This question gets asked repeatedly on Quora, a place where I answer questions on OCD. I thought it was worthwhile converting it into a blog. So here is my answer to it:
Firstly, do ascertain if it is OCD. Have you gotten it diagnosed? Have you taken the YBOCS test? If you have mild to moderate OCD, there’s a chance you may be able to beat it yourself. Here’s the test link: https://psychology-tools.com/yale-brown-obsessive-compulsive-scale. This link allows you to determine if you have OCD and how severe it is.
If it is severe, it becomes a clinical issue, which therapy will help, but it is better if medicines are added on. I would suggest seek a doctor for help if it is severe. Because apart from OCD, if there are any co-morbidities, a psychiatrist will be able to pin them down and suggest a comprehensive treatment regime.
If it is mild to moderate, you can do the following:
- Read Brain Lock by Dr Geoffrey Schwartz. He outlines the 4 step method to get control over OCD in it.
- You could also read up on Exposure and Response Prevention therapy and along with a willing caregiver, try and practise it at home. It is not an easy method but it is by far the best method for dealing with OCD. But it needs to be administered well. I have covered it in my blog on ERP.
Briefly though, it is relatively simpler if you’re aware of your compulsions. You need to list them down and grade them in order of severity. After that, you need to start picking up the ones with the least amount of power over you and face them. And then stop yourself from offering the usual response of performing your compulsions. This will cause anxiety. But if you stay with the anxiety long enough, without giving in to your compulsions, it will go down eventually and you’ll be able to handle that fear much better. Check out my Anxiety Graph blog to understand how anxiety increases first and then goes down.
This will of course take many attempts to master, there will be failures, anxiety and frustration to make you want to give up. But if you rise above all that and persist, you’ll be able to get better. Then slowly, inch your way upwards to larger fears. Follow the same process.
If you have Pure O, that is, where the compulsions are not apparent, it will take you help to identify what you need to stop. Is it rumination? Seeking reassurance? Proxy Compulsion? Avoidance? Distraction? Identify those and the first step towards getting better will have been taken.
- Practise mindfulness through meditation when you’re at your best and master it so that you can summon it at will, when you’re stressed.
- Keep yourself happy. OCD is draining and you may need to make special effort to keep yourself upbeat. Make sure you invest time in that.
- Make dietary changes. Some diet supplements have helped people, which you could explore more about.
What will NOT help?
- Obsessing over finding new information on OCD, in the hope that the more you know the better you will be able to deal with it. This is in fact, a type of compulsion, called Rumination. You should stop yourself from giving in to the temptation of more research.
- Avoiding things that trigger your OCD. The more you avoid, the larger the problem will become.
- Getting someone else to do the compulsions for you. That is proxy-compulsion and again, it only shifts the responsibility of the compulsion, it does not eliminate the need for it.
- Seek reassurance from people. That strengthens the OCD as well. You can read the Reassurance blog for more information.
- Distract yourself while your obsessions are triggered by praying, or talking to someone, in order to suppress the thought. Suppression will only provide temporary relief. It does not take the problem away.
All of this may be difficult to understand and hence a coach is required who will help you see this through. And it may not be easy to beat OCD at home, after all. But if you are determined and want to see it through, you can.
I have heard about acceptance commitment therapy & cognitive drill therapy? Are they also treatment methods for OCD? And at what levels of severity is it useful? Can they be administered by the person himself or need a coach?
If you notice, all these forms of therapy draw from the other. ACT talks about Acceptance through mindfulness and Commitment to change.The change then comes from distancing yourself from the reaction the inability to accept the difficult feelings and avoid them. In that sense, one is facing them.
Cognitive Drill Therapy is verbal exposure. Instead of a future fear, the fear is thought of as being in the present. So instead of “I will get infected”, the statement is changed to “I am getting infected”, and the resultant anxiety is tolerated to get habituated.
As for severity, all cases require a holistic approach involving combinations of medication, meditation, diet changes, and therapy. As for whether these two types of therapy work better or not, depends upon how committed the sufferer is to the process.
While it may be technically possible to beat OCD at home, as mentioned in the blog, it is extremely difficult. I would suggest therapy. Also, I wouldn’t suggest researching too much on OCD in the hope of finding a magic cure. The more one researches, the more one gets drawn into rumination, which is counter productive.
Hope this answers the questions.
Yes, it does answer the question. What i deduce is that mindfulness, tolerating anxiety and feeling the problem is in the present (in case of Cognitive drill therapy) is all a part of CBT itself. As ERP itself dwells on exposing to anxiety inducing stimuli. So these are different terminologies used but the foundation is understanding the irrationality (via being mindful) and facing the fears. Thanks for the info Sunil.