Is OCD Curable? It is commonly accepted that OCD is a chronic condition for which there is no cure. This idea is frequently used as an excuse for incomplete treatment, especially of compulsive rumination. Many patients who have completed ERP no longer do any physical compulsions but still ruminate. These patients are often told that the reason they’re not completely better is that OCD is a chronic condition, when the real reason is that no one has taught them how to completely stop ruminating. So, am I saying OCD is curable? Let’s answer that question with another question: Would you say someone who engages in absolutely no compulsion or avoidance has OCD? I would say they don’t. I would say that OCD consists of compulsion and avoidance, and that therefore, by definition, no compulsion or avoidance means no OCD. The counterargument I would expect is that this person would still have intrusive thoughts. But this argument falls apart when you break down ‘intrusive thoughts’ into (1) uncomfortable thoughts that occur to you, and (2) any engagement whatsoever with these thoughts — i.e., compulsive rumination. While an uncomfortable thought occurring to you isn’t controllable, this is also not a symptom of OCD; it’s a symptom of being human. And any engagement whatsoever with the thought is controllable and is a compulsion — and we said this person doesn’t do any compulsions. So would you say that someone who engages in absolutely no compulsion or avoidance — who sometimes has uncomfortable thoughts like all other humans, but doesn’t engage with them at all — has OCD? I would say they don’t, or at least they don’t right now. Thus, drawing a clear distinction between a thought occurring to you, and any engagement whatsoever with that thought, leads to the conclusion that a person can completely eliminate their OCD. So does this mean OCD is curable? Well, it’s definitely much more curable than people think it is. But if the word ‘cure’ means that something is permanently better, I wouldn’t say OCD is curable, because OCD will only remain better as long as compulsion and avoidance are completely eliminated. Consider the imperfect analogy of someone who gets their cholesterol under control by changing their diet.* Have they been cured? Only as long as they maintain the changes that made them better. While it might sound daunting, eliminating compulsion and avoidance does not entail an ongoing struggle. In fact, once a person sees that they have complete control over these behaviors, staying away from them becomes easy. This is why, in my mind, the goal of treatment is not only to eliminate current symptoms, but to help the patient see that they are completely in control of their behavior, including their mental behavior. That way even if they do fall back into compulsion or avoidance in the future, they know they have the ability to get back on track immediately. So I’m not sure whether I can say that OCD is ‘curable,’ but I know that it is possible to get completely better, to the degree that OCD is no longer a part of your life or even something you think about. And this is the standard that I think every patient and therapist should strive for. * The difference is that the dietary changes cause a change in the cholesterol, while the elimination of compulsion and avoidance are themselves the elimination of OCD.

Cassierole92

Date posted: 4y

I’d argue that it’s like being an alcoholic. It’s an addiction of sorts. You’ll always have OCD but with work, you won’t necessarily always be a victim of it. I say this because I improved my OCD by leaps and bounds over the years but after a year of quarantine I definitely backslid. Because you have a history of these thought patterns/behaviors, it’s very easy to engage them again. Giving in just a little too much to the tendency can result in a loss of momentum and if you experience some type of trauma it will definitely bubble up. But I do agree that with the right tools you can come very close to living as if you’re OCD free! Things that have helped me battle my OCD outside of therapy (therapy is important) - a healthy diet - keeping my body moving throughout the day - an early morning routine - having some type of creative outlet (painting, jewelry making, playing an instrument etc.) For me it’s like all this energy is stored in my brain and I need to get it out in other ways. Feeding myself fresh foods gives me the best kind of energy to expend physically. It did wonders paired with cognitive therapy/ERP.

ellie

Date posted: 4y

I think you can get close to cured but it's so important to remember it can come back because if it does and you're not prepared, it can be really destructive. like someone can recover from depression but they still need to be aware if they slip back into symptoms

BeachedMermaid

Date posted: 4y

Right, I think it can be super helpful to accept that it may come back, and that we have to keep up with doing the tools and techniques we’ve gained to help us.

stop.

Date posted: 4y

I get what you’re saying. I agree that you can get to a point where OCD isn’t an issue anymore. I’ve been there. But usually when we are looking at chronic it refers to long lasting and recurring, which OCD is. Bouts of OCD can last for years. I’ve gotten completely better and then so much worse so many times. I think it’s important for people who are better to still recognize they have OCD because it does comes back. It’s recurring. It may not come back as much as it did when it initially happened, but it comes back. That’s what makes OCD so hard and “incurable”. When you think it’s done, it’s not. I do think it helps patients and therapists to be more hopeful about treating OCD and reaching a place where it isn’t an issue anymore, but idk I think it’s good to know that it can come back too and be prepared to use the tools you learned in therapy to cope.

BeachedMermaid

Date posted: 4y

I’d say becuase OCD is a neurological disorder I’d consider it chronic, but there’s a lot of people who can get to points of having no active symptoms. The predispositions in the brain don’t go away, so doing therapy, and gaining tools to help can maybe get it to a point where it feels cured I think. Which is really all I can hope for.

stop.

Date posted: 4y

I didn’t even think of the neurological aspect. It’s great you brought that up. Even with the active behaviors and symptoms gone there’s still that chemical em balance in the brain. The OCD may not be active, but you’re right those predispositions in the brain are still there. It’s really cool you thought of that :)

Waaahmo

Date posted: 4y

Hi, don't you think that this might be reassurance seeking? :) You can be symptom-free and happy, and i think that should be good enough.

stop.

Date posted: 4y

Oh I didn’t even think of this being reassurance before I commented. Good on you for catching that.

Waaahmo

Date posted: 4y

@stop. My "trick" is to notice when something makes me feel anxious, and i start to engage..that's when i step back and wonder if it's reassurance haha

stop.

Date posted: 4y

@m666 That’s a good trick. I’m usually so impulsive that by the time I realize its reassurance or a compulsion the deed is done.

Waaahmo

Date posted: 4y

@stop. It took me a bit, i was the same as you and it's hard sometimes, but practice makes it easier and easier with time:)

Waaahmo

Date posted: 4y

I've read this again and i've come to realize that you probably didn't write this (unless you are a therapist/work in research), so i want to say apologize. It is common for people with OCD to think about this question as compulsion, which is different from when people study it in a scientifc way.

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