We all double checks things. But what happens when these habits spin out of control?
The need to perform repeated rituals to ward off intrusive thoughts is known as obsessive compulsive disorder. According to the National Institute of Mental Health (NIH), OCD affects nearly 2.2 million adults. Left untreated, it can take on a life of its own.
In a recent interview, we talked to renowned OCD expert Dr. Patrick McGrath. Our goal was simple: to learn the ins and outs of all things OCD.
Here’s what he had to say.
Thank you for speaking with us, Dr. McGrath. First of all, why does OCD have so much power over people?
OCD has so much power because it is directly linked to your emotions. Emotions are designed, evolutionarily, to be very powerful. When your Fight, Flight, or Freeze system gets activated, you do what you can to make that calm as fast as you can.
So what’s the best treatment for OCD?
The best way to decrease this power is to do Cognitive Behavioral Therapy and Exposure and Response Prevention (ERP) because ERP targets the emotional center of the brain. You can’t talk people out of being anxious, but you can behave people out of being anxious. Therefore, reduce the power of OCD and anxiety by doing the opposite of what they want you to do. Then you can overcome these issues.
Some experts in the mental health field suggest that those who suffer from OCD should resist compulsions, but others say that it is essential to embrace them. We find this to be confusing. Which method do you think is the most effective…and why?
I find it confusing as well, actually. The best way to help someone with OCD is to get them to stop doing their compulsions. Think of it this way…every time you do a compulsion and your feared consequence does not happen, you will feel as if it was the compulsion that kept you safe. Therefore, getting people to not do their compulsions is a way to teach them that their OCD lies to them. Never once has OCD told the truth to someone – it is just a liar. Remember that.
Can you ever really recover from OCD? For many of our readers, it has been an uphill battle. In other words, do you have any words of inspiration that will offer hope?
There may be no cure for OCD, but you can learn to live with it. I often use an example from my own life. Imagine being in a theater or church and someone walks up to the organ, turns it on, takes a rock, and puts it on the highest key on the keyboard. This would create the highest note possible from the organ. After 5 minutes or so, this would get to be pretty annoying. And yet, that is the sound that I have heard for over 20 years. I have tinnitus – a ringing in the ears. While it is annoying, I have gotten used to it. I know it will never go away, and I accept that.
OCD can be the same way – you can learn to live with it. You know it will never go away, but you can learn to not pay any attention to it. I do not always hear my tinnitus even though it is always there. Right now it is very loud because I am writing about it, but it will fade away again soon. Your OCD can be the same way – it can fade away for a period of time, and if it does rear its ugly head again, you can just recognize it and move on without paying it much attention at all.
Is OCD developed later in life, are people born with it… or both? And what causes it?
It can be both. Some people I treat can describe a stressor that they experienced that led to their OCD, while others describe it as “just always being there.”
Think of it like this – we all have certain predispositions to certain things, but we need the right stressors to kick something off. For example, in PTSD, three people may experience the same stressor or trauma. One thinks it was actually pretty cool, another is indifferent to it, and the third person feels as if it were the worst experience in their life. They all experienced the same thing… so why the different ways of responding?
This is because we are all different people, and we all perceive things differently. Therefore, we all respond to stressors in a different way. One day something may not bother you at all, while the next day it may bother you a great deal.
The take home message is really this – what caused your OCD is not as important as what maintains your OCD. If you want to overcome OCD, you have to eliminate the safety seeking behaviors- as they are the things that really do maintain your OCD.
So how did you come to specialize in this illness?
I was fortunate enough to get a practicum at the University of Illinois College of Medicine in Peoria at their Anxiety Disorders Clinic under the direction of Dr. Tim Bruce. I collected data for studies that they were doing and got to learn a lot about how anxiety worked and how to study it.
Years later for my postdoctoral fellowship, I worked at the St. Louis Behavioral Medicine Institute in their Anxiety Disorders Center. I was the postdoctoral fellow of Dr. Alec Pollard, a nationally known therapist for the treatment of anxiety disorders. It was in those two years that I really developed my passion for helping people who have anxiety disorders. I don’t work with any other kinds of patients other than anxious individuals. In the last 15 years, I have treated thousands of anxious individuals, and I look forward to treating thousands more.
I have also loved writing about anxiety disorders. I enjoy the fact that I get the chance to explain how anxiety works to not only people with anxiety, but to their family and friends as well.
Very interesting. Tell us a little bit about you-something unique and different that we would not find in a bio.
I have had the opportunity to travel a great deal and train therapists around the world on how to treat anxiety. On a trip to Turkey, a friend and fellow therapist, Brett Deacon, came with me. He has a side job as a photographer. Being there with him and seeing the pictures he took inspired me to get into photography as well.
Now, when I travel and do talks and trainings, I like to take my cameras with me and take pictures of landscapes. It is a thrill to capture that moment when the sun is just right and the scenery is highlighted with colors that seem almost too impossible to be real. Someday I will actually put them up on a website. While I may not be as good of a photographer as I would like to be, if I am going to tell my patients to take risks, I have to do that as well.
If you had to give our readers two tips on dealing with OCD, what would they be?
- Stop avoiding everything that makes you anxious. Sure, this may feel good at the time, but it doesn’t help you to move forward.
- Work on moving past avoidance, reassurance and distraction. These are called Safety Seeking Behaviors. They can make for a slippery slope because once you do one of these things, you will start to feel good right away. When people eliminate their safety seeking behaviors, they are given the opportunity to truly see that they can handle their fear on their own and that they do not need to do compulsions.
About: Patrick McGrath, Ph.D., is the Director of the Alexian Brothers Behavioral Health Hospital’s Center for Anxiety and Obsessive-Compulsive Disorder Program, President of Anxiety Centers of Illinois, and President of OCD-Midwest, an affiliate of the International OCD Foundation. He’s the author of a stress management workbook titled Don’t Try Harder, Try Different as well as The OCD Answer Book. Dr. McGrath has also been featured on the Discovery Health Channel’s documentary “Anxious” and on The Learning Channel’s “Hoarding: Buried Alive.” Dr. McGrath trains students and therapists across the country in the treatment of Anxiety Disorders. He is also the president of a Private Practice Group in Illinois called Anxiety Centers of Illinois.