Treating Anxiety and Depression With CBT

by guest blogger Dr. Denise Moquin

Obsessive Compulsive Disorder

OCD: Description

“Kathy is OCD… That’s John’s OCD.” These lines often are used lightly and in response to some behavior in another individual, a behavior they perceive as quirky or silly. I frequently hear similar kinds of statements, in non-professional settings, and by folks unaware that I treat obsessive-compulsive disorder (OCD). The line, however, has become overused, misused, and all-too -common in our society over the past few years. Perhaps you have heard it, or even said it yourself on occasion? But, for the person who really has obsessive-compulsive disorder (OCD), it is much more than exhibiting quirky behaviors. OCD can be paralyzing and debilitating in a multitude of ways.

Obsessive-compulsive disorder (OCD) is classified as an anxiety disorder. OCD symptoms often come on gradually and “wax and wane” throughout the course of the disorder.  OCD often runs in families, similar to depression or other medical conditions. Folks I work with sometimes can remember behaviors they observed in family members, two or more generations removed and, while they report not understanding the behavior at the time, they were struck by it for some reason.

The definition of OCD is two-fold; involving both obsessionsand compulsions, or repetitive behaviors (DSM-IV-TR, 2000).Obsessions are unwanted and intrusive thoughts or images that cause significant distress in the individual experiencing them. A few common obsessions include excessive doubt; fears around contamination;the need to have things in a particular order, or symmetrical; religiosity or a preoccupation with spiritual questions; and distressing thoughts or images of harming another person or loved one without intention (common in some women who have recently given birth).  Compulsions are behaviors the individual performs in an attempt to reduce or neutralize the distress around the obsession. Some common compulsions include reassurance-seeking;over-analyzing conversations or events that have taken place; excessive cleaning, praying, counting, or checking to name a few.

OCD: Treatment

Imagine there was something that caused you intolerable distress, how might you respond? Perhaps, one of the most problematic responses to OCD or anxiety, in general, is avoidance of the anxiety. Avoiding the anxiety reinforces for the individual that there is something to be anxious about or afraid of, thus increasing the likelihood of continued avoidance. Let’s say I avoid going over a particular bridge because I am afraid something bad might happen to someone I love. Instead of going over the bridge I find a different route to my destination and, subsequently, I do not experience the distress I felt at the thought of going over that bridge. Which way do you think I will choose to go the next time? For folks with OCD, in particular, this avoidance of distress takes the form of performing a compulsion, otherwise known as rituals. Unfortunately, people report the reduction in distress or anxiety is fleeting, followed by the need to repeat the ritual.

Professionals that treat OCD, or any mental health issue, are concerned with the impact the behaviors have on the individual’s ability to function. For example, to what extent do the behaviors affect one’s ability to get to work on time or to focus while at work?If someone was returning home multiple times in the morning to make sure the door was locked or the stove burners were off, then they may habitually arrive to work late.  Another example would be if someone was excessively preoccupied with making sure every word and punctuation in a document was correct by rereading multiple times, then they may miss deadlines. To what extent do the behaviors affect the individual’s relationships with others? If someone was constantly asking for reassurance or, perhaps, making people wait because they were taking too long to complete compulsions or rituals, then these behaviors could take a toll on relationships over time.

Here is the great news regarding OCD. There is treatment that has been proven effective, in numerous clinical trials, in treatment of OCD.  With therapy, people struggling with OCD have learned to more effectively respond to their obsessions. Can OCD be cured? No, but with cognitive-behavioral therapy (CBT) and, in particular, exposure therapy (a behavioral intervention), OCD can be managed.  As a result of treatment, people with OCD have gone on to lead happy and productive lives and experience fulfilling relationships.

Future events sponsored by Moquin Psychological Services:

Dr. Moquin will present on hoarding behaviors in February, date to be decided. Up to 33% of people diagnosed with OCD also endorse having hoarding behaviors. Hoarding behaviors also can be tied with depression, eating disorders, dementia, and other mental health issues. Hoarding can severely impact functioning, in addition to presenting health and safety concerns. If you or someone you know is affected by hoarding behaviors please plan to attend this presentation followed with a Q and A session.

About the author:

Dr. Moquin has been trained to treat several anxiety disorders. She works with individuals to identify behaviors, associated with the anxiety, that are impacting the individual’s ability to function effectively. Together, she and the individual develop and, when clinically warranted, she works with individuals in the environment that elicits the anxiety response (e.g., in the community, in the home). Dr. Moquin’s practice is located within Healing Hands Chiropractic in Londonderry, NH. She may be reached at 603-315-4614 or