OCD characterized as persistent and unwanted thoughts, images, or impulses (obsessions) that cause distress. In effort to reduce this distress, behavioural or mental acts (compulsions) are used. Unfortunately, compulsions do not work very well and the thought, image or impulse always returns. The compulsion worked the first time to manage distress so the brain learns to rely on that compulsion. When it no longer provides relief from the thought, the compulsion becomes more onerous or complex. OCD can take up one's entire day and cause significant impairment. It is considered one of the top 20 causes of disability worldwide.
OCD is not a character flaw or personality trait. It's fear that requires a unique form of treatment for each person.
ERP is a type of cognitive-behavioural therapy that exclusively works to treat OCD. ERP is the only research-supported therapy for OCD and is effective in reducing symptoms in approximately 70% of sufferers. Most people that respond to ERP need to stay vigilant to ensure symptoms do not return.
Following an in-depth assessment, ERP works by helping the person with OCD purposely confront fearful situations without performing compulsions. Done repeatedly and in a variety of situations, the person with OCD becomes less fearful and learns that the distress goes away or reduces on its own without the need for compulsions. This process is called habituation. Another process that may occur through ERP is called inhibitory learning. Occurring when the person with OCD learns to associate a new emotion with the fear, violating the negative expectation.
Certain types of OCD respond better to ERP than others. For this reason, identifying a symptom subtype helps the clinician to individualize their treatment plan for their client.
OCD is very diverse in nature. Although there are subtypes of OCD, everyone with the disorder has a unique feared consequence. Therefore, while we employ ERP, everyone's treatment plan is unique even if their subtype is the same!
The OCD symptom subtypes include: contamination, postpartum, sexual, harm, scrupulosity (religious), symmetry/exactness, relationship, health.
Exposure and Response Prevention is the gold-standard treatment for OCD and when used with a trained and knowledgeable therapist, the person with OCD can achieve remission in symptoms. Remission means that the person with OCD will leave treatment with new skills and tools to handle new OCD symptoms as they arise, while remaining vigilant to ERP symptoms.
Without proper treatment, OCD is chronic and does tend to get worse.
OCD can cause significant impairment in functioning, causing some individuals to be stuck in the OCD cycle for 9 hours per day or more.
Research indicates a genetic maternal link is common in young children with symptoms of OCD. More than 50% of adults with OCD report an onset of symptoms in childhood.
Only if the individual does not seek treatment. The earlier it's caught, the easier it is to treat!