If you suspect that you may have obsessive compulsive disorder, you may not know where to begin to take next steps, especially if you don’t have a therapist already. You may start with a Google search, which (at least at the time that this was written) will bring up a good number of mental health companies, blog posts, and videos about OCD. It might seem overwhelming to sort through all this information while trying to understand what parts of it make sense for you and figure out what to do next. Here’s some steps you can take to get support for your mental health.
- Find a therapist who specializes in OCD
If you think you have OCD symptoms that are interfering with your ability to enjoy your life, it’s probably helpful to find a therapist, regardless of whether or not you are certain that you have OCD. A therapist can help you understand your symptoms, clarify whether you meet criteria for a diagnosis, and recommend treatments that could be helpful for you.
One thing that is crucial for treatment of OCD is to find a therapist who has experience and training in working with OCD-related disorders and treatments. Regular “talk therapy” is not helpful for OCD, and inexperienced therapists may unintentionally increase OCD-related symptoms. This is because “talk therapy” can include a lot of reassurance and validation that actually reinforces OCD symptoms. As a psychologist, I have unfortunately heard many stories from clients with OCD who were misdiagnosed or inappropriately treated, sometimes for many years. This has led to these clients feeling discouraged and having low expectations for the effectiveness of therapy.
It can be crucial to find a therapist who is a good fit for you. To start your search, you can ask your primary care physician to refer you to a therapist specializing in OCD. You can also check out psychologytoday.com and use their therapist finder tool. (This has helpful filters, including insurance type, and whether therapists are taking new patients.) Double-check the therapist’s bio or website to see if their description is a “one size fits all” or if they talk specifically about working or specializing in OCD. The International OCD Foundation has a directory of therapists who specialize in OCD as well. A therapist who seems to specialize in a variety of unrelated areas may not be the best fit for you, but it can help to talk with them to clarify this. Often therapists will offer an initial, free consultation so you and the therapist can decide if you would be a good match, so take advantage of that if you have questions for them or think they could be a good fit!
- Prepare for your appointment
It can be helpful to you and your therapist if you spend a little time to consider which symptoms have been bothersome to you, including the intrusive thoughts or images that show up and cause a lot of worries, such as “I’m always worried that I might make myself sick because of germs.” Other symptoms might include rituals or habits that you do to help make the worries better, such as doing safety checks in your home. Reflect on how these things are impacting your life, and what you would like to work on in therapy. These thoughts doesn’t have to be written down, but it can be helpful to take a little time to organize your thoughts before talking with your therapist.
- Try to limit searches, reassurance-seeking, and rumination while waiting for your appointment
One thing that OCD in particular pushes people to do is to seek certainty, even in situations where certainty can’t be guaranteed. You may notice urges to check multiple websites to find out if you “really” have OCD. We live in a data-rich society, where we can find out almost anything at any time. It can be really informative to be able to learn more about OCD and have a better understanding of yourself. However, if you’re spending hours and hours on searches that you would rather be doing something else, that may be a sign of compulsive behavior.
- Meet and interview your therapist
The day has finally arrived, and you are meeting your therapist! This is not only a chance for them to get to know you, it’s also a chance for you to get to know them, hear their recommendations, and ask about their expertise. The International OCD Foundation has a great list of questions to help you know whether your potential therapist is a good candidate (link below). One piece of advice I often share with clients is that one of the best predictors of good treatment outcomes is good fit between therapist and client. Your first few sessions with your therapist will help you know whether you have a good match. Good fit includes having productive sessions, the therapist makes helpful recommendations that are relevant to you, and they build trust with you over time. If you don’t feel that you and your therapist are a good match, that’s ok and part of the process! Sometimes you have to shop around for the right therapist and try different people to find the style that works best for you.
- Decide what treatment option(s) you would like to pursue
There are a few treatments that have strong research support for OCD symptoms, which are listed below. There are other therapies that are used for OCD, but these have less and/or weaker research into their effectiveness. (Check out https://iocdf.org/about-ocd/ocd-treatment-guide/ for more information on these treatments.)
- Exposure and Response Prevention (or Exposure and Ritual Prevention), or ERP
- Medication management
- Add-on or second-line treatments can include Acceptance and Commitment Therapy (ACT), Cognitive Therapy, mindfulness/self-compassion interventions, Inference-based Cognitive Behavior Therapy (I-CBT), metacognitive therapy
- For treatment-resistant OCD: transcranial magnetic stimulation (TMS), deep brain stimulation
It is really courageous to take the first step toward treatment or to even talk about some of the ways that OCD symptoms impact your life. It can feel daunting to think that you might have OCD, but there are resources and treatments available to help you so that can live your best life, without being controlled by OCD.
Resources:
IOCDF: How to find the right therapist https://iocdf.org/ocd-finding-help/how-to-find-the-right-therapist/
Ideal Self Therapy, LLC 