During OCD Awareness Week in October, I sat in front of my computer, mesmerized, as I watched a live Internet broadcast of first-person OCD stories. At the same time these stories were being broadcast, there were chat rooms open where people could connect and talk about anything related to OCD. I joined right in, letting everyone know that while I was not an OCD sufferer myself, my 20-year-old son had recently recovered from severe OCD. I wanted to share our story as well as learn all I could about the disorder.
At one point during the chat, I connected with a distraught young woman who had been seeing a therapist for quite some time, but her OCD was getting worse, not better. “Is the ERP therapy too difficult for you to do?” I asked her. “ERP therapy?” she responded. “What’s that?”
I was stunned, though in retrospect I’m not sure why. Our family had floundered and then fought our way through a disorienting maze of treatments and programs, desperately trying to find the best help possible for Dan. But I had thought Dan was the only one who had been steered in the wrong direction, sent to the wrong therapists, and put on the wrong medications. It was then and there that I became an advocate for OCD awareness.
Exposure Response Prevention Therapy (ERP therapy) is a type of cognitive-behavioral therapy (CBT) and, in my son’s case, a very effective treatment for OCD. In a nutshell, this therapy involves the person with OCD facing his or her fears and then refraining from ritualizing. This is extremely anxiety-provoking initially, but eventually the anxiety starts to wane and can sometimes even disappear. A concrete example of ERP therapy in action would involve someone with OCD who has issues with germs. They might be asked to touch a toilet seat and then refrain from washing their hands. Treating OCD with ERP therapy has even been the topic of some reality shows over the past few years. So why do so many therapists remain in the dark?
When Dan diagnosed himself (with the help of the Internet) at the age of 17, he was referred to a well-respected clinical psychologist in our area. This therapist employed traditional talk therapy, which included examining underlying issues. This form of therapy is usually ineffective in treating OCD. In fact, talk therapy often exacerbates OCD. Repeatedly talking about their fears and reassuring OCD sufferers only adds fuel to the fire. OCD is not something rational that can be discussed. It is a neurologically-based anxiety disorder. In fact, a study done in 2007 showed that OCD sufferers had less gray matter in the areas of the brain associated with suppressing responses. Telling someone with OCD not to worry is like telling someone with asthma to stop having trouble breathing. It isn’t possible.
And so Dan spent months in therapy, getting worse. He ended up spending nine weeks at a world-renowned residential program for OCD, and that was his, and our, first introduction to ERP therapy.
You don’t have to go to a residential program to get the right help for OCD, but you do need to find a properly trained therapist who specializes in the disorder. What works for one OCD sufferer may not always work for another. You and your therapist will work together to find the right balance of therapy, medications, and stress management techniques that will give you the best chance of success. The best resource out there for finding these competent therapists is the International OCD Foundation. Not only do they list health care providers by state, they give you tips on what questions to ask when interviewing a prospective therapist.
ERP therapy is difficult, but with hard work the OCD sufferer can improve dramatically. Three years ago Dan was so debilitated by severe OCD that he could not even eat. ERP therapy literally saved his life and today he is a rising senior in college with a wonderful life ahead of him. ERP therapy often is very effective for those with OCD. Having OCD is tough — getting the right help shouldn’t be.