OBSESSIVE-COMPULSIVE DISORDER
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DEFINITION OF OCD:

Obsessive-Compulsive Disorder (OCD) is a disorder that manifests either obsessions or compulsions.
 
Obsessions are defined as:
 
* recurrent and persistent thoughts, images or impulses that are inappropriate and intrusive, causing considerable anxiety and distress
 
* these thoughts are not realistic
 
* attempts are made to ignore or suppress these thoughts
 
Compulsions are defined as:
 
* repetitive behaviors or mental acts that result from obessive thoughts
 
* these behaviors or mental acts attempt to prevent some dreaded event or situation
 
* these behaviors or mental acts are not connected in a realistic way to avoid these dreaded events
 
Adapted from: Diagnostic and Statistical Manual of Mental Disorders IV, American Psychiatric Association, 1994. 
 

 
MANAGEMENT OF OCD
 
I teach individuals with OCD the following four techniques to help them reduce the frequency and intensity of their obsessive thoughts and compulsive behaviors.
 
RELABEL
  1. Relabeling helps you recognize that an obsessive thought is a false alarm caused by biological imbalances in the brain.
  2. Call it what it is: learn to recognize and properly label obsessive thoughts and compulsive urges.
  3. Say to yourself: "This thought is an obsession; this urge is a compulsive urge."
  4. The goal is to control your responses to the thoughts and urges, not to control the thoughts and urges themselves.

REATTRIBUTE

  1. The most important thing is to realize: "It's not me - it's my OCD."
  2. OCD should be called: "Out of Control of me Disorder".
  3. OCD is caused by a biochemical imbalance in the brain. The brain tends to get "stuck in gear" - it has difficulty shifting out of one thought or action into the next.

REFOCUS

  1. You must shift your brains gears yourself by forcing yourself to engage in some other behavior to replace compulsive washing, checking or compulsive preoccupations.
  2. Say to yourself: "I'm experiencing a symptom of OCD. I need to do another behavior."
  3. Choose any constructive, pleasant behavior - such as a hobby or enjoyable activity. Go for a walk, exercise, listen to music, read, play a computer game, knit or shoot a basketball.
  4. The Fifteen Minute Rule: delay your response to an obsessive thought or an urge to perform a compulsive behavior by letting at least 15 minutes elapse before doing so. Never perform the compulsion without some time delay. The longer you wait, the more the urge will decrease.
  5. Most importantly - don't do what your OCD is telling you to do!
  6. Keep a journal of your successes in refocusing.

REVALUE

  1. Do not take OCD at face value. The obsessions are not constructive, they are not worth listening to. And the compulsions are not helpful and they are a waste of time.
  2. You can't make the thought go away, but you don't need to dwell on it or act on it.

     
 
 
 One of the best books on OCD, especially strategies and techniques to reduce obsessive thought and compulsive behavior, is "Brain Lock" by Jeffrey Schwartz, M.D. His four-step method that is summarized above helps the person with OCD learn to mentally shift gears to reduce obsessions, and offers techniques to develop behaviors that increase control over compulsions. The following is a link to purchase the book from Amazon.com at a price much lower than retail in a bookstore.

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