OCD Treatment in Washington State
Exposure and Response Prevention (ERP) in Spokane and by Telehealth state wide
OCD is often misunderstood, and some go years without realizing that's what they have. Most people with OCD recognize that something is wrong and that they are losing control of their life. They recognize that reassuring themselves stops working almost immediately. In real life, OCD rarely looks like what people expect it to, and because of this, it can go untreated for years.
Here is what OCD actually is, how it's treated, and what working together would look like.
What is OCD?
OCD stands for obsessive compulsive disorder and typically has two parts.
Obsessions:
Obsessions are unwanted thoughts, images, or impulses that seem outside a person's control and occur repeatedly. Very often, they would be considered “intrusive” and cause a considerable amount of distress or anxiety. These thoughts are typically “ego-dystonic,” meaning they go against the person's values, personality, desires, and how they view themselves as a person.
Compulsions
Compulsions are anything one does to get the obsessions to stop or decrease the distress of the obsession. These are repetitive mental or physical acts that one feels compelled or sometimes forced to do. This can be washing, checking, asking for reassurance, reviewing a conversation until it feels resolved, praying a certain way, avoiding people or places, etc.
Compulsions do work, temporarily. This is the trap that people fall into. Compulsions do not provide long-term relief. Instead, they cause the person to get stuck in the never-ending loop of “Obsession -> Compulsion -> Temporary Relief -> Obsession”. This cycle teaches your brain that the obsession was dangerous, and the compulsion is the only way to keep you safe.
The next time the thought shows up, it hits with more urgency. In response, the compulsion has to be bigger or longer. Over years of this process, the cycle expands and takes up more and more of one’s life.
The content of OCD can vary a lot. OCD in one person can look completely different in another.
Common Themes,
OCD Themes
Harm
Fear of hurting others or yourself, losing control, or already having done something without knowing it
“Pure O” or Mental Compulsions
Constantly ruminating or thinking about situations, can’t get out of your own head. Almost everything happens in your mind, and there is very little that other people can see.
Contamination
Fear of germs, illness, bodily fluids, or “just feeling dirty”
Religious OCD “Scrupulosity”
Fear of having sinned, prayed wrong, thinking something “blasphemous”, or having crossed a moral line.
Relationship Doubt
Constantly questioning if you love your partner, if they are the right person for you, if you have been tricking or deceiving them.
Unwanted Sexual Thoughts
Intrusive sexual thoughts that conflict with your values, identity, or orientation.
Postpartum Intrusive Thoughts
Frightening thoughts about a new baby.
Sensorimotor or “Somatic”
Fixating on breathing, blinking, swallowing, heartbeat, or other parts of your body.
“Just Right” or symmetry
Everything needs to be complete, even, or correct. Books lined up straight on a shelf, pillows perfectly placed on the couch, writing the “perfect” work in a letter, or having to read a word sentence perfectly in a book.
Existential OCD
Unanswerable questions about reality, consciousness, meaning, or making the perfect choice for your life.
Health Anxiety
Checking your body, looking up symptoms, constantly seeking medical reassurance.
Some people experience one theme for years, others multiple. Sometimes it can feel like the theme has shifted or changed. While this may feel like a new problem, it usually isn’t with the treatment reaming the same no matter how it presen
Exposure and Response Prevention (ERP) is the treatment with the strongest research support for OCD in both adults and children.
Exposures:
An exposure is directly experiencing the situation that triggers the distress. This is not done all at once, but in an intentional, gradual way.
Response Prevention:
Simply put, this means not doing the compulsion afterwards. Without this part of treatment, the exposures will only reinforce and make the OCD stronger. Facing the fear without the compulsions allows your brain to learn something new.
You aren’t going to learn that nothing bad is ever going to happen. You will learn that you can have the thought, feel the anxiety, choose not to do anything about it, and still be fine. Anxiety will naturally go down on its own, and you can handle a lot more uncertainty than you thought.
This pattern will help your brain break out of the endless cycle OCD traps you in, and you will start to win control back over your life.
What is ERP
Confidentiality & Safety
Everything shared in therapy is confidential, with a few legal and safety exceptions that will be clearly explained at the start of our work together.
I work in line with professional ethical guidelines and attend regular supervision to ensure your safety and wellbeing are always prioritised.