Obsessive-Compulsive Disorder (OCD)

OCD is Obsessive-Compulsive Disorder (OCD) is a mental health condition characterized by persistent, unwanted thoughts (obsessions) and repetitive behaviors or mental acts (compulsions) performed to reduce distress. OCD significantly interferes with daily functioning, relationships, and quality of life.

Obsessions are intrusive and distressing thoughts, urges, or images that individuals struggle to suppress. Common obsessions include fears of contamination, harming others, or catastrophic events, as well as intrusive doubts or taboo thoughts. Compulsions are behaviors or mental acts, such as excessive handwashing or showering, checking (e.g.: locks, stoves, etc.) counting, or repeating words, performed to neutralize anxiety caused by obsessions. While compulsions provide temporary relief, they reinforce the cycle of anxiety and compulsive behavior.

OCD symptoms frequently overlap with trauma symptoms, complicating diagnosis. Both conditions can involve intrusive thoughts, hypervigilance, and avoidance behaviors. For example, trauma survivors may engage in ritualistic behaviors to create a sense of safety, similar to OCD compulsions. However, OCD obsessions and compulsions often arise from internal fears or perceived threats, which may or may not be rooted in past experiences of actual danger, whereas trauma symptoms are consistently rooted in past danger or harm. Additionally, trauma symptoms can include flashbacks, emotional numbing, mood volatility, and other symptoms which are not hallmark features of OCD.

Treatment for OCD often combines psychotherapy and medication. Cognitive-behavioral therapy (CBT), particularly exposure and response prevention (ERP), is frequently used for treating OCD. ERP helps individuals gradually confront feared situations or thoughts without performing compulsions, reducing anxiety over time. For those with overlapping OCD and trauma histories, Eye Movement Desensitization and Reprocessing (EMDR) can help reduce psychic distress from past events and lower OCD symptoms. Internal Family Systems therapy can also be helpful in identifying internal psychic parts that most strongly hold obsessive thoughts, and how those parts might be comforted and unburdened in ways other than engaging in compulsions.

Medications, such as selective serotonin reuptake inhibitors (SSRIs), are commonly prescribed to reduce obsessive thoughts and compulsive behaviors. High doses of SSRIs may be required for effective symptom management, and for treatment-resistant cases, newer interventions like transcranial magnetic stimulation (TMS) or deep brain stimulation (DBS) may be considered.

A comprehensive approach that includes trauma-informed care is essential for improving outcomes in individuals experiencing symptoms of OCD. I have helped a number of individuals from Oakland, the great East Bay, and beyond reduce OCD symptoms. Please contact me if you would like to learn more.