Here’s Why Therapy May Seem Scary When You Have OCD

I was 9 years old and remember the excitement that filled the air as I got ready for a day of ice skating. I loved ice skating. As a surprise, my parents let me know they had invited a new friend over to join me. Although the gesture excited me at first, suddenly, I was filled with dread. 

My dad would be coming from work to take us to the skating rink. He worked in a factory, so it was common for him to come home covered in oil and smelling of gasoline. Some people may find the odor unpleasant, but most certainly wouldn’t find it terrifying; but for me, the thought of gasoline being on anything shook me to my very core. 

For as long as I could remember, I truly believed that gasoline on anything would poison a person, instantly bringing them to their death. I spent hours trying to rid our home of potential gasoline contamination. I would cautiously watch out for anything that my dad touched so that I could go back and clean it. Usually, this was a routine task that I had down to a science, but on this particular day, things did not go as planned. 

Maybe it was the introduction of a new friend who had never visited before that created my panic. It occurred to me that the ice skates she would be using were going to get contaminated with gasoline and she would die. It would be all my fault. You see, I was the only one who knew gasoline was on things, so I would be responsible. 

I was faced with a major dilemma for my age. Warning my friend of this perceived imminent risk would cause me to feel embarrassed because some small part of me knew it was illogical. At the same time, I wrestled with avoiding bringing it up and having her face her possible demise due to me not warning her. 

These were such heavy thoughts for a small child. It was the first time I came across the idea that I could be responsible for the safety and well-being of someone outside my family. I was suddenly hit by an onslaught of panic. My heart began to race and felt like it hurt. Before I knew it, I was convinced I was having a heart attack. 

I proceeded to do what most children in my circumstances would do: I went back to my parents and told them that I could not go ice skating that night because I was having a heart attack. They would need to cancel our plans. 

What if something is wrong with me?

I vividly remember the concern that washed over their faces. I had seen it many times in my short life. This was not the first time I had complained of my heart hurting or some other physical ailment. At this point, I was a regular in the principal’s office, asking to go home with any sort of illness one might encounter. A stomachache was my go-to ailment. 

The looks on my parents’ faces said something was very wrong. I think this was the breaking point for them. It was the first time I heard the word “psychiatrist.” They told me very matter-of-factly that if this behavior did not stop, I would need to see one. Ironically, I didn’t have any clue what a psychiatrist meant or what one did, but even as a 9-year-old who knew nothing of mental illness, I felt by their reaction that this must be a negative thing.

People in my family didn’t really talk about feelings or mental health, but I always knew that something wasn’t working properly in my brain. I don’t know how I knew, but I did. My parents’ reaction that day confirmed it for me. They were well-meaning parents who cared about their daughter, and they just wanted me to get better. 

But getting better would have meant accepting that I was not okay, that something really was wrong with me. If I believed I was not okay, then I would be accepting that the people I loved the most thought I was not okay. 

What if I get misdiagnosed or if I’m misunderstood?

My story is not unique. Over many years of treating people who have OCD, this has come up frequently: people are afraid to see a doctor or a therapist due to the fear of something being wrong with them. With any mental health issue, stigma can keep people from seeking help – we have come a long way, but there is still work to be done. 

The stigma around their symptoms and misrepresentation of OCD amplifies the fears and hesitations of people struggling with this condition in particular. OCD has historically been thought of as a peculiar disorder, and it has been misunderstood for many years. Even today, OCD is often misconstrued and misdiagnosed. 

OCD can come in many forms, called “themes” or “subtypes,” so it can manifest differently from one person to the next. Unfortunately, when people hear about OCD in TV shows or movies, they see a single stereotypical  – and often inaccurate – portrayal. How many times have you heard someone say “you’re not neat and tidy, so you can’t have OCD”? Or, “I’m so OCD, I like things lined up a certain way”? 

While those can be signs of potential OCD, these symptoms are far from reality for many who have this disorder. This keeps many who suffer from the condition from recognizing their debilitating symptoms as OCD. They have never seen what OCD actually looks like. 

The courage to get treatment

What I didn’t realize as a child, and what many people don’t realize, is that treatment can provide hope. Seeing a therapist or a psychiatrist doesn’t make someone weak or “crazy.” It makes them human. It makes them strong. It takes a lot of courage to admit that you are struggling and need help. When you have OCD it takes extra tenacity, because OCD often latches onto topics that cause you significant guilt, shame, and distress. 

When I meet people who are new to therapy, they are often reluctant to share the details of their thoughts. Why? Because they are not sure whether their thoughts “really” stem from OCD. They have seen false representations about OCD, or maybe they have seen several other professionals and been misdiagnosed. 

Seeing a new mental health provider for OCD can be daunting: you have to share all of the things that you feel most uncomfortable about. You are reaching out in the hopes that someone will see you, hear you, and truly understand you without judging you – of finding someone who can actually help you get better. 

Finding the right specialist makes starting treatment less scary

That’s why it is imperative that a person with OCD sees a professional who is well trained in OCD and treatment specifically for OCD. Far too many times I have worked with someone in my own practice who was emotionally damaged by a misdiagnosis that led to improper treatment and no improvement, or by the inaccurate or harmful words of someone who falsely claimed expertise as a “specialist.” What mental health professionals say is important, and how we say it is important. People put their trust in us. They share their most vulnerable thoughts with us. 

If you think you have OCD, you should seek out someone specialty-trained in exposure and response prevention (ERP) therapy. Research shows that this is the most effective therapy for people with OCD. Traditional talk therapy uses skills that may be helpful for many areas of mental health, but it is not the right treatment for OCD. 

Some people who have OCD may recognize that their thoughts are illogical or excessive in nature. ERP doesn’t try to challenge OCD thoughts or explore the meaning of these thoughts, because these thoughts don’t have to have any meaning. Instead, ERP teaches you to sit with anxiety and discomfort, and to allow those feelings to exist along with the intrusive thoughts. It teaches you that you do not need to do a compulsion or a ritual to get rid of those uncomfortable feelings and that they will dissipate on their own. 

When you practice ERP regularly, your brain learns that there is no “real” danger from OCD distress and anxiety. It’s like a broken alarm system, and it can only be fixed when you don’t engage in compulsions. With repeated ERP, your brain learns to set off these alarms less and less, and even when they’re still triggered, you’re able to recognize them as false alarms and move on more swiftly. 

Remember that you are not your OCD, and getting better is possible. If you’re struggling with OCD and have been scared to begin treatment, NOCD can help. Our licensed therapists deeply understand OCD and are specialty-trained in treating OCD with ERP. We work side-by-side with the OCD experts and researchers who designed some of the world’s top OCD treatment programs – and that means the best care for our members. You can book a free 15-minute call with our team to get matched with one and get started with OCD treatment.