsession based fears in a hierarchy of least to most distressing, and simultaneously challenged to resist their compulsive undoing or anxiety-neutralizing behaviors. It is hypothesized that ERP works because it makes use of the brain’s natural ability to habituate to repeated over-exposures to stimuli; OCD patients eventually “get used” to their obsessions, meaning, they are viewed as neutral thoughts. The result is a significant reduction in anxiety, or its elimination altogether. Under the guidance of a trained therapist, and with the support of others, patients can gain confidence over their OCD and get back control of their lives.
Selecting the Right OCD Therapist is Necessary
It is estimated that 60 to 80 percent of patients who undergo ERP can receive significant relief from their OCD symptoms, some without the need for medication management. ERP teaches patients essential coping skills for long term maintenance of OCD. CBT helps those with OCD to reassess the importance they give to their thoughts, including the tendency to overestimate danger. To foster the support of significant others, family and couples counseling is viewed as an important adjunctive treatment. The overall goal is to bring hope to the OCD sufferer. Selecting the right OCD therapist is necessary and essential to achieving this goal.
My experience in treating folks with OCD goes back to 1995. Over the years, I have studied formally and informally to advance my skill set. Forty-five percent of my practice is devoted to helping children and adults from all walks of life with OCD. Are you looking for the right OCD therapist? Please consider contacting me. I would like to help.
With warm regards,
Frank Morelli, M.A.
Licensed Mental Health Counselor