OCD (Obsessive Compulsive Disorder)

Obsessive Compulsive Disorder (OCD) is a type of anxiety disorder characterized by uncontrollable, unwanted thoughts and repetitive, ritualized behaviors that frequently co-occurs with eating disorders. OCD can cause distress, upsetting thoughts, and get in the way of daily life. The frequent upsetting thoughts are called obsessions. To try to control them, a person will feel an overwhelming urge to repeat certain rituals or behaviors called compulsions. People with OCD can't control these obsessions and compulsions but they feel the need to do them because they provide relief. Most of the time, the rituals end up controlling them. Women recognize that their obsessive thoughts and compulsive behaviors are irrational — but even so, they feel unable to resist them and break free.

Treatment in a holistic program with an environment designed to provide safety and cutting-edge treatment provides the client with OCD the optimal chance to heal. The client will begin to learn ways to explore her feelings and handle her thoughts in a more functional way. Even if she does not have an eating disorder or substance abuse, a woman with OCD will find that she can heal in an integrated, world-class program such as Mirasol.

Signs and Symptoms of OCD

Most people with obsessive-compulsive disorder (OCD) have both obsessions and compulsions, but some people experience just one or the other. Obsessions are involuntary, seemingly uncontrollable thoughts, images, or impulses that occur over and over again in your mind. Compulsions are behaviors or rituals that you feel driven to act out again and again. Usually, compulsions are performed in an attempt to make obsessions go away.

Obsessive thoughts

Common obsessive thoughts in obsessive-compulsive disorder (OCD) include:

• Fear of being contaminated by germs or dirt or contaminating others.
• Fear of causing harm to yourself or others.
• Intrusive sexually explicit or violent thoughts and images.
• Excessive focus on religious or moral ideas.
• Fear of losing or not having things you might need.
• Order and symmetry: the idea that everything must line up "just right."
• Superstitions; excessive attention to something considered lucky or unlucky.

Compulsive behaviors

Common compulsive behaviors in obsessive-compulsive disorder (OCD) include:

• Excessive double-checking of things, such as locks, appliances, and switches.
• Repeatedly checking in on loved ones to make sure they're safe.
• Counting, tapping, repeating certain words, or doing other senseless things to reduce anxiety.
• Spending a lot of time washing or cleaning.
• Ordering or arranging things "just so."
• Praying excessively or engaging in rituals triggered by religious fear.
• Accumulating "junk" such as old newspapers or empty food containers.

What are the Effects of OCD?

OCD can become permanently disabling. The thoughts and rituals can get in the way of daily life to the extent that the client is unable to attend school or work. OCD may be accompanied with eating disorders, other anxiety disorders, depression, or substance abuse. At a treatment center such as Mirasol we recognize the complexity of a woman's emotions and her need to normalize her life.

Causes of OCD

OCD sometimes runs in families, but no one knows for sure why some people have it while others don't. Researchers have found that several parts of the brain are involved in fear and anxiety. OCD can also be a result of a chemical imbalance in the brain but the specific genes have not been identified.

Treatment of Obsessive Compulsive Disorder

Treatment of OCD begins with a safe and supportive environment that is found only in a small, holistic treatment center such as Mirasol. The staff at Mirasol is caring and compassionate and understand the difficulties that the client is facing.

OCD is generally treated with psychotherapy or medication.

• Psychotherapy: A type of psychotherapy called cognitive behavior therapy is especially useful for treating OCD. It teaches a person different ways of thinking, behaving, and reacting to situations that help him or her feel less anxious or fearful without having obsessive thoughts or acting compulsively. Dialectical Behavioral Therapy (DBT) is used extensively in treatment of anxiety disorders. DBT combines behavioral, cognitive, and meditative therapies to help a woman heal.
• Medication: Doctors also may prescribe medication to help treat OCD. The most commonly prescribed medications for OCD are anti-anxiety medications and antidepressants. Anti-anxiety medications are powerful and there are different types. Many types begin working right away, but they generally should not be taken for long periods.

At Mirasol medications are very carefully prescribed and generally only for short periods of time.

Before Admission

Mirasol begins to assess the kind of treatment a woman needs early on in her admission process. Mirasol's professional intake staff speaks in depth with the future client and arranges a time for her to have a complete telephone assessment by our clinical director. We ask that the future resident have a complete lab workup as well as an EKG. We prefer to have a note from her physician stating that she is medically stable. By the time of admission Mirasol has gathered psychological and medical information about the client. When the client admits for treatment, she has a complete biopsychosocial assessment with her primary therapist. She will also have a physical by Mirasol's physician as well as a psychiatric evaluation. In the first week she'll have assessments by every member of her treatment team.

As Client Progresses in Treatment

Treatment can be thought of as organic, ever changing. A treatment plan is a continually changing plan that reflects how the client is going to become well, step-by-step. It serves as a road map, taking the client from illness to wellness! The treatment plan is updated weekly with input from the treatment team and the client as the client progresses. If a client has severe medical issues, she is referred to a cardiologist, gynecologist, orthopedic surgeon, gastroenterologist, or a dentist. At Mirasol the whole person is treated — not just parts of her. If new symptoms, such as an undiagnosed mood disorder, appear while the resident is with us, we make sure those symptoms and their origins are immediately addressed.

Dedicated Committed Staff

Mirasol's staff members, most of whom are in recovery themselves, are gentle and nurturing in their approach to clients. They treat all residents with dignity and respect, even down our youngest 12 year old. Mirasol believes that this is the only way anyone can heal. The staff has a great deal of empathy and compassion for the clients. They are aware that the client has complex fears and obstacles and are in emotional turmoil. The staff is committed to help the client find a new path with different behaviors, ways of thinking, and coping mechanisms. Mirasol's integrative, individualized approach helps women, boys, and girls:

• Identify emotional triggers for binges, which may have underlying causes that have not been properly identified or addressed.
• Create awareness of healthy ways to respond to fear, anger, sadness, stress, anxiety, trauma or shame
• Avoid destructive "either/or" thought patterns that add to the experience of hopelessness and unmanageability for many women in their disease
• Develop confidence in his/her potential to make healthy choices to manage emotions

A client with OCD ultimately is responsive for making healthy choices. It is not a treatment center that makes a person well or a particular therapist. It is the client him or herself that learns to heal him or herself. The client receives coaching, psychotherapy, and positive reinforcement while they are learning a whole set of new skills, distress tolerance, reality acceptance skills, and emotional regulation.

Holistic, Integrative Treatment

At Mirasol we wish we could just wave a magic wand and everyone would be cured. But that is not the case unfortunately. Mirasol uses an integrated model of treatment where we combine the best of the cognitive-behavioral world combined with the most effective alternative interventions. We focus on skill-building so when our residents leave they have the tools to deal with their emotions and everyday life as it presents itself. The residents have a full range of healthy choices to make rather than having to use dysfunctional behaviors which is all they knew before Mirasol. As they learn to trust themselves and their tools, their self-esteem and self-confidence rises, anxiety and stress are reduced, and increased self-awareness gives them start they need to live a full, healthy life. A client's individualized treatment plan uses interventions that are proven to help people learn to modulate their emotions and to recover!

Some of the treatment alternatives offered are:

• 3-4 groups daily
• one-to-one psychotherapy sessions, 2-4 times a week
• 2-4 additional individual sessions daily
• expressive and experiential therapies
• meal support and regular consultation with dietary staff
• meeting with dietitian 2-3 times a week
• group sessions to teach and practice behavior modification and emotion management
• family therapy (including family participation)
• onsite and offsite twelve-step meetings
• weekly psychiatric consultation
• trauma awareness and recovery
• educational services for school-age women

Each school age resident will also have input on her academic course work. She will sign off on her treatment interventions and on the progression of her treatment plan, giving her responsibility for her recovery from the beginning.

Experiential therapies, a vital part of treatment

Experiential therapies are a large part of the Mirasol program. Not every person can heal doing DBT or cognitive-behavioral therapy. We have found that experiential therapies may be the keys that open the door to helping a person access an inner state and provide release of emotion. Experiential therapies can help increase self-esteem, help the client develop a strong sense of self, and help her feel empowered.

Experiential therapies can be body oriented such as polarity therapy, and can be physiological as when we also examine via neurofeedback how a person's brain and brain wave patterns are an integral part of the disorder. Art therapy, movement, dance, and music therapy all are a part of modalities offered. We don't treat a person from just the neck down, but we treat the whole person including any imbalances in the brain that might have been caused by chronic stress and life experiences.

Why Do We Focus on Co-Occurring Conditions with OCD?

Whenever we're treating a woman for one condition, we don't stop there. Frequently there are co-occurring disorders. Probably 90% of our clients admit with severe depression and an anxiety disorder. Women and girls will use substance abuse or an eating disorder as a way of coping with PTSD to help her control the intense feelings she's having.

Many times OCD is ignored by other health care professionals wrongly assuming that when the eating disorder or other psychiatric condition is in remission, the symptoms of OCD will disappear. Ignoring the mood disorder can negatively impact recovery. When they are able to gain some semblance of recovery, they are at high risk for relapse.

Here is a list of other psychiatric conditions that frequently co-occur with eating disorders and substance abuse as well as other mental health conditions:

• chronic anxiety (generalized anxiety disorder or social anxiety disorders)
• depression
• bipolar disorder
• panic disorders
• post-traumatic stress disorder (PTSD)
• obsessive compulsive disorder (OCD)
• personality disorders
• various phobias and compulsions