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If you've learned about ocd, you've probably heard that compulsions can make OCD worse. Doing a compulsion, be it mental or physical, allows for some short term reliefs, but it really unfortunately reinforces the OCD cycle. Now, recognizing a compulsion can be harder than it sounds. And compulsions aren't the only thing that keeps OCD going. So I want to talk today about compulsions and also some of the other less obvious things that can keep OCD Alive. Foreign I'm Dr. Patrick McGrath, I'm the Chief Clinical Officer here at NOCD and I spend my day helping people with OCD and helping to train therapists to help others with OCD so that they could start to do the things they want to do without having influence of OCD and everything that goes on. The first thing that happens, of course, is the safety behavior of compulsions. The now there can be visible compulsions that maintain ocd. You might see these on movies and tv. It's things like checking or repeating actions or doing things a certain number of times, asking others for reassurance. There could be excessive cleaning and sanitizing that goes on. But there's also invisible examples. How do I ruminate or review things over and over my head? Do tons of mental review of the behaviors I've done or that how I'm going to do it in the future, thought neutralization or replacement. I don't like that thought. So I'm going to think of a thought that I do like that just becomes a compulsion over time. Or having to give yourself a ton of reassurance that what you did was all right. And of course, it never quite feels good enough. Unfortunately, even though the Diagnostic and Statistical Manual of Mental Disorders talks about OCD as having anxiety and discomfort, it misses some things. There's also guilt and shame and disgust. Shame can really come into play. And guilt can come into play because people believe that the thoughts or the images or urges that they have really say something about who they are as a person. And therefore people can stay silent for a very long time out of a fear of judgment or evaluation. And because of this, people might spend time punishing themselves, thinking they're terrible, awful, horrible people for having the thoughts and images and urges, as we call obsessions, that they're having, when the reality is OCD's nature is to attack things that are most important to you. And, and therefore the obsessions you're going to have are about things that really mean something to you that leads people to feel lonely or kind of just isolated. Right. And they Feel like they're the only one who's experiencing these symptoms. This isolation gives OCD more power. People will do other safety behaviors like avoidance. They will avoid therapy or triggers of things. They will avoid conversations that might be triggering to OCD and lead to thoughts and images and urges. They could also do a ton of reassurance seeking, wanting everyone to tell them that they'll be fine and everything will be okay. But reassurance is kind of like a drug. We build up a tolerance to it, and every day we need a little bit more than we got the day before. There might be distractions that people do. I bet within a foot of you or maybe you're watching is this thing. It's the greatest distraction ever created. And if we find ourselves in a situation that's not comfortable, we could just go on and say, ooh, kittens in a field. Look at those adorable kittens. They're so cute. Oh, my God. And I'm not paying any attention to all the stuff that's going on around me. And some people might even turn to substances as a way to try to calm their brain down so that they could get even a few minutes of peace from whatever the obsessions are. All of these things are done to try to self manage yourself through ocd. And this can be a really difficult thing to do because you're actually better off getting professional help for this than trying to just manage all of this on your own. I see time and time again people who attempt to do these things just by themselves, unfortunately, without knowing it. Give in to safety behavior behaviors. There can be really subtle safety behaviors that happen, and because of that, people might get stuck in doing things in ways that aren't really, really helpful. Then they might think they're even undeserving of help in the first place. So if you truly want to get some help with ocd, reach out to a professional. If you were trying to learn piano, you could just try to teach yourself, but a few lessons could be very helpful to just learn the basics and help you through the experience. That's what meeting with a therapist for OCD could do. And you don't have to do that forever, right? There are people that I see now that I've seen for a very long time, but I see them once every three months for half an hour. Just as a check in. Therapy doesn't always have to be what you think of it as being that one hour every single week. In fact, our model at NOCD is a bit different. We start people at twice a week sessions. Why we want to front load that exposure and response prevention therapy in when people hit certain levels of improvement, we go down to once a week and then, then when they hit more levels of improvement, we can go down to every other week. We can go down to 45 minute sessions, half hour sessions and we could build that out to once every three months. With folks we've got a pattern that we can show you really, really works. Front load the therapy now. Do better in the long term. You don't have to needlessly suffer and you don't have to feel the shame or guilt that leads you to feel like I'm the only person in the world that has this thought or this image or urgent. I can promise you that's not the case. That's why we even have support groups here at NOCD so that you can be surrounded by other people who are just like you. And the first time a new person goes to the support group and sees 75 other people in that group who have the same exact thoughts, images and urges, it's a life changing moment for them to realize, I'm actually not alone. I can be different, I can change. I don't have to have my life ruled by ocd. If you want help with that, if you want to be able to meet with a therapist, have access to support groups to help you, we've got that for you here at NOCD. You can reach out to us@nocd.com our therapists are standing by our care team. If you hit that free 15 minute call button, we'll be there to help get you set up with one of those therapists so that you can start to live the life that you want to live and not the one that OCD wants. You deserve more. We hope to see you soon.