Health Anxiety and Obsessive Compulsive Disorder (OCD)
The same treatment techniques used in treating OCD are used with health-related anxieties. The treatment for hypochondria is exposure and response prevention (ERP). This means that you must learn to challenge your need for certainty. This also means that you must work on stopping the compulsive checking, challenge your avoidance ritual, and work on tolerating the unknown.
If you were concerned about having a tumor, a negative magnetic resonance image and assurance from an oncologist would likely be enough to put your mind at ease. But, if you are a sufferer of health anxiety you may need more relief after receiving this news. Suffers will often questions the judgement of the physician and keeping looking for reassurance.
We work with suffers to challenge their thoughts, bring on acceptance, stop wasting time with rituals, and ultimately learn to live with the uncertainty.
Dysfunctional perfectionism is defined as the tendency to hold excessively high standards which brings on significant distress or impairment. This could include struggling to be the perfect parent, artist, or student. Holding such standards can bring on symptoms of fatigue, anxiety, and depression. At times, it can also trigger eating disordered behaviour.
Perfectionism is a dimensional construct with varying degrees of severity. David Burns (1980) argues that perfectionism can be clinically significant when it starts to impair performance and mental health. He indicated that a goal worth achieving is best to be achieved through a healthy pursuit of excellence than dysfunctional perfectionism. Burns argues that the healthy pursuit of excellence allows you to be who you are in being extra ordinary, but creates awareness in maintaining healthy self-boundaries. This means that you aren’t sacrificing your relationships, yourself, or personal boundaries to achieve goals. You can be ‘extra,’ but not give up your life doing so.
The program that we have helps individuals recognize patterns of dysfunction and creates challenges to their all or nothing thinking patterns. In other words, the world will not end if you give yourself a break, study a little less, or not get 100% on every assignment. Analyzing your path and questioning if it can be done while living the life you want is what’s imperative to the therapeutic journey.
Self-monitoring (which is done daily) is important in this type of therapy. Recognizing and challenging your thinking and behaviour helps you create change. Creating alternatives to your negative thoughts will help bring clarity and challenge core rigid beliefs. Behaviour change is also a necessary component to the program. We work with you hand in hand to help facilitate all changes. We will never force you to do something you aren’t comfortable with, but we will challenge you to see an alternative perspective that you may consider as a healthier way of operating.
Contamination Obsessive Compulsive Disorder
Contamination OCD can take on a variety of forms in individuals. Most patients report an overwhelming anxiety or fear that they can be contaminated or accidently spread their contamination to other people. Most of the fear of contamination are grossly out of proportion to the actual risk. Patient symptoms may differ as some may present with fears of being contaminated by germs of other physical contaminants and others may present with fears of being contaminated by other unlikely sources that most people wouldn’t typically consider to be contaminated. Other OCD suffers report a general sense of feeling dirty and often become anxious of their emotional reaction to the feeling. Contamination OCD isn’t always typically associated with over washing and cleaning. An assessment will be done to determine if perfectionism OCD or other compulsions may play a factor in maintaining the behaviour.
One of the major goals of treatment is to highlight the irrational thoughts that the individual sufferer experiences. We challenge the OCD by identifying how their OCD patterns and thinking don’t make sense. Some of these challenges include helping patients understand that germs don’t survive hours even days on chairs or germs cannot jump if you get too close to them. Of course, these are just some examples of irrational thoughts and not every patient will identify with them. But, the goal still remains the same- challenge the irrational thinking and help them identify how they are already breaking their OCD rules that they have created for themselves. For example, we may highlight that they may not want to hold or touch inside a garbage can, but at the same time it may be easy for them to take a wrapper off a sandwich and touch the garbage can flap when throwing it away and continue eating. The flap may just be as dirty as the insides of the garbage can, but most people continue to carry on with their day (including OCD sufferers) without a second thought. This unawareness and inconsistency is what’s highlighted during our cognitive work.
Of more importance, we help our clients live with the risk and maintain some level of acceptance that nothing is certain in life.
Some of the irrational thoughts we challenge:
Mental pollution is a term used to describe a sense of internal dirtiness that can be brought on by certain thoughts, words, or memories. Mental pollution are typically brought on by thoughts of a potential threat, it’s also associated with emotions such as shame and responsibility.
Sympathetic Magic is a term used to describe the implausible belief about the nature of getting contaminated. This can manifest in many ways, but two irrational thoughts most often thought by OCD suffers are ‘once in contact, always in contact’ and if one object touches another contaminated object, it too can contaminate many other objects (a pencil touching a toilet seat and the pencil now contaminating many other objects it comes in contact with)
How we Challenge the Unnecessary Behaviours
We work with each patient to recognize and challenge their avoidance behaviours maintaining their fear reactions. This may look like helping the patient recognize that compulsive washing and cleaning may be a form of active avoidance, which only creates more anxiety. Passive avoidance is also addressed in session.