Everything You Need To Know About OCD Treatment
You've read that OCD is treatable. Then you look into it and find CBT, ERP, medication, apps, and a lot of advice that says to "stop thinking about it." This page sorts out which OCD treatment has the most support, what it looks like, and how to start.
By Nathan Peterson, LCSW, OCD therapistDifferent types of OCD
OCD is made of obsessions (unwanted thoughts, images, or urges that bring anxiety, doubt, or disgust) and compulsions (whatever you do to get rid of that feeling). OCD can latch onto almost anything. Some common types:
- Contamination OCD and germ OCD
- Harm OCD
- HOCD (sexual orientation OCD)
- Religious OCD and moral OCD
- Magical thinking OCD
- Relationship OCD
- Pure OCD, where the compulsions happen mostly in your head
The theme can change over time. The treatment works the same way no matter which theme you have.
What are the different types of treatment for OCD?
Exposure and response prevention (ERP)
ERP is the treatment with the most research behind it for OCD. It's a type of CBT made for OCD, and it's where OCD specialists start.
Cognitive therapy
Some CBT focuses on changing unhelpful thoughts. That can help with a lot of problems, but with OCD, arguing with the thought tends to backfire, because OCD always has one more "but what if." Some therapists use cognitive skills alongside ERP, but ERP does the heavy lifting.
Medication
Medications called SSRIs are often prescribed for OCD, sometimes alongside ERP. That's a conversation to have with your doctor or psychiatrist.
How ERP works
- Map your OCD. You list the situations and thoughts that set off your OCD, from easier to harder.
- Exposure. You face those triggers on purpose, starting with easier ones.
- Response prevention. You skip the compulsion afterward, like washing, checking, confessing, or reviewing.
- Let the anxiety be there. You don't have to make it go away. You bring it along and keep going.
- Repeat and build. Over time your brain learns it doesn't need the ritual, and you move up the list.
I know, "face the thing that scares you and don't do the ritual" sounds like the worst plan ever. That part is what makes it work.
What backfires with OCD
- Reassurance. Asking "are you sure it's okay?" helps for a minute, and then you need to ask again.
- Arguing with the thought. Trying to prove the thought wrong starts a debate OCD always wins.
- Avoidance. Staying away from triggers shrinks your life and teaches your brain they're dangerous.
- Trying to calm down first. Relaxation is fine, but using it to get rid of the anxiety can turn into another ritual.
Choose the right treatment for you
An ERP therapist
A therapist who specializes in OCD and ERP can build a plan with you week by week. Online OCD therapy works well too, which makes it easier to find a specialist. The International OCD Foundation has a directory at iocdf.org. It's fine to ask a therapist directly if they use ERP before you book.
An online OCD program
A structured program teaches ERP at your own pace. It helps if a specialist is hard to find, has a long waitlist, or costs more than you can do right now. You can also use one while you wait for a therapist, or alongside one.
OCD self-help
Books and free videos can help you understand your OCD and start small. Self-help works best when it gets you practicing ERP, not only reading about it.
Write down one compulsion you do every day. Tomorrow, delay it by five minutes. Notice the urge and let it sit there. (Five minutes. Easy, right?)
If you want the whole plan laid out step by step, that's what Master Your OCD is for.
Guides by OCD type
Common questions about OCD treatment
Can OCD be cured?
There's no switch that turns OCD off for good. With treatment, OCD can get a lot quieter, and you can get your life back. The thoughts may still show up sometimes. The difference is you know what to do with them, and they stop running your day.
Can I do ERP on my own?
You can make real progress with self-guided ERP, using a structured program or workbook. If your OCD is severe, you're not sure where to start, or you're struggling to keep going, working with an ERP therapist is a good idea. Some people do both.
Does online OCD therapy work?
Yes. ERP works well online, since the practice happens in your own life anyway. That can make it easier to find a therapist who specializes in OCD, even if there isn't one near you.
How long does OCD treatment take?
It depends on the person and how severe the OCD is. Changes often show up within a few months of steady ERP practice. Staying with it after you feel better helps keep OCD from creeping back.
