By: Michael Puskar

Updated March 24, 2021

Medically Reviewed By: Whitney White, MS. CMHC, NCC., LPC

Unwanted violent or sexual thoughts

Fear of germs or being contaminated

An intense focus on religion or morality

Sometimes obsessions can be less specific and involve worrying about forgetting to do something, such as locking the door or making sure the stove is turned off. Additionally, people may be affected by multiple themes. For example, a person might obsess and worry about doing something that goes against their religion but might never experience the same stress toward germs or symmetry.

It's important to note that the thoughts that a person who has OCD has are unwanted and can be distressing, and this is especially true for those who deal with explicit themes. The thoughts may go against the person's values, which can cause them to worry and question themselves.

Because these thoughts can be undesirable and create stress, an individual may perform specific actions to reduce anxiety and push the thoughts away. These are known as compulsions, and they are typically ritualistic and carried out repetitively. These are some examples of compulsions that someone with OCD may perform:

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• Checking
• Washing
• Counting
• Organizing
• Saying mantras (phrases)
• Seeking reassurance
• Avoidance

Regardless of the content of the thoughts, all individuals with OCD will have these obsessions and compulsions and spend a great deal of time and energy controlling or trying to eliminate them. People with OCD also typically recognize their thoughts are not logical and delusional, which separates OCD from psychotic disorders. Nonetheless, these thoughts are still typically burdensome, and OCD can be detrimental to one's quality of life.

If you haven't been diagnosed yet but all of this is familiar to you, a mental health professional will be able to confirm whether you have OCD by listening to you describe your situation. Receiving a diagnosis and discussing what's on your mind will get you on the right track to getting treated.

How Is OCD Treated?

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OCD has a few different treatment options, but, thankfully, the ones that are currently available are very effective. Just a few decades ago, OCD was considered a life sentence and untreatable, but nowadays it can be successfully managed, if not eliminated.

One of the most widely recognized treatments for OCD is cognitive behavioral therapy (CBT). CBT has also been useful for treating depression and anxiety, and because OCD is centered around thoughts and beliefs and how people respond to them, it has been a practical modality for treating it.

CBT is a form of talk therapy that is designed to change a patient's negative thought patterns into constructive or positive ones. For instance, in OCD a person can perceive a situation as extremely harmful when the actual severity is low or nonexistent, and the threat of something bad happening is exaggerated.

A classic example is the one related to public doorknobs and germs. A person with OCD will believe that if they do not wash their hands, a severe disease will be contracted and can be spread to someone else. Likely, the worst that can happen is catching a common cold, but to the person with OCD, this situation is perceived as a major threat.

OCD patients also require evidence for safety, and if that is not there, whatever is happening is automatically assumed to be dangerous. This contrasts with people without OCD, who need evidence for something to be dangerous; a situation or object is considered safe unless proven otherwise.

To alter this way of thinking, a therapist will need to address the subject of their patient's fears directly. This is done by exposing the individuals to the themes of their obsessions.

A specific form of CBT therapy that carries this out is appropriately known as exposure and response prevention (ERP), also sometimes referred to as exposure and ritual prevention (EX/RP).

The premise of ERP therapy is by subjecting the patient to their thoughts and resisting the urge to perform their compulsions, they will gradually become desensitized to the obsessions.

This can be done in two different ways:

Exposure in vivo: involves physically confronting the triggers for obsessional thoughts. For instance, touching a public object and abstaining from handwashing will reduce the anxiety toward germs.

Imaginal exposure: the patient imagines the distressing obsessions and the perceived consequences of them. This is useful for themes that are explicit and cannot be exposed to in reality (i.e., might be illegal or have real health consequences).

Following these primary exposure methods, the results will be processed by the therapist. They will ask you to measure your stress levels to a situation and compare it to how you felt before receiving treatment.

Because of this, CBT and ERP therapy are some of the only methods that are supported by empirical evidence and have quantifiable data to support it. Even in the earliest trials, 66 percent of chronic OCD sufferers reported a significant improvement in their condition, whereas 20 percent partially improved.

Therefore, the probability that receiving treatment and seeing results is very high and millions of OCD patients have praised CBT’s and ERP's efficacy.

If you've been trying to learn what the best OCD therapist can offer, they should be trained and have experience with CBT, and, ideally, ERP therapy. In addition to helping you achieve results and decrease your anxiety toward triggers, your therapist should also help you avoid relapses and maintain all of your progress.

How To Find Your OCD Therapist

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There are a few ways to find a local therapist that works with OCD patients.

The quickest therapist finder is your favorite online search engine. By looking up "OCD therapist near me," you should find at least one result. It can either be private practice or a clinic.

Following this, you should view their credentials and confirm that they have the necessary experience in treating OCD. If they are the right fit, you can contact them and see if you can make an appointment and perform an initial assessment.

Another way to get connected to an OCD specialist is through your primary doctor. This is a practical option for those who have a specific medical insurance plan, especially one provided by an employer. The physician may be able to connect you with a therapist that is in the same network.

Online Therapy 

Finally, another option is to try online therapy. While an online therapist won't be with you during any real-life exposure scenarios, they can still give you instructions on how to practice them on your own. In-person therapists have been known to give homework assignments as well, so it's entirely possible to work semi-independently.

As mentioned, CBT is not only a common therapy method for OCD, it’s one of the more common talk therapies overall, so there has been a lot of research looking into whether or not it’s effective to deliver remotely. A recent study found that not only does CBT deliver substantial benefits but that it is also more cost-effective than face-to-face CBT.

On top of the fact that online therapy is often less expensive than traditional therapy, online therapy is often more convenient too: you can participate in online therapy from the comfort of your own home as long as you have an internet connection – no finding an office, no commute, no negotiating traffic or public transportation. Plenty of others have already given BetterHelp a try:

“Very friendly, empathetic, and excellent communication. Fantastic descriptions of how our brain works and the thought functionality. Streamlined and easy to follow ‘homework.’ He helps me stay on track (I am one giant tangent) and get to the root of the issue and he helps create a step by step game plan on how to effectively assist me with my anxiety and OCD.”

“I've been working with Cicely for a little over six months now, and she's been really helpful in gently pointing out areas to work on. She provides a safe space to vent, a listening ear, and feedback based on her professional expertise and religious faith (something I requested). In more recent months, I've begun to see my life transform into a better me. I'm not perfect by any means, but my thoughts and emotions aren't as damaging to my life (and others) as they'd once been.”

At BetterHelp.com, there are licensed professional counselors and therapists who work with many patients with different conditions, including OCD. Online therapy offers you an affordable and convenient way to receive treatment and should be considered if you somehow cannot receive in-person ERP sessions.

Conclusion

OCD can be incredibly challenging to tackle by yourself, and having a great therapist who knows the ins and outs of the condition can be a crucial part in helping you take your life back.

OCD therapy isn't as straightforward as just talking and being counseled; instead, it involves specific techniques that change the way you think about stressors. By resisting compulsions and refusing to carry out rituals, the patient will gradually become less anxious toward their obsessions. Essentially, it's not the thoughts that are problematic; rather, it's how we respond to them.

OCD can be complicated but the way it is treated is the same for everyone. Therefore, if you're going to run a search on "the best OCD therapist near me," you should focus on whether they have experience using CBT and ERP on patients rather than tackling the specific themes that bother you.

Whether you decide to go with in-person or online therapy, seeking help is the first step to take to improve your life. To learn more about OCD and related conditions, BetterHelp has informative articles like this one that not only aim to teach others about mental health concerns but also encourage people to find the treatment that they deserve.

Therapy Is Personal

If you’re still wondering if therapy is right for you, and how much therapy costs, please contact us at contact@betterhelp.com. BetterHelp specializes in online therapy to help address all types of mental health concerns. If you’re interested in individual therapy, please reach out to contact@betterhelp.com.