When my kids mix their play-doh colors, I get so OCD.
I am so OCD during Christmas, you know, the Obsessive Christmas Disorder.
I’m so OCD; I like everything neat and clean.
Don’t be so OCD; just do it.
My kid is such a picky eater; he is so OCD about his food.
Sadly, you’ve either heard someone say one of these phrases, read it on a shirt on the shelves of Target or seen jokes made in popular TV shows or movies. But there is nothing funny or truthful about any of these comments. Because wanting your closet to be color coordinated does not mean you have OCD. Loving Christmas and decorating every inch of your house does not mean you have OCD. Having strict preferences with things like food does not mean you have OCD. These phrases and comments are wrong, hurtful, and an insensitive misuse of a very real and difficult mental health struggle.
OCD (Obsessive Compulsive Disorder) is NOT an adjective. Everybody is not a little bit OCD. Because, If it makes you happy, it is not OCD!
When a mental health disorder such as OCD is misused to describe someone who is simply rigid, strict with their routines, or loves to organize, it doesn’t help but actually hurts the situation.
These comments don’t make light of a situation; it actually stigmatizes the rituals associated with OCD.
Comments like these don’t leave people with OCD feel seen; it actually makes them feel misunderstood.
It doesn’t open the line of communication of mental health and OCD; it leads to more shame, isolation, and feelings of loneliness. So let’s get the facts right!
What is OCD?
Obsessive-Compulsive Disorder is a mental health disorder that consists of obsessions and compulsions. Like any other mental health disorder, the person caught up in the vicious cycle between their obsessions and compulsions experiences impairment in the social and occupational areas of their life. While these impairments can vary in severity and duration, every person struggling with OCD feels overwhelmed, stuck, and powerless by their OCD and its rules.
There is a specific cycle of OCD that looks like this: you have an obsession, which triggers anxiety, and to reduce this anxiety, you engage in a response, which is the compulsion. The relief is short-lived, and obsession is experienced again.
What are obsessions and compulsions specifically?
Obsessions are recurrent, persistent, and distressing. They can be thoughts, feelings, sensations, and images. They are unwanted and repetitive. While the person identifies these obsessions as irrational, the possibility of them coming true is powerful enough for the person to experience intense anxiety and fear.
In response to the anxiety and fear, the person engages in rituals, which are the compulsions that reduce the anxiety and discomfort associated with the obsessions. Since the compulsions initially help the person to “feel better,” they only become more frequent in time. But, the compulsions are simply the bandaid: they don’t fix anything; they simply make the anxiety go away temporarily. Compulsions are repetitive, unrealistic, and excessive responses to obsessions. Obsession increases anxiety, and compulsions decrease anxiety.
As the intrusive thoughts or images return, the person suffering from OCD will engage in the rituals for a more extended period of time or, in more specific ways, becoming a perfectionist in the way they carry out the rituals.
Compulsions can be behavioral or mental. Behavioral compulsions are anything you can behaviorally observe, such as checking, walking away, avoiding, grabbing a tissue to hold the doorknob, googling, or asking questions to others (which are also known as reassurance seeking). Mental compulsions are any mental activity you engage in response to your obsession that calms anxiety. Most commonly, the mental compulsions are counting while performing a task to end on a “good,” “right,” or “safe” number, mentally reviewing events to prevent harm, repeating a specific phrase or words, praying, “canceling” or “undoing” (example: replacing a “bad” word with a “good” word to cancel it out) or rumination.
Understanding the biology of OCD:
OCD is a debilitating brain disorder that has a biological and learning basis. It is not a choice. People don’t cause their OCD. It is not a character flaw or something that your parents did to you.
The current research indicates that OCD has a neurobiological basis where certain areas of the brain function differently in people with OCD. Meaning, OCD symptoms involve communication errors among different parts of the brain.
However, biology is not the only “explanation” for OCD. It only sets the stage for learning. Because compulsions are learned through classical and operant conditioning.
According to operant conditioning, a behavioral response that leads to a desirable outcome will, in turn, increase the likelihood of engaging in that behavior in the future. On the contrary, a behavior that leads to an undesirable outcome will decrease in frequency. For example, every time you have a headache, you might take ibuprofen, and your pain subsides. Next time you feel a similar pain, you are more likely to engage in the same behavior because it worked last time.
In the cycle of OCD, when compulsion effectively reduces your anxiety, you are more likely to engage in that behavior the next time you are feeling anxious. OCD is learned such that it gets stronger over time through repetition, association, and reward system. What’s also dangerous about operant conditioning is that each time a compulsion effectively reduces anxiety, it also signals to the brain that the Obsessional thinking was dangerous and serious. Since your behavior reduces the anxiety, the brain walks away, concluding that the perceived trigger, such as the doorknob, was “really” threatening.
You store this information the next time you have obsessional thinking. It is believed that the brain of a person with OCD misfires and misperceives danger when there is no “real” danger.
What does OCD look like?
While biology and learning factors help to explain how OCD develops, we still can’t predict how one’s OCD will form. OCD has subtypes, and therefore, no two people may have the same OCD makeup. Few examples of different types of obsessions are Harm OCD, Contamination OCD, Relation OCD, Sexual Orientation OCD, and Pedophile OCD. Ultimately, OCD latches on to things you love and value.
4 Steps You Need to Take Today to Manage Your Symptoms of OCD:
1) Practice ERP:
When learning about OCD, it is necessary also to understand the most effective treatment modality: Exposure and Response Prevention (ERP). ERP is a form of behavioral therapy. It is an evidence-based practice that has been proven in research studies to be the most effective therapy in the treatment of Obsessive-Compulsive Disorder (OCD).
Exposure targets the obsession such that you expose and face the obsession. Response Prevention focuses the compulsions such that you are preventing the response that reinforces the anxiety. Meaning you commit to not engaging in the urge to do the compulsions. You learn to live your life without doing the compulsions.
The idea is that you cannot always control your incoming thoughts and feelings, but you can control how you behaviorally respond to them. The goal is not to have these thoughts but to learn how to tolerate them. You learn to exist without performing the compulsions.
When you perform a compulsion, you reinforce the idea that the fear is legitimate and that you cannot tolerate it, making your OCD more powerful. When you pair the exposure with response prevention, you teach your brain how to respond differently when your obsessions show up. Your thoughts do not have the power to hurt you beyond just being very uncomfortable.
You cannot always control your incoming thoughts and feelings, but you can control how you behaviorally respond to them. The goal of ERP is not only to avoid the compulsions but also to learn to sit with and tolerate the discomfort and anxiety.
2) Build a community to lean on and learn from:
If you know me, you know that I love the work of Dr. Brene Brown on embracing imperfections, letting go of shame, and showing up authentically. When it comes to building a support network, one of her quotes explains it perfectly when she says, “If you think you are supposed to do this work alone, you don’t understand what the work is.” I know it has been said a million times, but please hear me out when I say: You do not have to do this work alone. You do not have to go through this struggle alone. Because asking for help is not a sign of weakness.
The first step I want you to take, NOW, is to go to International Obsessive Compulsive Disorder Foundation, also known as the IOCDF website, and sign up for their newsletter. I know you are thinking you have tons of emails coming to your inbox daily. But you need to be in a community with others who are either living with OCD, treating it, or just understand it. For your next steps, I want you to search for your local groups. Here in Los Angeles, CA, OCD So-CAL is the Southern California Affiliate of the IOCDF. They hold events annually, and I am excited to share that I will be speaking at their 5th annual OCD So-CAL conference on July 31st on Perfectionism and OCD.
Other great ways to build a community are through social media and podcasts. Simply go to your preferred social media platforms and search for OCD. Many individuals share their stories to bring awareness and advocacy for OCD. There are talented mental health professionals who share information to improve your knowledge and education on OCD. Check out podcasts episodes. Read books on OCD.
3) Add mindfulness into your toolbox:
Mindfulness is being in the present moment non-judgmentally. When you are struggling with OCD, your thoughts either focus on the past to mentally review what you did or said. Other times, your thoughts are focused on the future to examine all the bad things that can happen.
When you try to bring your attention to the present moment, it can still be challenging since, in this present moment, you are experiencing intrusive thoughts.
When it comes to OCD, mindfulness isn’t just about being in the present, but it is about being non-judgmental. Mindfulness in OCD is about not resisting or rejecting the thoughts you are experiencing. It is actually doing the opposite. Doing the opposite is not about agreeing or giving in to the thoughts. Being in the present non-judgmentally means noticing and observing your thoughts without attaching meaning to them. It is about being able to recognize and “see” that you are having the thought of “harming your kid” or “sexual images with the same sex,” and intentionally allow those thoughts to exist. In this way, mindfulness is actually somewhat similar to ERP.
ERP is about confronting your fears and resisting the urge to ritualize. In mindfulness, you notice and observe your intrusive thoughts, as well as any discomforts caused by such thoughts, and resist the urge to respond with compulsions.
No matter where you are in your journey of understanding and managing your OCD, I hope that you always keep self-compassion close to your heart. Because addressing your OCD symptoms is hard and challenging work. I know it requires a lot of courage, strength, and resilience to try over and over again.
When things are tough, we tend to blame ourselves for our mistakes or struggle. We think something must be wrong with us for getting it wrong or having such a hard time. Especially when it comes to OCD, when there are setbacks, OCD will say, “maybe this ERP is not working” or “maybe you are having such a hard time because you don’t have OCD; you are what your thoughts say you are.”
Whatever your journey of managing OCD looks like, stay self-compassionate. When you are struggling, show yourself patience and kindness. Acknowledge that at this moment, you are feeling tired, defeated, overwhelmed, and/or scared. And remember that this is hard on anyone who is dealing with OCD. This is not hard just on you. It is hard on everyone. You are not alone.
Celebrate your efforts. Be proud of how you show up every day. Notice no matter how it turns out, you are giving your best today. Some days your best may be imperfect, but nonetheless, you are doing your best. Rest when you need to. Take a break to catch your breath. And when you are ready, get yourself back up and keep going. Because you deserve to live a life where you are the boss, not OCD. Remember, you are the author of your life, not OCD.
Embracing You Therapy Group Practice
Here at Embracing You Therapy Group, we invite you to explore with us how life would be different if you had more control over your thoughts and emotions, and we invite you to consider that it is possible to accept things just as they are, EMBRACING imperfections to create a gentler place for CALM in your life.
At our mental health practice in Woodland Hills, CA, we offer individual therapy and couple’s therapy. Both Dr. Menije and Cindy Sayani, AMFT offer virtual therapy to treat mental health concerns include Anxiety, panic attacks, OCD, phobias, and stress; Mood disorders including depression; Relationship issues, both in couples therapy and with individual clients; Perinatal mental health issues such as postpartum depression or anxiety.
If you are ready to learn more about ways perfectionism is showing up in your life, Dr. Menije has a self-study digital course on Breaking-up With Perfectionism.
Let’s learn what drives your unique perspective on anxiety and stress, and then let’s find the tools-your unique tools-that help you respond to life in a healthy, calm way. Contact us today.