How to Deal With OCD: A Therapist’s Guide to Managing Your Condition

Published on: 07 Oct 2021
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Obsessive compulsive disorder (OCD) can become all-consuming, and you may feel like your entire days become filled with it. It’s estimated that OCD affects about 1% of adults in the United States. This mental health condition causes uncontrollable excessive thoughts, obsession, and the urge to act on compulsive behaviors that are often irrational. It can be an overwhelming, frustrating, sometimes frightening anxiety disorder that you feel like you can’t escape. 

“Having OCD is not your fault. It’s not a character flaw or something you did wrong. There is hope to manage OCD symptoms successfully so that you can achieve your goals.”

Talkspace therapist Liz Kelly, LICSW.

When you have the information and tools you need to help learn how to deal with OCD, you can better manage your mental health condition so it doesn’t continue to control your entire life. Read on to learn what you need to know about how to overcome OCD and what causes OCD to get worse. 

Understanding Your OCD

The first step in knowing how to cope with OCD is understanding which type you have. OCD is sometimes called a heterogeneous condition, meaning symptoms can widely vary from person to person. Most people will fall into one of several types of OCD — a subtype is just how OCD affects someone. These are some more common subtypes or clusters that researchers have found most people with OCD fall into.

Harm OCD

People with Harm OCD often have overwhelming, violent, disturbing thoughts. They may experience an obsessive thought and aggressive obsession about acting out in horrifying ways. Like other forms of OCD, harm OCD thoughts come as what-if questions. What if you lose control and something awful (usually specific) happens? What if you act out violently against someone else? What if you kill or seriously hurt yourself or someone else?

Examples of harm OCD obsessions:

  • What if I stabbed someone?
  • What if I drove through that crosswalk with people in the street? 
  • What if I jumped in front of that car or train? 

Examples of harm OCD compulsions:

  • Hiding all knives
  • Going back repeatedly to check (and recheck) if you hit someone or something with your car
  • Refusing to go anywhere near train tracks

Pedophilia OCD (POCD)

Pedophilia OCD is defined by the DSM-V as “recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving sexual activity with a prepubescent child or children.” The most difficult part of POCD is the stigma attached to the idea of pedophilia. This can make it hard for many to compartmentalize the concept that the thoughts attached to POCD aren’t reflective of what they actually want.  

Examples of POCD obsessions:

  • What if I did something inappropriate to a child and I don’t remember? 
  • What if I have inappropriate sexual thoughts about a child I know? 

Examples of POCD compulsions:

  • Avoiding all children
  • Berating yourself continuously for the thoughts you’re having
  • Researching pedophiles to prove to yourself you’re not one

Sexual orientation OCD (SO-OCD)

People with sexual orientation OCD are obsessed with their sexuality. SO-OCD can present as a constant worry or wonder about sexual orientation, without actually having an attraction to someone of the same sex. For this reason, it’s sometimes referred to as homosexual OCD (HOCD). But this name can be confusing, since SO-OCD can be experienced by anyone, with any sexuality.     

Examples of SO-OCD obsessions:

  • What if I’m gay because I was attracted to that woman? 
  • What if I’m into guys more than girls? 

Examples of SO-OCD compulsions:

  • Constantly looking at images of people of the same sex to see if there’s an attraction
  • Avoiding spending time with people of the same sex out of fear that there’s confusion about your own sexuality

Relationship OCD (ROCD)

People with relationship OCD (ROCD) will focus on intimate relationships. They may have insecurities about if they’re “right” for their partner in a romantic relationship. There are two common forms of ROCD — partner-focused and relationship-centered. 

Partner-focused ROCD will focus on social qualities, physical features, or personality traits like intelligence or morality.  

Relationship-centered ROCD tends to result in overwhelming doubts about their own feelings about their partner, or about their partner’s feelings about them. 

Examples of ROCD obsessions:

  • What if this relationship is wrong for me? 
  • What if we aren’t right for each other? 
  • What if there’s someone out there who’s better for me?

Examples of ROCD compulsions:

  • Repeatedly taking relationship quizzes in magazines, online, or in apps
  • Constantly replaying experiences over in your mind — wondering if you really had fun or truly enjoyed each other

Contamination OCD

Contamination OCD is characterized as people being afraid to get ill after being exposed to an aggressive type of bacteria. They also may worry about infecting others. 

Examples of contamination OCD obsessions:

  • What if I got AIDS? 
  • What if I just gave my daughter a really bad sickness? 

Examples of contamination OCD compulsions:

  • Washing hands over and over
  • Constantly sanitizing
  • Openly avoiding medical spaces or being in public

“Just Right” OCD

With “Just Right” OCD, someone will have a strong, deep feeling that things are “off” or “just not right.” There’s usually not a specific or identifiable fear that can be pinpointed, however. 

Examples of “Just Right” OCD obsessions:

  • What if this feeling that something’s off is real? 
  • What if I try to start everything over to get it right this time? 

Examples of “Just Right” OCD compulsions:

  • Opening and closing doors repeatedly
  • Organizing or rearranging things time and time again

Identifying Your OCD Triggers

Identifying triggers that may bring on OCD obsessions or compulsions can help you learn how to manage your OCD. To do this, keep a list of any triggers you experience throughout the day that result in an obsessive thought or compulsive urge.

It’s a good idea to rate how powerful each trigger is, and how much anxiety it produces. Tracking triggers and their intensity can help you begin to anticipate urges before they happen. This, in turn, can help you ultimately manage your OCD thoughts and behaviors.  

“Don’t try to avoid having certain thoughts or push them away. Negative and intrusive thoughts will happen. You can notice these thoughts accepting that they are true.”

Talkspace therapist Liz Kelly, LICSW.

Overcoming OCD: 5 Helpful Tips

Once you understand what form of OCD you have, and you begin identifying and tracking your triggers, you can then take additional steps to learn how to control OCD symptoms.

“Managing obsessions and compulsions takes practice. You are training your brain just like you would train a specific muscle at the gym.”

Talkspace therapist Liz Kelly, LICSW.

As you learn to manage your OCD, practice these tips below.

Challenge obsessive thoughts

While repressing obsessive thoughts is virtually impossible for someone with OCD, it is possible to learn to challenge them. 

  • Try writing down any obsessive thoughts as they begin.
  • Create an OCD “worry period,” where you allow yourself a couple of short time periods every day to really worry. This may help you spend a large portion of the rest of your day without worry.
  • Challenge your thoughts by asking yourself things like: Who told me this? How do I know this is true? Is this a helpful thought? 

Resist compulsions

Sometimes by repeatedly exposing yourself to certain OCD triggers under the supervision of a licensed therapist, you can learn how to resist certain urges. This is a therapy technique known as exposure and response prevention (ERP), which is one of the therapy options for OCD.

Manage your stress

Stress management can be an important factor when learning how to cope with OCD. While stress itself isn’t an actual cause of OCD, it is known to trigger symptoms. Connecting with others in social situations as a distraction and physical exercise are two ways you can begin to manage your stress. 

Other ideas include practicing relaxation techniques such as mindful meditation or yoga, or learning how to self-soothe by listening to calm music or stroking your pet, for example.

Make lifestyle changes

Lifestyle changes to your diet, exercise, and sleep schedule are all positive ways you can try to help manage OCD. Additionally, you may want to avoid alcohol, drugs, and nicotine, all of which are associated with higher levels of stress and anxiety.

Ask for help or get support

Reaching out for support can be key when learning how to deal with OCD. Building a strong support system and keeping connected to people you trust can help if you’re feeling vulnerable or powerless over your condition. OCD support groups are incredibly effective as well. And of course, a licensed therapist who’s experienced and trained in OCD treatment is always an excellent idea.

“One suggestion for treating OCD is to practice exercises and strategies outside of your therapy sessions, just like you would learn to play an instrument or train for a 5k race.”

Talkspace therapist Liz Kelly, LICSW.

Treating Your OCD

Getting treatment is a brave first step toward learning how to deal with OCD. There are several options for treatment, including OCD therapy, medication, and more. What works best for you will depend on the form of OCD you have and your goals for treatment. 

  • Exposure and response prevention (ERP): In exposure therapy, you are repeatedly exposed to your obsessions so you can learn how to navigate them without giving in. 
  • Cognitive therapy: Cognitive behavioral therapy (CBT) is a form of talk therapy that teaches you how to identify negative thought patterns in the present, and then change them without giving into compulsive behavior.
  • Medication: Anti-depressants are often used in addition to therapy to treat OCD. Note that used alone, medication is rarely an effective form of treatment though. 
  • Family therapy: Encourage understanding by family members to eliminate or drastically reduce some of the family stress that tends to result from a family member’s OCD. This is a great start for those who are dating someone with OCD or that want to know how to help someone with OCD.
  • Group therapy: Can offer much-needed encouragement and support to reduce feelings of isolation.

“Treating OCD symptoms requires that you face what makes you feel anxious and resist the urge to engage in compulsions. You don’t have to do this alone! A licensed therapist can guide you through this process.”

Talkspace therapist Liz Kelly, LICSW.

Sources:

1. NIMH » Obsessive-Compulsive Disorder (OCD). Nimh.nih.gov. https://www.nimh.nih.gov/health/statistics/obsessive-compulsive-disorder-ocd. Accessed September 7, 2021.

2. NIMH » Obsessive-Compulsive Disorder. Nimh.nih.gov. https://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd. Published 2019. Accessed September 7, 2021.

3. Hershfield, MFT J. Overcoming Harm OCD. Adaa.org. https://adaa.org/learn-from-us/from-the-experts/blog-posts/consumer/overcoming-harm-ocd. Published 2019. Accessed September 7, 2021.

4. Bruce SL, Ching THW, Williams MT. Pedophilia-Themed Obsessive-Compulsive Disorder: Assessment, Differential Diagnosis, and Treatment with Exposure and Response Prevention. Arch Sex Behav. 2018;47(2):389-402. doi:10.1007/s10508-017-1031-4.

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