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Treating and Managing Obsessive Compulsive Disorder

Dr. Oded Ben Arush, Medical psychologist
15 June 2025

Obsessive-compulsive disorder (OCD) may affect daily function in all spheres of life. If you or someone close to you is compelled by obsessive behaviors, with or without irrational thoughts, you should undergo a professional assessment and diagnosis and, if necessary, begin treatment. With suitable and personalized treatment, a full recovery and significant improvement in quality of life can be achieved.

The currently recommended treatment involves three components: cognitive-behavioral therapy, medication (primarily drugs from the SSRI family) with an exposure and response prevention (ERP) technique. It is important to contact professionals who are experts on this disorder to obtain a diagnosis and personalized treatment.

Obsessive-compulsive disorder (OCD) is a spectrum of extremely varying disorders in terms of their visibility in each person, and in terms of the content and the resulting behaviour. This disorder can affect every sphere of life, but the severity can be prevented or reduced with professional therapy and support. The recommendation is to begin and treat as early as possible in order to significantly improve quality of life.

Personalized treatment

You should contact professionals who specialize in this complex disorder and who have the specific training to treat it. They will diagnose the disorder, will map and identify the areas where it manifests and propose relevant treatment. Treatment must be specifically adapted to the patient, while addressing the nature of the obsessive thoughts and unique compulsive behaviors. For example, if the disorder manifests as hoarding, the recommendation is to largely manage the hoarding environment instead of classic treatment in the clinic.

When relevant and accurate treatment is administered, a full recovery (remission) can be achieved. In other words, a state can be achieved in which the disorder does not manifest in everyday llife. At the same time, even after full recovery has been achieved, the achievement should be maintained and there must be periodic follow-up on a need basis.

An integrated approach for an effective treatment

The recommended treatment for these disorders combines 2 main components:

Behavioral-Cognitive Therapy

Many studies indicate that the patient’s environment (family and close friends) unintentionally affects the generation of distress and its greatest dependency on them to perform challenging activities on a daily basis. In other words, to help the patient alleviate their distress, the assistance of close relatives and friends who make adjustments (accommodations) in order to ‘reduce’ the difficulty for them.

Although this principle occasionally goes against common sense and accepted social perspectives regarding empathy and inclusion, in practice the very commitment and attempt to help are what harm and sabotage the recovery. To elucidate the subject, it can be compared to the satisfaction of a "drug" or even the purchase of it experienced by those addicted to it. In addition, the therapy also incorporates a method known as ERP (Exposure and Response Prevention) that is based on a technique for exposing and preventing a response. It refers to behavioural practices designed to trigger the patient's urge to compulsive behaviour in order to control and stop it. Daily exercises can help break the cycle of addiction.

Medication

This treatment is recommended as a first line, in other words – the standard and recommended treatment that is applied when therapy begins and helps all patients suffering from the disorder (coupled with cognitive-behavioral therapy).

Medication, in and of itself, does not indicate the severity of the disorder and is not therefore administered only in severe cases. In most cases, the treating physician will prescribe for the patient medication from the family of SSRI (Selective Serotonin Reuptake Inhibitors) medications, such as Prozac, Cipralex, Favoxil, Paxxet or Lustral. The standard dosage is generally higher than the standard dosage for treating anxiety disorder or mood disorders. In case of the onset of tics or other associated motor disorders, such as hair pulling (trichotillomania) or compulsive skin picking low dose of drugs from the family of partial dopamine blockers, such as Ariply or Cariprazene may be added. There are cases where the medication is administered at the same time as the cognitive-behavioural therapy only, and after achieving recovery, the dose is gradually lowered. At the same time, some patients will need to continue taking medication for the long term, even after recovery.

Recommendations for coping with noticeable patterns

Because of the many different manifestations of the disorder from person to person, it is difficult to issue one general recommendation on how to behave and react to prevent it. At the same time, some patterns repeat themselves in most patients, regardless of the specific manifestation of the disorder, and if we are familiar with them, we will be able to deal with and help the person close to us:

  • Questions of confirmation: In the absence of treatment, or parallel to the treatment, the recommendation is to avoid issuing confirming responses to the questions of the patient that are attributed to the difficulty that lies with uncertainty. For example: if a patient asks his parents whether they love him dozens of times a day, the recommendation is not to answer the question because it is not related to the relationship between him and his parents but rather to the addiction to receiving a feeling of "approval".
  • Difficulty in decision-making: Avoid helping the person dealing with the disorder in making daily decisions, thus "sparing" him from dealing with uncertainty. For example: if you are sitting at the dinner table and he is unable to choose what he should eat, it is important not to help but let him decide on his own without recommendations.
  • Compensation: Do not compensate for actions that the patient avoids for any reason and let them deal with the consequences of the avoidance alone. For example, a patient who is repeatedly late because he is performing rituals that waste considerable time can ask someone from the neighborhood to drive him to the district of his choice to compensate for the wasted time. In such a case, the patient should assume responsibility even at the cost of being late and the unpleasantness involved. Thus, the price that the disorder exacts from him will motivate him to resist and prevent the compulsive rituals. Some patients perform compulsive rituals only among family but not with friends or at work. This selectivity is mainly attributed to the fact that the price for performing the rituals in front of the friends is not worth it and can even damage these relationships, while in the family, which is often characterized by unconditional relationships, there is no “price tag" for the rituals.

In conclusion, OCD affects many areas of life and can be extremely disturbing. Happily, treatment is currently available that is capable of resulting in full recovery. The recommendation is to seek professional help and commit to the personalized therapeutic plan. Despite the initial difficulties and overwhelming urges, in most cases positive results will be achieved.