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Page 1 of 4 online conference transcript
Dr. Gerald Tarlow joined us to discuss different treatments for OCD (Obsessive-Compulsive Disorder), such as behavior therapy, exposure and response prevention, and OCD medications (like SSRI's). He discussed how facing your fears through therapy can abolish your compulsions and significantly reduce your obsessive thoughts, thus alleviating your feelings of shame and guilt.
David Roberts is the HealthyPlace.com moderator.
The people in blue are audience members.
David: Good Evening. I'm David Roberts. I'm the moderator for tonight's conference. I want to welcome everyone to HealthyPlace.com. I'm glad you had the opportunity to join us and I hope your day went well. Our topic tonight is "Getting The Best Treatment For OCD, Obsessive-Compulsive Disorder." Our guest is Gerald Tarlow, Ph.D., of the UCLA OCD Day-Treatment Program. He is also director of Center for Anxiety Management. We'll be discussing therapy, meds, and hospitalization to treat OCD. Dr. Tarlow will also be taking your personal questions.
Good evening, Dr. Tarlow, and welcome to HealthyPlace.com. Thank you for joining us tonight. What would you say defines the "best treatment for OCD?"
Dr. Tarlow: The best treatment for OCD could be behavior therapy, OCD medications, or a combination of the two.
David: Some people may live in or near Los Angeles and may have access to a great treatment program, like the one at the UCLA Medical Center. However, many people don't. How does one find excellent treatment for Obsessive-Compulsive Disorder in their community?
Dr. Tarlow: It is difficult to find good, experienced behavior therapists. I would suggest that people contact the OC Foundation in CT.
David: When you use the term "good, experienced behavior therapists," what do you mean by that? What should people be looking for when selecting a behavior therapist?
Dr. Tarlow: It is important that the therapist have experience treating OCD patients using the techniques of exposure and response prevention.
David: Don't all therapists have that type of training?
Dr. Tarlow: No. In fact, very few have been trained in these techniques.
David: I want to address some OCD treatment issues. Many people with Obsessive-Compulsive Disorder suffer from shame and guilt because of the symptoms associated with the disorder. That, alone, may prevent them from seeking the treatment they need. They experience tremendous amounts of guilt, not only for their unsavory thoughts but also for what it implies about their character. How do you remove the shame and guilt pervasive among OCD sufferers?
Dr. Tarlow: It is important for people with OCD to talk to other people who have had similar problems. The attention that OCD has received in the media (e.g. talk shows) has also been helpful in getting people into treatment.
David: I think some people with OCD have expectations of what will happen when they take OCD medications, like Prozac, Paxil, Zoloft, Luvox and combine that with therapy. From emails I receive, many are expecting to be cured. Is that reasonable?
Dr. Tarlow: I don't like to use the word "cure." The problem can be controlled and people can lead very productive lives.
David: So are you saying the obsessions and compulsions never really go away completely?
Dr. Tarlow: Since obsessive thoughts are experienced by about 90% of the population, I would say it is difficult for them to go away completely. However, the frequency and intensity of the thoughts can be greatly reduced and the compulsions can be eliminated.
David: I know that each person is different, but roughly how long does it take, using medications and therapy, to experience a significant improvement in your daily life if you have mild to moderate OCD? Then, extreme OCD?
Dr. Tarlow: For mild to moderate OCD you could expect treatment to last 3-6 months. For more severe OCD it may take several years to really get the problem under control. However, with the intensive treatment programs, similar to the one at UCLA, we can reduce the symptoms significantly in a short period of time (3-6 weeks).
David: Is there any reason you can think of for someone to be afraid of therapy for OCD? Will it initially be a scary process?
Dr. Tarlow: Behavior therapy involves facing the fears. This may produce a great deal of anxiety for many patients. However, we can make the process easier by starting with mild fears and working up to more difficult ones.
David: One other question before we start with the audience questions. When is it time to consider hospitalization for OCD, whether it be inpatient or outpatient? And what is the difference in the treatment program between the two types of hospitalizations?
Dr. Tarlow: Very few people need to be hospitalized for OCD. Most of the intensive treatment programs are usually 2-6 hours per day. It is important that patients learn to confront the fears in their home environment, not just in the hospital.
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