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Manage OCD and live a better life, thanks to this friendly Dummies guide
People with obsessive-compulsive disorder (OCD) need skills and tools to manage their symptoms. OCD For Dummies offers help for you or your loved one when it comes to recognizing, diagnosing, treating, and living with this common mental and behavioral disorder. Dummies gives you all the information you need on getting your symptoms under control and working toward remission. This edition updates you with the latest research on OCD, new therapeutic treatments, and all the most up-to-date resources to help you along on your OCD journey. You’re not alone—there are millions of people out there who understand what you’re going through, and OCD For Dummies does, too. Understand obsessive-compulsive disorder and get the help you need with this book.
If you or someone you know has symptoms of OCD or has received a recent diagnosis, this book will gently guide you through building the skills and awareness that will let you live life to its fullest.
Laura L. Smith is a clinical psychologist and former President of the New Mexico Psychological Association. She has presented workshops and classes to national and international audiences, including the University of New Mexico adult continuing education program (Osher). She wrote Anxiety For Dummies and Depression For Dummies.
Introduction 1
About This Book 2
Foolish Assumptions 2
Icons Used in This Book 3
Beyond the Book 3
Where to Go from Here 3
Part 1: The Ins and Outs of Ocd 5
Chapter 1: Facing Obsessive-Compulsive Disorder (OCD) 7
What Is OCD? 8
Suffering shame 9
Wrestling with risk 9
Dealing with doubt 10
Counting the Costs of OCD 10
OCD and the Media 11
Pandemic panic 11
Disgusting filth 12
Exploring Treatment Options for OCD 13
Changing the way you think with CBT 14
Thinking about thinking: Metacognitive therapy 14
Approaching OCD mindfully 15
Modifying behavior through ERP 15
Controlling OCD with medications 16
Sending signals deep into the brain 17
Helping People with OCD 17
Chapter 2: Understanding What OCD Is All About 19
Seeing the Two Sides of OCD 20
Obsessing about obsessions 20
Considering compulsions 22
Coming to Terms with OCD 24
The OCD worry cycle 24
Thinking and believing 26
Inspecting impulses 27
Categorizing the Types of OCD 28
Doubts, fears, and uncertainties 29
Contamination, germs, and dirt 30
Shame, embarrassment, and inappropriate thoughts and behaviors 31
Superstitions and rituals 34
Symmetry and perfectionism 34
Parenting OCD 35
Obsessive feelings and sensations 36
Separating OCD from Normal Worries 38
OCD and Diversity 39
Getting to a Diagnosis of OCD 40
Avoiding self-diagnosis 41
Avoiding misdiagnosis 41
Chapter 3: Meeting The Associates and Relatives of OCD 43
Recognizing the Guests or Associates of OCD 44
When anxiety and OCD hang out together 44
Moods and OCD 45
Meeting the Close Relatives of OCD 45
Body dysmorphic disorder (BDD): A seriously distorted self-image 46
Hoarding disorder 47
Trichotillomania: Pulling your hair out 49
Skin-picking: Excoriation disorder 50
Distant Cousins of OCD 51
Obsessive-compulsive personality disorder 51
Smelling bad: Olfactory reference disorder 52
Tics and Tourette’s syndrome: Involuntary sounds and movements 53
Somatic symptom disorder: I think I’m really sick 55
Eating disorders: Intense fear of fat 56
Impulse control disorders: unstoppable bad habits 57
Chapter 4: Blaming the Brain for OCD 59
Looking at the Brain’s Role in OCD 59
Connecting genetics with OCD 60
Getting inside your head 60
Choosing a Path to OCD 61
Taking information in 62
Selecting the shortcut 62
Picking the high road 63
Communication within the Brain 65
Electricity and chemicals 66
Serotonin, dopamine, and glutamate 67
Chapter 5: Developing and Living with OCD 69
Developing OCD Early 70
Good intentions; bad results 71
When bad things happen 73
Learning by seeing 75
Developing OCD as an Adult 76
Reinforcing OCD with Positives and Negatives 77
Supporting OCD with positive reinforcement 77
Supporting OCD with negative reinforcement 77
Combining positive and negative reinforcement: A double whammy 79
Worsening OCD with Bad Thinking 80
Exaggerating risk 81
Not accepting uncertainty 82
Needing everything perfect 82
Controlling thoughts 82
Being too responsible 83
Viewing thoughts as real 83
Thinking magically and illogically 84
Part 2: Starting Down The Treatment Path 85
Chapter 6: Overcoming OCD Obstacles to Change 87
Realizing Resistance Is Futile 87
Fearing treatment 88
Handicapping against treatment success 92
Believing the worst about yourself 96
Overcoming Resistance and Changing for the Better 97
Embracing the process of change 98
Defeating self-handicapping 100
Dismantling change-blocking beliefs 102
Taking one step at a time 104
Chapter 7: Getting Help for OCD 105
Going After the Types of Help You Need 106
Educating yourself about OCD 106
Getting support from family, friends, and others 107
Choosing a professional to help you 108
What to Expect in Therapy 113
Keeping your therapy private 114
Digging deep into an OCD diagnosis 115
Speaking the truth to your therapist 115
Evaluating your therapist 116
Reviewing the game plan 117
Part 3: Overcoming Ocd 119
Chapter 8: Cleaning Up OCD Thinking 121
Realigning Interpretations with Reality 122
Seeing common types of OCD distortions 122
Using CBT to correct distorted thinking 122
Defeating unreasonable doubts 123
Ending exaggerating risk 126
Rethinking the idea that thoughts have real power 129
Decoupling facts and feelings 131
Overcoming the need for perfection 132
Sidestepping obsessive thoughts 132
Letting go of feeling excessively responsible 134
Pushing Out OCD Thinking with New Narratives 137
Creating made-up, OCD-like stories 139
Writing down your OCD narratives 140
Assessing and rewriting OCD narratives 141
Chapter 9: Meta-Mindfulness for OCD 145
Thinking Erroneously 146
Separating Your Thoughts from You 147
Acquiring the Attitudes of Mindfulness 150
Making time to be mindful 150
Pursuing patience 151
Letting go of striving for striving’s sake 151
Discovering acceptance 152
Suspending judgment about emotions 153
Living in the now 154
Minding Meditation 156
Breathing meditation 156
Walking meditation 158
Chapter 10: Tackling OCD Behavior with ERP 161
Exposing the Basics and Benefits of ERP 162
Understanding why and how ERP works 163
Seeing the upsides and downsides of ERP 164
Exploring an alternative when ERP isn’t appropriate 165
Working through ERP Therapy 166
Step 1: Determining your OCD theme 167
Step 2: Making a list and choosing your challenge 167
Step 3: Identifying and preventing the response to compulsions 170
Step 4: Preparing to engage in ERP 172
Step 5: Moving through your triggers with ERP 173
Managing the ERP Process 175
Knowing what’s cheating and what’s not 176
Troubleshooting ERP 177
Rewarding yourself 180
Limiting ERP 180
Chapter 11: Considering Medications or Brain Stimulation for OCD 181
Deciding whether Medication Is Right for Your OCD 182
Getting a thorough check-up 182
Coming clean with your doctor about your health and medications 182
Looking at reasons for medicating your OCD 183
Understanding the side effects and risks of medications 185
Examining Your OCD Medication Options 187
SSRIs 188
Tricyclics 188
Other medications 189
Directly Altering the OCD Brain 189
Understanding how deep brain magnetic stimulation works 190
Looking at the evidence 191
Chapter 12: Responding to and Recovering from Relapse 193
Understanding the Steps of Recovery and the Risks of Relapse 194
Medication relapse rates 194
ERP relapse rates 195
CBT, metacognitive therapy, and mindfulness relapse rates 196
Responding Well to Relapse 196
Strategies for Reducing Relapse 197
Knowing the difference between a lapse and a relapse 197
Prolonging treatment 199
Phasing out your sessions gradually 199
Staging a fire drill 200
Remaining vigilant 201
Zeroing in on especially problematic beliefs 201
Recognizing events that trigger relapse 203
Part 4: Targeting Specific Symptoms Of Ocd 205
Chapter 13: Sanitizing Risk: Contamination OCD 207
Considering Contamination Obsessions 207
Germs 208
The disgustingly gross 209
Unusual contamination fears 210
Pandemic contamination 210
Staying Clean: Contamination Compulsions 211
Washing 212
Cleaning 212
Avoiding 212
Rituals 213
Discarding 213
Reassurance seeking 213
Confronting Contamination OCD 214
Making a list 214
Setting a goal 216
Exposure and response prevention (ERP) 216
COVID complications 217
Alternatives to ERP 218
Chapter 14: Dealing with Doubting and Checking OCD 219
Defining Categories of Doubting 220
Harming your home through negligence 220
Harming others through negligence 221
Harming others with your car through negligence 222
Harming your health through negligence 223
Getting stuck on unanswerable questions 224
Categorizing Approaches to Checking 225
Obvious or overt checking 225
Mental checking 226
Getting others to check 226
Taking Steps to Defeat Doubting and Control Checking 226
Step 1 Searching for signals, triggers, and avoidance 227
Step 2 Identifying obsessional doubts 227
Step 3 Compiling compulsions 228
Step 4 Disputing obsessional doubts 229
Step 5 Applying ERP to doubting and checking 231
Chapter 15: Subduing OCD-Driven Shame 235
Surveying Shaming OCD 236
Being afraid of losing control 237
Struggling with thoughts of aggression 237
Wrestling thoughts of acting out sexually 237
Worrying over losing control of bodily functions 238
Questioning established sexual identity 239
Taking religious or moral beliefs to the extreme 240
Treating Shaming OCD 241
Changing OCD thinking by challenging the evidence 241
Using ERP to change shaming OCD 243
Losing bladder or bowel control in public 244
Vomiting in public 245
Complementary Treatments for Shaming OCD 246
Revealing to others 246
Experimenting with being “off duty” 247
Experimenting with self-critical versus self-accepting views 247
Chapter 16: Messing with “Just So” OCD 249
Being Driven to Make Things Just So All the Time 250
Enforcing order and symmetry on life 251
Trying to get it right by repeating and redoing 253
Taking Steps to Change Just So OCD 254
Rearranging your thinking 254
Rethinking self-image 255
Rethinking emotional responses 256
Redoing your responses to repeating 258
Chapter 17: Shrinking Superstitious OCD 261
Seeing When Superstitions Constitute OCD 262
Revealing Common OCD Superstitions and Rituals 263
Changing Thinking About OCD Superstitions 265
Creating competing superstitions 266
Managing discomfort differently 268
Deflating the Power of OCD Superstitions with ERP 269
Facing off with scary superstitions 269
Defeating the power of superstitious charms 269
Chapter 18: Uncovering OCD Accomplices 273
Concerning Counting 274
Miscounting on purpose 275
Resisting the act of counting 276
Taking Charge of Touching 276
Messing with your touching 277
Discontinuing touching 277
Doing Away with Doodling 278
Doodling in different ways 278
Denying the urge to doodle 278
Speeding Up Slowness 279
Mixing things up 279
Speeding things up 281
Handling Hoarding 281
Chapter 19: Dealing with OCD-Related Impulsive Problems 283
Changing Behavior to Reduce Impulsive Problems 284
Increasing awareness of your impulsive problems 285
Relaxing away impulsive problems 285
Sidetracking impulsive problems with something different 288
Reinforcing positive gains in overcoming impulsive problems 289
Changing Thinking to Reduce Impulsive Problems 290
Finding reasons to change 290
Pushing hopelessness aside 291
Undoing unfairness worries 292
Designing supportive self-statements 292
Applying ERP to Impulsive Problems 293
Treating Impulsive Problems with Medication 293
Part 5: Assisting Others With Ocd 295
Chapter 20: Wondering about Children and OCD 297
Understanding Childhood OCD 298
Recognizing possible symptoms 298
Ruling out normal growth and health issues 299
Sorting through other childhood disorders 300
Observing the Effects of OCD 302
Having problems at home 302
Experiencing problems at school 303
Having difficulties with friends 304
Finding the Right Help for Your Child 304
Chapter 21: Helping Your Child Conquer OCD 307
Separating Your Child from OCD 308
Helping Your Child and Working with the Therapist 309
Parenting differently and not being the therapist 310
Managing your emotions 311
Working with the therapist 312
Explaining OCD to Family, Friends, and Schoolmates 316
Getting More Help at School 318
Chapter 22: Helping Family and Friends Cope with OCD 319
Discerning What It Takes to Be Supportive 320
Understanding how OCD challenges you 321
Assessing whether you’re the right person to coach 322
Knowing your limits 322
Applying Appropriate Coaching Techniques 323
Recognizing OCD’s dirty tricks 323
Coaching with kindness 324
Part 6: The Part of Tens 329
Chapter 23: Ten Quick OCD Tricks 331
Breathing Better 331
Considering a Delay 332
Distracting Yourself 332
Accepting Discomfort 332
Doing Jumping Jacks and More 333
Realizing It’s Not You, It’s Your OCD 333
Making Flashcards 333
Getting Support 334
Minding Meditation 334
Strolling through Nature 335
Chapter 24: Ten Steps for After You Get Better 337
Forgive Yourself 337
Search for Meaning 338
Strengthen Family Ties 339
Find Friends 339
Reach Out to Others with OCD 340
Help Others 340
Engage in Exercise as a Lifestyle 341
Learn New Skills 341
Pursue Hobbies 341
Find Healthy Pleasures 342
Chapter 25: Ten Dirty Little Secrets about Dirt 343
Defining Dirt 343
Living Dirt 344
Digging Dirt 344
Dirt Just Isn’t What It Used to Be 344
Chimps Who Eat Dirt 344
Speaking of Washing Off Dirt 345
Building with Dirt 345
People Who Eat Dirt 345
Kids Who Eat Dirt 346
Pica 346
Index 347
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