OCD: Getting Control of Your Obsessions and Compulsions - Getting Control of OCD

Written by HealthyPlace.com Staff Writer

David: Scrumpy brought up the fact that she had an OCD relapse after several years of doing well. Is that common?

Dr. Baer: An OCD relapse can be caused by several factors. Sometimes things like pregnancy can lead to relapse, or a major life stress like marriage or moving or changing jobs. Also, when people stop taking SRI medications that have helped control their OCD symptoms, about 50% notice a recurrence of symptoms in the months following.

David: Here's a description of Scrumpy's OCD symptoms, then we'll continue:

scrumpy: These are my biggest fears: I can't seem to get past this stage when I was told I was in the same room as someone who had just had a baby. I froze then I went all hot and cold in a matter of seconds. I found out the baby was 3 months old and the lady would not be menstruating anymore. I feel anxiety as well as fear. I had behavior therapy before when I relapsed.

David: Here's the next question:

PowerPuffGirl: Would the speaker please give some behavioral examples of mild vs. moderate vs. severe OCD?

Dr. Baer: We have a residential program at McLean hospital for people with severe OCD. Most of these people have not responded to many different medications. Often to behavior therapy as well. Some of these very severe OCD sufferers need help to even get into the bathroom, or out of bed, or out of the shower. Some are so affected they can't eat!

By the way, Moderate OCD is usually treated on an outpatient basis. These people are usually able to work, or go to school, but their day is interfered with by OCD symptoms. People with mild OCD rarely come to our clinics, but they can benefit from self-help OCD books.

David: Please post the phone number where people can find out more about the residential program.

Dr. Baer: If anyone has severe OCD, they can contact our residential program manager Diane Baney at 617-855-3279 for information.

David: To those in the audience, if you have found some effective method or way or coping with or relieving your OCD symptoms, please send them to me and I'll post them as we go along. That way others can benefit from your knowledge and experiences.

bedford: What should family members do so they are not enabling the OCD suffer? Any good books out regarding this? When is Imp of the Mind due out?

Dr. Baer: Easy question first - Imp of the Mind is out Jan 15th 2001, but amazon.com is taking orders now, and probably shipping now.

Dr. Gravitz has written a good book on families and OCD. I don't remember the title, but it came out a year or so ago. Most self-help OCD books, including my Getting Control, include one or more chapters for family members to read about how to try to help (often by not helping so much!)

scrumpy: Herbert L. Gravitz, book for families is called Obsessive Compulsive Disorder, New help for the family. I have it in front of me.

Nerak: Can you explain the difference between OCD & OCPD and how one treats OCPD (Obsessive-Compulsive Personality Disorder)?

Dr. Baer: OCPD is obsessive-compulsive personality disorder. It is really what we mean when we say that someone is "compulsive". These people are very detail oriented, they can be workaholics, they can insist that family members do things exactly the way they ask them to, they have also been traditionally described as "stingy" with emotions and with money, and they may have trouble throwing things away. Notice that they do not have the classic obsessions or compulsions of OCD. Honestly there is not much research on treating OCPD because most of these people don't come to us for treatment - their symptoms may bother their family members, but usually not the person him/herself. However, when a person has BOTH OCD and OCPD, we often see the OCPD get better as the OCD gets better.

David: Here are a few audience tips for coping:

PowerPuffGirl: I've found that by addressing the cognitive/ emotional piece, specifically in terms of, for example, contamination fears, that clients have seen great success.

JagerXXX: I find that drinking and using substances can lead to terrible OCD episodes.

joshua123: Doctor, I have scrupulosity and I am trying to find help for the last 7 years. It is extreme and I have been on many meds. I need a specialist in the San Francisco bay area. Do you know how I could obtain this?

Dr. Baer: As far as behavior goes, Dr. Jacqueline Persons is an excellent behavior therapist, with offices I think in Oakland and SF. For medication, Dr. Lorrin Koran is very experienced with OCD and is at the Stanford medical school. Finally, if you happen to be covered by Kaiser Permanente, I recently participated in major training program for 90 of their therapists to learn how to treat OCD. They seemed very competent. Good luck.

David: And could you define scrupulosity for us, please?

Dr. Baer: Scrupulosity is usually associated with religious or moral guilt. Usually the person is worried about having committed a sin. The Catholic church has written about this for centuries, and their is even a religious organization called "Scrupulous Anonymous." I know they have a web site too.

EKeller103: Could Dr. Baer please discuss the connection between OCD and Ruminating?

Dr. Baer: Ruminating is worrying or thinking about something over and over again. Often it is about real life things, like not having enough money, or whether something will work out or not. Therefore, ruminating occurs in depression and in anxiety. Obsessions are a very specific kind of ruminating, about being dirty or contaminated, or about having made a mistake, or about things being out of order and not perfect, etc.