Ron was on the verge of tears as he asked me, “Do other people with OCD have violent and aggressive thoughts? He refused to tell me what his thoughts were on the first session. I told him he didn’t have to talk about it yet if he didn’t want to. However, I reminded him that if he wanted the right kind of treatment, he would need to tell me about the thoughts that were distressing him.
He said he had not been able to find much literature regarding OCD and violent thoughts. He said that what he had found was so minimal that he believed he was unique with his particular obsessions. He held a book in his hands and said, “I bought this book that talks about all types of OCD, and there are only two pages with the topic of violent thoughts. I read these pages over and over just so I can reassure myself that I am in the ‘normal’ range of OCD. These are the only words that have helped me maintain my sanity.” Then he asked for more reassurance. I told him what I knew about OCD and violent thoughts. The book he had found may not have been the best OCD book. Unfortunately, he had been suffering for quite some time without getting the appropriate treatment for his obsessions.
Of course, the first step in treatment is to do a thorough assessment. He completed various questionnaires so that together we could map out his road to recovery and help him get better. We talked about his medical history and how medication had helped him. Psycho-education was an important part of therapy and this was done throughout his treatment. We talked about the common OCD thinking errors that were affecting his functioning.
The fact is, most of the clients I see in my office are suffering primarily with scrupulosity, perfectionism, sexual or aggressive mental obsessions. As they are able to understand what is happening to their brain and how their erroneous beliefs distort their thinking and their functioning, they begin to make changes. Clients also learn about mindfulness and are able to practice basic mindful meditation skills. Ultimately, Exposure and Response Prevention therapy is what takes clients to “the light”. When they begin to see the light at the end of the tunnel, they understand there really is hope for them.
Honestly, the best pay day for me is when clients say, “I get it! I understand and know what to do now.” It’s not easy and they know they cannot be neglectful . They not only get it but understand that hard work does pay off! Their brain pathways can only change with exposures, practice, and more practice.
It’s all worth it. There is help and hope; and yes, you can do it too!