Therapy for OCD and Phobias

Are You Struggling With Phobias or OCD?

One of the really debilitating parts of having phobias or Obsessive-Compulsive Disorder (OCD) is how the efforts we make to avoid anxiety-provoking situations, things and thoughts gradually take over our lives. Over time these efforts we undertake to try to avoid and manage the things that cause us fear and distress take up more and more of our time, edging out everything that used to give us pleasure. It gets harder and harder to find time for our work or social life, harder to freely go places that we want to go, harder to make space for the things we used to enjoy. It ends up feeling like most of our time is spent trying to manage the focus of our anxiety with less and less success so that we end up trapped in an ever-increasing loop of anxiety and our attempts to manage it.

OCD and Phobias are Characterized by the Following:

An intense "obsessive" fear of a situation, object, or thought
Attempts (compulsions) that we engage in to attempt to avoid or reduce anxiety about the obsession or phobia
The compulsions, over time, working less and less well to manage the obsession or phobia
A resulting increase in our use of compulsions to work harder to manage the obsession or phobia
The compulsions take up more and more of our time and leaving less room for how we want to live our lives

Fortunately there is effective and evidence-based help for gaining control over OCD and phobias.

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OCD and Phobias are Very Common

About 2% of the US population will experience OCD and about 9% will experience phobias at some point in their lifetime. That means about one out of every ten people you know probably has or will experience OCD or phobias. We tend not to talk about them in society because people with OCD and phobias often feel ashamed about not being able to figure out how to get control over their symptoms, and people generally do not know how to help so, while being well-intended, can often respond unhelpfully when we reach out for support in ways that can make us feel more ashamed about our symptoms and more isolated.

There is nothing to be ashamed about. OCD and phobias are very common, and people who have OCD and phobias are courageous and creative about how we try to handle them. In the same way that having a medical diagnosis such as asthma or arthritis takes courage and determination to learn how to handle, having OCD or phobias is not a sign of personal failure and take enormous creativity and strength to carry.

I Have Tried Therapy and It Hasn't Worked

Many people who experience OCD and phobias have tried therapy without success. It's important to understand that the normal approaches therapists use that work well to help people with managing anxiety tend not to work in the case of OCD and phobias, and can actually make the symptoms worse. That's because the core problem in both OCD and phobias is that the coping strategies we try to use to eliminate or avoid the things that are causing the anxiety actually become the main problem since they work less and less well over time, and we tend to respond by trying to increase the amount we are using them in the hope that they will begin working if we use them more, but by using them more the compulsions themselves begin to take over our lives. Trying to add further coping strategies in therapy can end up worsening the problem by effectively adding more behavioral compulsions to our growing list, and trying to reality-test or think differently about the sources of our anxiety has the same effect with our thoughts, often causing more mental compulsions.

Effective Treatment Involves Exposure Response Prevention Therapy

As a result, a specific form of evidence-based therapy called Exposure Response Prevention Therapy (ExRP) is usually needed to get a handle on OCD and phobias. ExRP works differently than other forms of therapy by not focusing on developing coping skills, but instead by gradually exposing us to the source of our fear in a way that reduces the fear or phobia itself so that the strategies or compulsions we have been using to manage it are no longer necessary.

The strategy is similar to watching a horror movie over and over to the point that it becomes boring and no longer triggers fear, so we no longer need to avoid it or use anything to deal with it. Once the compulsions drop away we are able to move on with our lives and get back to the things that make life worth living.

There is Hope

Our team of OCD and Phobia therapists at Engage Psychotherapy (see below) are all trained in ExRP. We understand that OCD and Phobias are often not the only symptoms a person may be dealing with so each therapist is also trained in several other approaches, such as trauma work and CBT, and can integrate several concurrent approaches into your work together to ensure there is flexibility and support available for everything you are going through.

For ExRP we use evidence-based assessment tools, will work with you to understand what OCD and Phobias are and the details of your specific experience so you can gain a full understanding of your symptoms, the diagnosis, and the treatment model in order to build a solid foundation of trust and understanding. This will allow you to feel comfortable and confident in approaching the ExRP work together with your clinician. ExRP will then guide you together through gradual, controlled and safe exposure to the source of your anxiety or fear both in sessions and during the week in your daily life to gradually deactivate the anxiety and fear so that you no longer need to avoid the source of that fear or use compulsions to manage it. Once you begin ExRP you will begin to experience the benefits quickly so you do not need to wait a long time before you begin to get relief.

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You May Still Have Some Questions About ExRP Therapy…

I’m worried about the cost of ExRP therapy.

We are registered to bill with most insurance companies and accept assignments using your out-of-network benefits, so you can usually just pay your cost-sharing amount. In any case, we also urge you to consider the lifelong benefits that can be gained from seeking professional support. Therapy can set you up for long-term happiness, ensuring that you don’t have to keep spending money trying to manage anxiety in the future.

I’m concerned about the time commitment involved.

OCD and Phobias are both very treatable, and you might be surprised by how quickly you can experience noticeable improvement in the short term. And if you’re considering therapy, then you’re already motivated to work on the issue, which gives you a head start. By working in tandem with a skilled ExRP therapist, you will be able to make even greater progress.

I’ve had a bad experience with OCD or Phobia therapy in the past.

The first step of ExRP therapy involves your clinician working with you to understand your previous experiences in therapy in order to understand what has and has not worked in order to avoid repeating the parts of therapy that have been disappointing for you or which have made your symptoms worse. We are highly collaborative in our approach and our work will involve seeking feedback as we go along so you have control and input into the process together. ExRP works differently than other forms of anxiety therapy and it’s not unusual for anxiety therapy to make OCD and Phobias worse. ExRP is different and is highly evidence-based and demonstrated to be the leading therapy for helping people find relief from OCD and phobias.