I'm Ian Reeder, a therapist here at NOCD. Ask Me Anything in the comments below!

Hello Anonymous, It is best to sit with the uncertainty. Intrusive thoughts can often be phrased as, "What if this happens?" Then something is done to make you feel better. I recommend messages we call response prevention messages. If you do something to reduce your anxiety about the intrusive thought, either by doing or saying something in your head, instead say something like, "Maybe I will do (specific intrusive thought); maybe I won't do (specific intrusive thought). I will see what happens." Bye sitting with this uncertainty, the anxiety will eventually pass. I hope this helps to answer your question and know that at NOCD, we are always here to help!

@Ian Reeder Thanks for replying, what I was meaning was that I know not to do compulsions and when the mental images appear I let them be there. With that said is it best to focus on the mental images in a sense for ERP or let them go away on there own and not focus on them in a sense for ERP?

@Anonymous - Hello Anonymous, I apologize for the delayed response. A valid questions. The simple answer is let the image be there, as that is the point of the exposure, but don't argue with it, rather stick with the uncertainty of "Maybe it is true, maybe it isn't true, I can handle not knowing". I hope this helps and know that at NOCD, help is always here.

Hello LiaExe28, Regarding dreams, in short, we don't know the answer to their meaning. I can say that compulsions are exhausting. The very nature of OCD is it's desire for you to do more. This inevitably takes time and energy away from other things in your life. I hope this helps and if you are looking to make a change, know that at NOCD, we are always here to help!

Hello Badar, I can share a hypothetical example. Now the key to any successful ERP is your therapist working with you as a team, to identify the relationship between you obsessions, compulsions, triggers, and what the feared outcome is. This is critical in developing exposures for ERP. Hypothetically, say an obsession was "What if I am transgender?"; one trigger might be hearing the word transgender, and a compulsion might be to tell yourself something reassuring. Using this information an example of an exposure would be to play a loop tape with the word transgender. This would be the exposure or the E in ERP. As anxiety rises the compulsion to reassure is resisted and this is the RP in ERP. Now say the person engages in the compulsion of reassurance, well a response prevention message "like maybe I am transgender, maybe I am not would be used by the person to negate their reassurance to sit with anxiety, until it naturally goes down. I want to highlight 2 things in this example. The first person with this type of obsession is struggling with identity, not with persons of a specific gender identity, sexual orientation, or even race. In fact person with this type of OCD are highly considerate of the challenges faced in the aforementioned communities, which is why OCD latches onto these thoughts. The second is that we never use people as props, as this would be inherently unethical and discriminatory. We as experts pride ourselves on our social justice advocacy. I hope this helps and know that at NOCD, we are always here to help!

@Ian Reeder So one should just wait for OCD thoughts to strike and avoid doing anything that reassures them?just sit with indifference?

@Badar - Hello Bader, in essence yes sit with it, but not indifference, rather uncertainty. OCD wants an answer, but no information is enough. The goal is to have habituation occur, which is your body naturally calming. When this happens then eventually we hope that the thought that was distressing causes indifference instead. I hope this finds you well and know that at NOCD, we are always here to help!

Hello Ajfake, In short the best method for any type of OCD is Exposure and Response Prevention (ERP). ERP is the gold standard of treatment, with near a century of research baking the evidence of its effectiveness in treating OCD. At NOCD each therapist is trained and vetted, to deliver ERP according to the research. Further this process is data driven. If you are seeking help in accessing effective treatment for OCD, don't hesitate to reach out to our care team at care@nocdhelp.com or our website at www.treatmyocd.com to begin working with an expert at NOCD. I hope this reaches you well and know that at NOCD, we are always here to help!

Hello jlopes234, The key is not to try to do anything with the thought. OCD wants an answer, a certain answer, but no amount of information will satisfy it. By sitting with "Maybe it is or maybe it isn't, I can handle not knowing." or a statement that keeps uncertainty there, then eventually the anxiety passes. By doing this repeatedly, the intrusive thought becomes like any other passing thought, just something to let go and not engage with. I don't recommend doing this alone. Here at NOCD, we have ERP trained experts that can assist you in gradually taking on this challenge. I hope this reaches you well and know that at NOCD, we are always here to help!

Hello Anonymous12345**, Yes OCD does this often. The nature of OCD is doubt itself. If you care about something, OCD can latch on to that and make as ask ourselves, "What if?" Simply saying reassuring ourselves, just brings the intrusive thought back asking for more. This is why ERP is the recommended treatment, as we don't try to talk OCD out of being there, we work with you to take action and diminish the strength of OCD, until it is just another thought passing like a cloud. I hope this reaches you well and know that at NOCD, we are always here to help!

Hello JawnyD, If you are seeking help in accessing effective treatment for OCD, don't hesitate to reach out to our care team at care@nocdhelp.com or our website at www.treatmyocd.com to begin working with an expert at NOCD. I hope this reaches you well and know that at NOCD, we are always here to help!

@Ian Reeder Insurance isn’t taken

@JawnyD Hello JawnyD, Insurance can be a barrier. I want to highlight that we take this into consideration. We have payment plans that allow for you to engage in recovery. You can find more info at https://www.treatymyocd.com/about-us/billing-resources. I would like to highlight that our goal in treatment is recovery. This means therapy is meant to end and once you recovery. I say this because we have seen in the research that our protocol reduces overall recovery costs from OCD by 15%. I hope this helps and know that at NOCD, we are always here to help!

@Ian Reeder That link didn’t open and I was told you guys won’t do cash pay

Hello gage736, Think of compulsions as food for the OCD part of the brain. By doing compulsions you feel a little better, because the OCD part of the brain says ok, you did that thing that helps so it's ok for now. The key is not doing the compulsion. This will make the OCD louder and make you feel like you have to do the compulsion. Not doing the compulsion eventually, your anxiety will reduce and the OCD will quiet down. This is the response prevention piece of Exposure and Response Prevention (ERP). If you are seeking guidance, in working on overcoming OCD, we here at NOCD specialize in ERP. Please reach out to our care team at care@nocdhelp.com. I hope this reaches you well and know that at NOCD, we are always here to help!

Hello lizzie11811, I would like to answer your question by first clarifying what the categories of HOCD, POCD, ROCD, and other categories are. These categories are themes that help persons who have OCD symptoms, identify that they may struggle with OCD, and seek help. As far as treatment and diagnosis go, there are no subcategories. There is only OCD. I make this distinction because the categories do not capture all of the experiences of OCD. What is important is the relationship between the obsession, trigger, compulsions, and the feared outcome. So to the 2nd point to answer your question, yes it would not be HOCD if the obsession was ego syntonic, as all OCD is ego dystonic. However, the case where the client turned out to be gay, likely had OCD, but did not fit neatly into a category. In any case treatment is the same, Exposure and Response Prevention. To identify the relationship that exists between your symptoms, the therapist you work with will engage in an in depth analysis with you to identify. I hope this helps to clarify your question and know that at NOCD, we are always here to help!