Far more common than previously thought, obsessive-compulsive disorder (OCD) now receives widespread attention from the general public. Reports in the media are frequent, but not always correct. The terms “obsession” and “compulsion” are sometimes incorrectly applied to various psychological difficulties, such as gambling or overeating, which are in fact quite different from OCD. Since the treatment methods used for OCD are not necessarily useful for other types of problems, it is important to understand exactly what OCD is.
The most widely accepted form of psychological treatment for OCD is behavior therapy, using procedures known as “exposure and response (ritual) prevention.” In this treatment method, the therapist first helps the patient develop a list of obsessively feared and avoided situations and a list of all compulsive rituals. Then the list of obsessive situations is put into order according to the amount of discomfort provoked. Exposure begins with the client being asked to confront easier situations for an extended period of time. As therapy continues, the client works toward dealing with the more difficult situations until all the feared items on the list have been faced and no longer provoke more than mild discomfort.
Most commonly, exposure is carried out directly, with the therapist and the patient going to each situation on the list and remaining as long as necessary for anxiety or discomfort to be reduced substantially. In some cases, exposure may be conducted in imagination, with the person imagining him- or herself going step by step through a scene designed to imitate the type of situation that provokes obsessive fear.
A publication from the Association for Behavioral and Cognitive Therapies
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