Help for OCD

A few weeks ago I wrote about seeing an episode of the OCD Project and wondering if the treatment shown was typical or being sensationalized for TV. Some of you were upset that I would even question what was being broadcast, and others were dismayed that I only had questions (not answers). So today I'm back to present you with some facts. I spoke with Dr. Jeff Szymanski, executive director of the International OCD Foundation, and he provided me with some great information about how to treat OCD and also how to evaluate various reality shows (like the OCD Project on VH1 and Obsessed on A&E) that depict the condition. First, some basics…

What is OCD?

Obessive compulsive disorder (OCD) is a condition in which someone is plagued by anxiety-provoking intrusive thoughts or images and then practices repetitive behaviors or rituals in an effort to quell that anxiety. There are many different types of obsessions and compulsions: You've probably heard the example of someone who washes her hands incessantly because she's deathly afraid of germs. Another OCD sufferer might be convinced that her house will burn down if she doesn't go back 200 times to check that the toaster is turned off. Or she might do something that seems completely unrelated—like spin around in circles 3 times every time she leaves the house to "prevent" it from burning down. These fears and behaviors may seem irrational to other people, but they cause crushing and overwhelming anxiety in someone with OCD, explains Dr. Szymanski.

What's the best treatment?

Most OCD patients will benefit from a combination of medication (usually anti-depressant drugs) and a type of therapy called exposure and response prevention (ERP). This therapy basically entails facing your fears while resisting the urge to use compulsions to calm you. For example, if a patient is obsessed with a fear that germs are going to give her a disease (so she normally washes her hands non-stop), it may be necessary for her to go longer than usual without washing up or for her to intentionally touch dirt or garbage so she can eventually learn that it's not actually going to make her sick.

A therapist might send you home with different assignments for behaviors to practice (or avoid) in between office sessions. Some therapists will actually take you into real-world situations and help monitor your behavior, but that kind of treatment may be more difficult to find (unless you have severe OCD and are being treated in an in-patient setting).

So how accurate are those reality shows?

The International OCD Foundation isn't willing to publicly praise or criticize shows like the OCD Project and Obsessed. Dr. Szymanski explains that the organization would rather provide viewers with some tools to use when coming to their own conclusions about these programs. If a show is doing a good job of representing proper OCD treatment (with ERP), you should see:

â¢The treatment plan being explained clearly to the patient (and the viewing audience). The patient should understand the treatment she will undergo and why it will help her.

â¢A therapist acting as a collaborator with a patient. The patient should be following a therapist's instructions because she really wants to get better (not because she feels forced to do something).

â¢A patient being treated respectfully. As a viewer, you should have the sense that the therapist is suggesting treatments that are truly in the best interest of the patient.

â¢A step-wise process. A patient should be eased into the therapy, not face her worst-case-scenario fear on day one.

â¢Success. You should see that, at the end of the treatment program, the patient has dramatically improved. The patient (and you, as a viewer), should feel that any uncomfortable parts of her treatment were worth it because they helped her get better.

Keep in mind that when it comes to some reality TV shows these crucial elements could be spread out over a series of episodes, so you may not get the full picture if you only tune in occasionally.

Have you tried ERP? Did it work for you?

—Barbara Brody, Health Editor

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