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Episode 23

Q&A on OCD

July 2nd, 2021

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In this episode of Purely OCD, Kelley and Lauren answer questions from viewers related to OCD and OCD recovery.

Question 1: How do you best control Obsessive Compulsive Disorder?

Control is an interesting choice of words because OCD is a lot about control. We can’t control it, but we can manage it and really the first line intervention… is going to be Exposure and Response Prevention.

Kelley Franke, LMFT

Lauren weighs in, stating that Control is the problem. ERP is about being in the presence of anxiety and uncertainty without trying to control the anxiety or the thoughts.

Question 2: Does OCD ever go away?

First off – Everyone’s recovery looks a lot different.

Lauren talks about the fact that 76% of people with OCD will have a co-occurring Anxiety Disorder in their lifetime. Lauren posits that, perhaps, there are underlying mental tendencies that don’t go away even when people are in recovery from OCD.

For example, people with OCD have an incredible ability to problem solve. The trouble is this is true even when the thing isn’t a problem or something that can be solved. The creativity and intelligence that make people with with this disorder especially adept at problem solving don’t go away. That said, we can better learn how to operate our minds.

Kelley talks about the fact that OCD can go into remission.

Ultimately, we can’t control the thoughts and feelings, but we can control whether or not we do compulsions. That’s what OCD recovery is all about.

Question 3: Can OCD manifest mentally, more through thoughts than physical compulsions?

Yes – a lot of people with are more prone to mental compulsions.

Mindfulness is very helpful with this. We have to know we’re thinking in order to disengage. Mindfulness helps with this awareness of thinking.

Lauren: My personal favorite and specialty when it comes to compulsions are the mental ones

Kelley: Oh boy me too

Lauren: My brain just loves doing those mental compulsions

Question 4: Why does OCD attack everything that you love?

Here’s the thing, OCD only sticks on the content that bothers you.

People tend to envy each other’s OCD themes, but the thing is OCD latches onto the thing that is scariest to the individual. There is no “easier” theme, per se. Some themes are more taboo – like POCD for example – but OCD lands on what most bothers each individual, making each subtype very challenge to every person it impacts.

Question 5: How do you deal with and handle when depression interferes with OCD treatment?

Psychiatric assessment might be helpful.

Behavioral Activation – that is getting out and engaging with life on a consistent basis – can be very effective in treating depression. This could look like

• Getting physically active
• Getting out of the house
• Seeing friends

You can also practice being mindful of negative self-talk without engaging directly with the content of the negative self talk. Lauren gives an example: 

The brain says: “if you cared more, you would have already done your exposure homework for the day, but clearly you don’t care enough and you suck.” 

You can respond: “Oh, thank you brain. That’s such a lovely thought.  I have to get my exposure homework done now, so I’m not having this conversation with you now about how much I suck, but thank you for the thought. Namaste Asshole!”

One last thing – CBT, which is the primary treatment for OCD, is also an evidence-based treatment for depression.

Question 6: How do you know it’s OCD or Intrusive thoughts because of Anxiety/Panic Disorder?

In brief: We don’t and it doesn’t matter. We treat OCD, Anxiety and Panic Disorder in the same manner.

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Disclaimer: This information is meant to be general information not unique to any individual. Before following any guidance or advice found on this site or in the Purely OCD Podcast a visitor or listener should always consult with their own licensed healthcare practitioner. The Purely OCD Podcast and Website are not therapy or intended as a replacement for therapy. They are for educational purposes only.