Obsessive compulsive disorder - OCD treatment and therapy from NOCD

There will always be one more “what if” with OCD

5 min read
Stacy Quick, LPC

If you have OCD, you’ll know that it can feel like a game of whack-a-mole. One theme pops up after another, and intrusive thoughts will always return after the short-term relief that comes from compulsions. It can leave you feeling lost in seemingly endless spirals of obsessions and compulsions. 

One of the most important things to recognize when beginning OCD treatment is that the goal is not to get rid of the thoughts. As an OCD specialist, I hear this all the time: I just want the thoughts to stop. It makes sense to want to avoid difficult feelings such as anxiety, but they’ll always return. Instead, the solution to breaking the OCD cycle is to change how we respond to these thoughts and feelings.

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The thoughts aren’t the problem

It is important to note that if you are experiencing OCD, the thoughts are not the actual issue. I know it feels like they are, but they are not: the real problem is that your brain demands certainty about the thoughts or relief from them. Your brain gets stuck on them, unable to move forward without feeling perfectly at ease or certain. Every time you perform some compulsion or attain some reassurance about your fears, OCD will return with yet another “what if” because you can never find 100% certainty.

In this way, OCD is often predictable. It starts with a thought, image, or urge, and the brain’s alarm system is set off. Your brain tells you to do everything in your power to stop the feelings of discomfort that you are experiencing. Your compulsions can sound so ridiculous and illogical, even to yourself, but the slightest chance of reducing your anxiety is enough to pull you in. In this way, the process is reinforced, as you believe that you just prevented something dangerous or distressing from happening.

Breaking the cycle

Rather than focusing on the content of your obsessions, it is important to shift your attention to the actual cycle of this disorder. That is where OCD’s power lies. That is where we need to cause disruption. 

To break the cycle of OCD, you must learn that you don’t need to engage with distressing thoughts, images, or urges that come your way. To break the cycle, you must remain diligent. Consistency will be your new best friend. You must regularly choose to allow discomfort, rather than fighting it. 

Yes, that’s right, I am asking you to do nothing when OCD is screaming at you that you must act. You will need to make a choice: allow these often terrifying feelings to be present and fade on their own, or try to fight them off, only for them to return later with a vengeance. 

Each time a new theme or obsession emerges, you may feel like it is somehow “different” or more “real” than previous ones. It isn’t. This is how OCD maintains its power: it demands your attention, it goes to great lengths to obtain it. Each time a new theme emerges, people often say that it feels more important than the last, or they may even start to doubt whether they have OCD at all. This intense doubt should be a red flag. The sense of urgency that comes with the intrusive thoughts, images, urges, or feelings can often alert you to the presence of OCD. 

Refuse to play along

The truth is that you may always feel doubt surrounding your thoughts or obsessions. You may always feel a sense that you need to find the answer to whatever your brain has focused on. Here’s the good news: you get to choose whether or not you will engage with OCD in a way that makes it worse.

Exposure and response prevention (ERP) therapy works by interrupting the vicious cycle of OCD. In ERP, a therapist will guide you as you’re safely, gradually exposed to your fears and obsessions. With your therapist’s help, you will resist the urge to respond to anxiety or uncertainty with compulsions.

ERP helps you learn to sit in the anxiety and discomfort of your obsessions and see that you can indeed survive them and most importantly, you don’t need to do any compulsions to rid yourself of this perceived danger. When you don’t give in and do a ritual or a compulsion, your brain actually learns that there was no danger in the first place, breaking the vicious cycle of OCD over time. But it takes consistent practice—retraining your brain takes time, commitment, and perseverance.  

If you’re tired of the incessant what-ifs and want to take the power away from your intrusive thoughts, NOCD can help. Our licensed therapists deeply understand OCD and are specialty-trained in treating OCD with ERP. We work side-by-side with the OCD experts and researchers who designed some of the world’s top OCD treatment programs—and that means the best care for our members. I encourage you to learn about NOCD’s accessible, evidence-based approach to treatment.

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Taylor Newendorp

Taylor Newendorp

Network Clinical Training Director

I started as a therapist over 14 years ago, working in different mental health environments. Many people with OCD that weren't being treated for it crossed my path and weren't getting better. I decided that I wanted to help people with OCD, so I became an OCD therapist, and eventually, a clinical supervisor. I treated people using Exposure and Response Prevention (ERP) and saw people get better day in and day out. I continue to use ERP because nothing is more effective in treating OCD.

Gary Vandalfsen

Gary Vandalfsen

Licensed Therapist, Psychologist

I’ve been practicing as a licensed therapist for over twenty five years. My main area of focus is OCD with specialized training in Exposure and Response Prevention therapy. I use ERP to treat people with all types of OCD themes, including aggressive, taboo, and a range of other unique types.

Madina Alam

Madina Alam

Director of Therapist Engagement

When I started treating OCD, I quickly realized how much this type of work means to me because I had to learn how to be okay with discomfort and uncertainty myself. I’ve been practicing as a licensed therapist since 2016. My graduate work is in mental health counseling, and I use Exposure and Response Prevention (ERP) therapy because it’s the gold standard of OCD treatment.

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