OCD Therapy Online for New Yorkers
Whether you have a known diagnosis or you’re looking to learn more, we are here to help!
What is OCD?
Obsessive-compulsive disorder (OCD) is a type of anxiety disorder defined by the presence of both obsessions and compulsions. Obsessions are recurring, distressing thoughts, and compulsions are repetitive behaviors which provide temporary relief from obsessions. Many people with OCD begin to experience symptoms as children or adolescents, while others may develop OCD later in life as adults.
What Causes OCD?
Mental health professionals have yet to pinpoint exactly what causes OCD. However, research suggests that OCD is caused by a combination of genetic, neurological, and environmental factors. Family history and brain chemistry may play a bigger role for people whose symptoms start during childhood.
Obsessions
Obsessions are unwanted, repetitive thoughts or mental images that cause feelings of anxiety, guilt, shame, or disgust. Obsessions are often referred to as “intrusive thoughts” because while people do not want or choose to think about them, they are also unable to stop these thoughts from returning, despite their best efforts to suppress them.
Obsessions may feel like your mind is stuck, not unlike a record player that skips or a song that is set to “repeat,” playing again and again on a continuous loop.
Compulsions
Compulsions are specific behaviors or rituals that folks with OCD feel they have to perform in order to alleviate the emotional distress that accompanies their obsessions. Compulsions feel involuntary and often involve tasks that people would prefer not to do, were it not for their OCD. Compulsions can be external, observable actions like checking that household appliances are unplugged, doors are locked, or washing one’s hands. They can also be rituals that are not visible to others, like repeating a particular word or phrase in one’s head. These are sometimes referred to as “mental compulsions.”
What Does OCD Look Like?
The content of each person’s obsessions and compulsions tends to vary significantly. However, many people with OCD experience symptoms connected to the following four themes:
Contagion OCD
Obsessions may involve intense fear of contracting or spreading a particular illness, disease, or infection. Folks may also experience excessive preoccupation with germs or cleanliness in general. Common compulsions include excessive hand washing or cleaning practices; avoiding shared spaces, such as public restrooms; seeking repeated medical testing (at a frequency that exceeds recommended guidelines), or obsessively researching a feared illness or medical condition.
“Just Right” OCD
This sub-category involves a preoccupation with symmetry, order, and exactness, accompanied by a recurring feeling that something is “off” or “incomplete.” Compulsions are performed in an effort to resolve this nagging discomfort, as well as to achieve a subjective “just right” feeling. Examples may include arranging and re-arranging objects, the need to perform tasks in a highly specific order, repetitive grooming habits, or re-writing texts and emails. Rituals may also involve counting (either mentally or out loud).
Taboo OCD
These obsessions pertain to behavior deemed wrong or unacceptable by society. Intrusive thoughts may involve blasphemy, inappropriate sexual behavior, graphic violence, or acts that violate a person’s values like having an affair or abandoning their children. People who struggle with taboo obsessions tend to feel horrified and disgusted by these thoughts, usually have no history of violence, and do not experience urges to actually engage in these behaviors. Compulsions may include efforts to intentionally think “good” thoughts, confessing intrusive thoughts to others, or mentally reviewing past social interactions to check that they didn’t “lose control.”
Responsibility & Harm OCD
People with OCD often worry excessively about hurting others, either emotionally or physically. This is often coupled with unjustified feelings of responsibility. Compulsive behavior usually involves “checking” that harm did not occur or rituals aimed at preventing future harm. For example, a person may mentally review a prior conversation to make sure they didn’t say something offensive, seek verbal reassurance from others by asking questions like “are you okay,” or repeatedly check that doors and windows are locked (out of fear that their family will be harmed in a home invasion).
If you believe you may have OCD, but you don’t see any of your symptoms described above, we encourage you to schedule a consultation call with a member of our team. Only a trained mental health professional can provide an accurate OCD diagnosis.
OCD is a vicious, self-perpetuating cycle.
While compulsions help people to feel better at the moment, they also train the brain to believe that these rituals are the only way to experience relief. They also contribute to the faulty belief that obsessions themselves are dangerous. By acting on compulsive urges, people with OCD actually become more likely to feel the need to repeat the ritual again in the future when the intrusive thought inevitably returns.
When OCD Becomes a Problem
Whether you have a known diagnosis or you’re looking to learn more, OCD may be a problem for you if you identify with any of the following:
Life Impairment
Compulsive rituals take up at least an hour of your day, or they interfere with your functioning on a regular basis. Tasks that once felt manageable now take much longer to complete or involve increasingly elaborate steps. Your OCD causes you to run late, miss deadlines, or cancel plans due to mental or physical exhaustion.
Self Doubt
You worry about the meaning of your obsessions and think that your intrusive thoughts must be “true.” You fear that you are dangerous, feel overwhelmed by guilt and shame, or believe that you’re a “bad person.” You may begin to doubt your judgment, your memory, or your self-worth.
Your World Becomes Smaller
Activities you once enjoyed now feel dangerous or impossible. Your efforts to navigate potential triggers leave you feeling like you’re constantly walking on eggshells. You find yourself avoiding certain places, social situations, or topics of conversation because they feel unsafe, or simply too draining to engage with.
Rigidity and Control
Your life is governed by rigid rules and routines, and you struggle to adapt when plans change. You may feel easily overwhelmed or begin to panic when circumstances are beyond your control. This pattern of inflexibility may cause you to become easily irritated with others, creating strain on your personal relationships.
ExRP Therapy for OCD
Therapy can empower people with OCD to take back control of their lives.
Psychotherapy can help people with OCD experience significant, long-term relief from their symptoms.
Exposure and response prevention (ExRP) is a type of cognitive-behavioral therapy (CBT) that is highly effective for treating OCD.
As the name suggests, ExRP is a kind of exposure therapy. It involves clients learning to approach their fears under safe circumstances with their therapist’s support. During exposures, clients practice facing specific thoughts, body sensations, and real-life situations that trigger their OCD, without engaging in compulsive rituals.
This might seem very difficult, but with the right guidance, ExRP should actually be an empowering experience. You and your therapist will work as a team to create a personalized plan for how to face your triggers gradually, allowing you to build your confidence over time.
This process disrupts the OCD feedback loop, causing compulsive urges to become less powerful and easier to ignore. The urge to engage in certain rituals may even disappear completely. Resisting compulsions also creates cognitive shifts in the brain, causing intrusive thoughts to become quieter and eventually fade into the background.
Other OCD Related Disorders
OCD is sometimes confused with other mental health conditions. While these disorders are distinct from OCD, they may involve similar symptoms or patterns of behavior.
Body Dysmorphic Disorder (BDD)
BDD is defined by excessive worry and preoccupation with one’s physical appearance.
Individuals with BDD struggle with negative judgments and distorted beliefs about their looks, which tend to differ markedly from the way they are perceived by others.
Hoarding Disorder
Individuals with hoarding disorder struggle to throw things away, even when these objects are broken, decaying, or have no apparent financial or sentimental value.
This results in the accumulation of excessive amounts of clutter that can cause their living spaces to become unmanageable or even hazardous.
Trichotillomania & Excoriation Disorder
Both disorders are characterized by specific body-focused repetitive behaviors (BFRBs), which may feel similar to other compulsive urges. Trichotillomania involves repetitive hair-pulling or plucking, while excoriation disorder is defined by a pattern of skin-picking, often resulting in patches of irritation, inflammation, or lesions. Unlike intentional grooming practices, these behaviors feel involuntary and cause significant emotional distress.
Cognitive-behavioral therapy can be very effective for folks experiencing OCD and other related disorders.
If OCD is preventing you from living the life you want, schedule an assessment as soon as possible.