The International OCD Foundation (IOCDF) is a non-profit organization focusing on spreading awareness, erasing stigma, and providing support to those living with Obsessive Compulsive Disorder. IOCDF hosts an annual conference for clinicians, OCD sufferers, and loved ones that is a wonderful opportunity to network and learn about OCD.
This year’s conference in Seattle was canceled due to COVID-19. Thankfully, IOCDF decided to host the event virtually. This made the conference available for individuals all around the world. The best thing about having a virtual conference was that the talks were prerecorded and available on demand for two weeks after the actual event. This allowed me to really enjoy all the brilliant presentations and expand my knowledge base. Here are some of the key takeaways I got from the many wonderful talks I watched!
Working with Families and OCD
I was very excited to see that there were multiple talks about working with families of OCD sufferers. OCD affects more than just the person with OCD. Parents, spouses, children, and friends are also often impacted by OCD. Because loved ones find it difficult to see the OCD sufferer in pain, they often do anything in their power to try to make them feel better. This is natural and understandable, but unfortunately not helpful as it leads family members to accommodate and provide reassurance to the OCD sufferer.
Jenny C. Yip, PsyD, ABPP gave a talk on family accommodation and how to reduce it to enhance treatment gains. Family accommodations might involve telling the OCD sufferer “I love you. I’m not going to leave you.” repeatedly. It might mean turning off the lights, driving the car, or doing the dishes for the OCD sufferer because doing these things is too difficult for them. Accommodation can include avoiding talking about certain things that cause the OCD sufferer to get upset. It can also include neglecting own self-care and changing daily routines to accommodate for the OCD sufferer’s rituals.
In the short term, accommodation and reassurance makes the OCD sufferer feel better. So as you can imagine, it makes a lot of sense that loved ones engage in these accommodating or reassuring behaviors. However, it is actually counterproductive and ends up making the OCD stronger while the OCD sufferer ends up struggling even more as a result.
If the OCD sufferer refuses treatment, their loved ones can still benefit from therapy. Heidi Pollard, RN, MSN, and C. Alec Pollard presented on how family members can learn about being supportive but not accommodating. Family members also learn to engage in self-care and prioritize their own psychological needs. It is very important to learn ways to be supportive but not accommodating. This can lead to the OCD sufferer facing their anxiety and therefore being more motivated to seek treatment. Additionally, loved ones learn to maintain self-care and enjoyable activities in order to manage their own feelings of anxiety, frustration, and anger.
Peripartum OCD
Becoming a parent brings along many unprecedented challenges. Joy Burkhard, MBA, Peggy Richter, MD, FRCPC, and Kate Destefano-Torres, MA, LPC discussed the presentation of peripartum (time period that involves pregnancy as well as postpartum period) OCD, which is a common triggering life event for worsening OCD symptoms. Both men and women can
experience peripartum OCD, which most often presents as sexual or violent intrusive thoughts concerning the baby that lead to compulsive behaviors, such as checking, extensive avoidance, and reassurance seeking.
Research supports CBT as the first choice of treatment, however there are some unique challenges that new parents face when seeking treatment, such as scheduling conflicts. Medication can also be used as a treatment after carefully weighing pros and cons to both mother and child.
Scared to eat – It’s a type of OCD
Eating can often become very difficult for individuals with OCD due to various reasons. Contamination concerns can make eating and preparing certain foods difficult. Steven D. Tsao, Ph.D, and Beth Brawley, MA, LPC discussed the interconnection between OCD and eating disorders, such as anorexia nervosa, bulimia nervosa, and binge-eating disorder.
Eating disorders involve various obsessions and compulsive behaviors similar to OCD. There is also an increasing awareness of ARFID, which is food- and body-related OCD. ARFID features fears of choking, vomiting, allergic reactions, fear of ingesting contaminants through food and drinks, fear of not being able to tolerate certain flavors or textures, excessive concern about digestion and defecation, and religious or moral concerns about food. When trying to discern between an OCD diagnosis and an eating disorder diagnosis, clinicians must ask about the consequences of eating certain foods as well as thoughts about weight gain. Malnutrition and other physical effects of disrupted eating need to be addressed as well often by a medical professional.
Body Dysmorphic Disorder
OCDCon also featured multiple presentations on Body Dysmorphic Disorder (BDD), which is considered an OC-spectrum disorder. Just like with OCD, a person with BDD has an obsession with a certain part of their body and engages in rituals such as checking, grooming, and reassurance seeking to deal with their feelings of disgust, shame, and anxiety.
Scott Granet, LCSW, and Chris Trondsen, AMFT, APCC, shared their personal experiences with BDD. Individuals with BDD often think they look deformed, distorted, and just wrong, compared to other people. Cognitive Behavioral Therapy focuses on challenging negative core beliefs, such as “I need to be beautiful in order to be loved” that maintain the disorder. CBT also focuses on building self-esteem in ways that go beyond appearance. Exposure exercises are a core feature of BDD as well. Exposure involves, as an example, wearing a piece of clothing that makes the person feel unattractive or draws attention to a certain body part.
Similar to the treatment of OCD, a fear hierarchy is created, starting with the easiest items and gradually work through the hierarchy. Ritual prevention is key and involves limiting mirror checking, grooming behaviors, and avoidance behaviors. CBT for BDD also involves learning to focus attention on the whole of one’s experience and appearance, rather than solely focusing on the perceived flaws.
Get Help for You or Someone You Love with OCD
If you or someone you know are suffering with the symptoms of OCD or anxiety, Houston Center for Valued Living can help. We offer both in person and telehealth sessions with evidence based treatment for OCD and anxiety. Houston Center for Valued Living also offers an Intensive Outpatient Program (IOP) for OCD and anxiety. To learn more about how an intensive outpatient program can benefit you, visit our IOP page.
Eeva Edds is a Licensed Professional Counselor with a passion for working with teens and adults experiencing anxiety and Obsessive Compulsive Disorder. She provides individual therapy as well as intensive outpatient therapy at Houston Center for Valued Living.