Getting Treatment

If you are reading this section, there’s a pretty good chance that you are thinking about how to get help for your OCD. Some people feel weak and hopeless, and tell themselves, “Why bother, what’s the use? “I don’t have any control over my OCD, I’m helpless, and there’s nothing I can do.” It is pretty likely that if you are looking up information about treatment, you don’t totally believe these things (or so we really hope). This is very smart on your part, because these ideas are totally untrue. In fact, checking out the idea of getting treatment is a really good idea for a number of reasons because:

• OCD is very treatable if you get the right kind of help – it is not hopeless.
• OCD usually just doesn’t go away one day all by itself – you have to work to get it under control, and you have to know what kind of work is best.
• The work you have to do to get recovered may not always be totally easy, but it isn’t impossible to do, either. There are thousands of people doing it every day.
• Learning how to stand up to your OCD won’t make you worse.
• There is more help for, and information about OCD these days than there has ever been before, and there is no good reason why anyone should have to suffer.

Before we get to talking about treatment, there are a few really important things you need to understand about OCD. One is that obsessive thoughts are simply just thoughts, and by themselves, do not have the power to make you scared or make you do anything. It is true that OCD can put extreme, bizarre, and scary thoughts into your mind. Strangely enough, it is also true (believe it or not) that what the thoughts are about turns out to not be important at all. There are dozens of different types of obsessions. The thoughts can be about anything. Most people, if they really think about it can see how ridiculous many of them are. They can be the same thing every day, or can keep changing all the time. It turns out that the real problem is not the thoughts or even the anxiety. The problem turns out to be the solutions you come up with. Compulsions are the things you do to get rid of the anxiety that takes over your life. Your brain tells you to avoid or run away from the things you fear, and then you mistakenly believe that this is possible. Compulsions can really scam you, because it looks like they can make your anxiety go away, even if the help they give you only lasts for a little while. After a while, they become big habits that are hard to stop doing. So like we said, compulsions start out as solutions, but they end up becoming a bigger problem. They may start out taking only a few minutes every day, but can end up taking many hours at a time that you could be spending with your friends or doing your schoolwork. So as you can see, trying to escape things only worsens the problem and increases your fear. The truth is, you cannot run away from what you fear because fear is really in your mind, and you can’t run away from your own brain. If you are going to control it, it has to be faced. People with OCD do not stay with they fear long enough to learn the truth, which is that – NOTHING WILL HAPPEN IF YOU DON’T DO COMPULSIONS! Ever. Really.

So now we come to what it was you were looking for in the first place – information on treatment. What is treatment all about? Basically, treatment for OCD is all about

• Getting you to see that your solutions won’t really get rid of the anxiety.
• Seeing how your solutions only make you worse.
• Understanding that you finally have to face your scary thoughts while learning to not do compulsions.

What type of treatment can help you to do this? The answer is - COGNITIVE/BEHAVIORAL THERAPY!(Also known as CBT)

There are different types of CBT treatments, but the one you should be interested in is a treatment known as Exposure and Response Prevention (also known as E&RP). This is a way of facing thoughts in a step-by-step way, while at the same time, not doing anything to escape or avoid them. The idea behind it, as we said before, is very simple. If you stay with what you fear long enough, and see that nothing really happens, you can’t stay fearful. What actually happens is that you get bored with it.
Okay, this sounds good, but how do you do it? You start by finding a trained therapist who specializes in helping people with OCD. This may be a psychologist or a social worker. Actually, before you even do this, you have to talk to an adult (or adults) in your life that you trust. Telling someone about your OCD isn’t easy, and can be hard to explain to those who don’t have it. This will usually be your parents, but if you think they may not understand what you are going through at first, you might start with your school psychologist, your family doctor, a religious leader (such as a priest, rabbi, imam, minister, reverend, etc.). They might be willing to talk to your parents for you, if you think this will be easier.

The next step is to get your parents to help find a therapist and make an appointment for you. If they can’t find one locally, you can tell them to check out the referral listings at the International OCD Foundation’s website, or the website of the Association for Behavioral and Cognitive Therapy. These are the best places to start. When you do get your appointment, the therapist will want to know all about what you are going through. It is important to tell them everything, no matter how weird or crazy you think it sounds, or even if it is kind of gross to talk about. Don’t keep any part of it a secret. The therapist can’t help you with what you don’t tell them, and they won’t think you are crazy. If they treat OCD, they will understand what you are saying. Along with finding out all about you, they will want to make lists of all the different thoughts you are having, and all the compulsive things you are doing – the ones that someone could see you do, and the ones you do only in your head. The next thing the therapist will usually do will be to list all the people, places, things, and thoughts that make you nervous, and then rate each one on a scale of from 0 to 10 or from 0 to 100. This is known as a hierarchy. This list will be used to plan what you will do in the therapy, and in what order you will do it.

Now, the actual work of therapy can begin. You will be given assignments to work on either with the therapist in their office, on your own at home, or both. You will start with the easiest ones on your hierarchy list. This work isn’t supposed to reassure you or tell you that nothing bad will happen to you or others. Instead, it gets you to feel some anxiety by getting you to agree with the thoughts, or to go to or do whatever makes you nervous. Remember, it does this a little at a time, and goes at your speed. If you can’t do an assignment all at once, you may do it in steps, or be given more time to do it. No one will ever force you to do anything, or surprise you with anything. Some of the work may involve having you do such things as:

• writing assignments
• reading things
• looking up things on the internet
• listening to recordings that you or the therapist make up
• going to places or being around people that make you nervous
• touching things you usually avoid
• breaking rules you made up for yourself
• making up signs to hang in your room
• agreeing with dislikable thoughts
• saying or writing names, words, or numbers that make you anxious
• throwing things away (if you are a big-time saver)

At the same time you do these assignments, you will be asked to not do anything to escape or avoid them, or to cancel them out in any way. You will feel yourself getting more nervous at the start of each assignment, but you will also see yourself gradually getting less nervous if you stick with it. Like we said before, the idea is to stay with them so you can finally see that nothing really happens, and so you can get bored with them. You will probably have a few different things to work on every week – some old (because some things take longer) and some new.

As you work your way through your list, you will see yourself gradually getting braver about your fears, and getting the feeling that you really can do it. As each week goes by, it will take more and more to make you nervous. The therapy work will probably take a number of months of steady work. If you stubbornly keep at it, you will finally get to the end of your list, and we then say that you are recovered. This means that your symptoms are now under control, and by doing a little work here and there every week after therapy ends, they will stay under control.

If you do have OCD, do something today to help yourself! Ask yourself, if you don’t get help, then what will you do? Take the first step and talk to someone about it – someone who can help. You don’t have to feel bad or nervous every day. Life can be a lot better than it is.