FREQUENTLY ASKED QUESTIONS
CHECK OUT SOME OF OUR FREQUENTLY ASKED QUESTIONS. If you have further questions feel free to email a question to Dr. Brodsky or request a free consultation within 24 hours to learn about the drug-free cure for Obsessive Compulsive Disorder. It's completely confidential. Only Dr. Brodsky will ever read your questions. If you feel ready to get started, you can make an appointment online now or call 212-726-2390.
WHAT IS THE TREATMENT OF OCD?
OCD is a very treatable condition and, in many cases, medication might not be necessary. Hundreds of research studies agree that the best treatment for OCD is a form of cognitive behavioral psychotherapy known as "exposure response-prevention" (ERP). ERP helps OCD sufferers overcome their fears and reduce their compulsive and avoidant behaviors gradually, at a pace they're comfortable with.
While results are gradual, ERP does not require long term traditional psychotherapy. Results occur in months not years. ERP is more effective in the long run (in terms of curing and preventing later relapses) than either medication or other therapies.
OCD is very treatable.
Part of the treatment is a very structured step-by-step procedure, directly addressing symptoms of anxiety, obsessions, compulsions, avoidance. We ask clients to choose something to do in every session that they're comfortable with, yet feels like a modest "stretch" outside their comfort zone, like baby steps. You'll always be in complete control of the pace of therapy. You'll never be pressured to do anything you don't want to do. You'll have behavioral homework to do every day during the week. Again, it's never scary or time consuming, so you can just focus on the rest of your day. For example, some clients start by simply writing a single word.
Therapy is structured, behavioral, and results-driven.
CAN WE ALSO TALK ABOUT OTHER ISSUES?
We definitely will! The other half of the therapy is really getting to know each client as a whole person with all their issues, aside from OCD. We identify "real life" issues and lifelong patterns of behavior and feelings that might fuel the OCD along. That might be self-esteem, relationships, work stress, childhood or family issues, social skills, and assertive communication, among others. It's not a "cookie-cutter" approach. You aren't "just another OCD case," and therapy is customized for each person. We'll never suggest something to you just because we recommended it to someone else.
You're not just another OCD "case." We deal with everything in a person's life. It's not a "cookie-cutter" approach.
HOW LONG WILL IT TAKE? HOW OFTEN DO I COME?
Therapy involves coming to the office at least once per week. You'll notice relief gradually over time, little by little, but in the long run that will add up to a dramatic difference. It's not completed in 5-10 sessions, but it doesn't go on indefinitely either. It does take work, but those who don't skip sessions, and follow through with their behavioral homework usually make excellent progress. When you're done, however, you're really finished, living on a whole new level--moving on with career, school, relationships, enjoying life--finally following your dreams at last, without OCD holding you back anymore!
CAN I TALK TO MY THERAPIST DURING THE WEEK?
We contact you between sessions to see how you're managing or answer questions.
Please do! We look forward to your contacting us during the week. In fact, we'll regularly contact you every week between appointments just to see how you're managing, answer questions, and keep you focused if you're stuck, confused, or overwhelmed. You'll never feel like you're doing all this alone in between sessions. You're very brave to take this step and to do the work involved, but we'll be there with you all the way.
WILL I NEED MEDICATION?
Medication might not be necessary. Many people find the therapy alone to be effective enough. Medication helps many people reduce their symptoms, but the symptoms come back once they stop the meds. ERP, by contrast, gives OCD sufferers a technique to "boss back" the OCD, reclaim their lives, and prevent relapses. The majority of my OCD clients, and I've seen many severe cases, benefit from therapy with no medication at all. And those who are on meds, usually wean off them (supervised by an MD) by the time ERP therapy is concluded.
Medication may be unnecessary.
Having said that, I have recommended to some people to discuss with their psychiatrist the use of medication as a temporary measure if they are in an emergency (potential job loss, divorce, absences from school) or if they're too severe to even engage in therapy, but I usually save it as a last resort and only as a temporary measure. I usually recommend to others that they start with the therapy first and see how far they can go without medication. You can always add them later if needed. However, if you are on medication now, I wouldn't drop it until your condition has largely been stabilized by ERP. I would only recommend discussing with your doctor weaning off them while you continue with ERP therapy for some months after, and eliminating leftover OCD symptoms that the medication was masking.
There are at least a dozen medications for OCD, such as "SSRIs," "Tricyclic Antidepressants," "Anxiolytic Benzodiazapines," and "Neuroleptics," who's names I'm not permitted to mention, but you can discuss with your doctor. Different things work for different people and it sometimes involves some trial and error before the right medication is found for each individual. So if one medication doesn't work, don't give up. Each person's chemistry is different, and usually there is some medication that will work for you.
HOW DO I FIND AN OCD THERAPIST?
The best place to start your search for a qualified OCD specialist in your area is the International OCD Foundation website https://iocdf.org. Note that "in your area" might in some cases be a 2 hour drive away, but it's worth it compared to someone not competent. Today a growing number of specialists also do online teletherapy, but insurance might not always cover it if the therapist is not licensed in your state even if they are licensed elswhere. That might change in time.
Find an OCD specialist on the International OCD Foundation website.
HOW DO I KNOW MY THERAPIST CAN HELP ME?
CAUTION! Every therapist claims to treat OCD, but extremely few do the right kind of therapy for OCD, which is Exposure Response Prevention (ERP). None are on any insurance network (see below). I only want you to get the right kind of treatment, regardless of whether you see me or someone else. Insurance networks only provide generalists. A well intentioned general therapist might be helpful to talk to, but they can perpetuate or worsen your problem if they're not a true OCD specialist. Most people have seen multiple therapists with little result until they find a specialist.
Many therapists claim to treat OCD, but very few use the right kind of therapy, ERP.
THERE ARE 2 "TEST QUESTIONS" YOU MUST ASK A THERAPIST before you make an appointment:
1) Is ERP their main technique? If not, don't make an appointment. ERP is the only therapy endorsed by the International OCD Foundation. If you have a current therapist and they don't use ERP, switch to one that does. They might be nice to talk to or skilled in other issues, but they won't help your OCD.
2) How many people have they SUCCESSFULLY treated for OCD? By "successfully" I mean by the end of therapy, the person is not on any medication, and is almost if not completely free of obsessions, compulsions, and excessive anxiety.
They shouldn't just help you "deal with OCD better" or "manage symptoms." They should get rid of OCD! They should have accomplished this with at least several dozen people if they're in a major metropolitan area (New York, Los Angeles, Chicago, Philadelphia, Boston, etc.) or at least several people in other areas or countries.
CAN I FIND AN OCD THERAPIST IN MY INSURANCE NETWORK?
No! Remember, every therapist claims to treat OCD (and they mistakenly believe they know how to). However, there are no therapists in any insurance network who are competent to treat OCD. They are generalists, good for other issues, but not experienced specialists in OCD. Don't prolong your suffering while going on a wild goose chase calling therapists on your network. (See next question.)
HOW CAN MY INSURANCE COVER AN OUT-OF-NETWORK OCD SPECIALIST?
We negotiate insurance to cover you.
Fortunately, OCD treatment is more affordable than ever before! Most clients' insurance reimburses them for the majority of my fee and offer a generous number of sessions. Even better news is that due to a new law, called Timothy's law, that requires insurance to cover treatment for OCD and anxiety (which they term a "biological condition") at a higher rate (as much as 80%), and usually for more or unlimited sessions. So going of network isn't as expensive as it used to be.
In fact, even with if you have an HMO or Medicaid with no out-of-network coverage, I will negotiate with your insurance to cover me as if I were in network. (Click for instructions.) Very few therapists do this, but I want to give more people access to help they couldn't otherwise afford. The client pays no out of network deductible and might get refunded between a third to 70% of my fee by their insurance, usually about 30-60 days later depending on how fast they submit their claim. Note that clients still pay the same full fee of $180 at each appointment, but are given a receipt to be reimbursed by their insurance.
HOW CAN FAMILY AND FRIENDS HELP?
The most important thing family and friends of an OCD sufferer can do is to educate themselves and the sufferer, and empathize with what the OCD sufferer is going through. Don't blame or criticize them: they are the victim. Indeed, the whole family is victimized by OCD. OCD is the enemy, not the person suffering with it. They can't stop it themselves. They don't call it "compulsive" for nothing; it means the person feels forced against their will to have disturbing thoughts and time consuming rituals or seek reassurance. It's important for family and friends to unite with the sufferer against the true enemy, OCD.
Encourage, don't overly reassure.
You have to live your lives as if no one in the household has OCD. And if they repeatedly ask for reassurance, compassionately remind them it won't help them and change the subject. Encouragement and general reassurance that "things will get better" is always fine. Or, tell them to talk about it to their therapist at the next appointment. If that doesn't work change the subject or find any excuse to leave the situation ("uh, oh, I have to make an important phone call").
Most importantly, don't try to reason with or persuade an OCD sufferer that their worries are irrational. That will just make him worry more. It's like telling someone not to think about a white elephant. It just makes them think about it more. And the sufferer already knows their worries are irrational, they just can't stop. Again, that's why it's called "compulsive." The person feels forced against their will to have these worries and compulsions.
What should you do instead? Tell the sufferer that OCD is extremely treatable, extremely common, and that it's not the worst thing. It's a lot easier to accept they have OCD if they know it can be treated. Tell them it doesn't require long term psychotherapy and might not require medication. Emphasize that therapy is not scary and they will never be asked to do anything that they're uncomfortable or unwilling to do.
Unite against OCD, not the sufferer.
Finally, encourage the OCD sufferer to read some books about OCD, show them this website, and encourage them to email their questions (it can even be anonymous) for a free consultation with no obligation to ever come to our offices. Only Dr. Brodsky will ever read their message or speak to them. It's completely confidential. If they're ready to take the next step, they can make an appointment online or simply call 212-726-2390.
Once your loved one starts therapy, and it's the right kind of therapy (i.e., ERP) you can rest assured that you've done everything you can for them. There's nothing you've overlooked or neglected. Now the best thing to do is to take a step back. It's a matter of time and work on the part of the client and the therapist.
If your loved one sees you're consumed by their suffering, then it will confirm that their fears are true. Hard as it may be, force yourself to be a good actor and act in a nonchalant manner offering general empathy, encouragement, and support. Try something like, "I know it's very painful for you, but don't give up, keep going to your therapist, we know you're working very hard, you're very brave to take care of this, it will get better and work out in the end."). That will be more effective than overly reassuring them (e.g., "I've told you a hundred times, there's nothing to worry about, everything is OK, you're over-reacting or manipulating us!").
WHY DO PEOPLE HESITATE TO SEEK TREATMENT?
It's a shocking fact that in the 21st Century the vast majority of people with an emotional problem never seek any help at all! That's even more shocking since 15-20% of the population has a diagnosable disorder, whether mild or severe. They just suffer unnecessarily, miss out on the enjoyments of life, avoid relationships, or self-medicate with alcohol or drugs. Some, completely without reason, go on disability or leave school.
Therapy is never scary, embarrassing, or pressured. Don't continue to suffer unnecessarily.
Of the small fraction that seek any help, 80% never go beyond their family physician, and a smaller number do nothing but take medication with mixed results. The tiny trickle that go to a therapist are misdiagnosed or given the wrong type of treatment. This is entirely unnecessary, which begs the question: Why? On some level every OCD sufferer knows something is wrong, but it's scary to accept it. It's hard to acknowledge a problem if you think you're the only one and nothing can be done about it. Reading about OCD, by showing them this site, can help the sufferer realize they're not alone, that OCD is treatable, and isn't something worse, even though it's interfering with their life.
If you still have OCD, it's not because you can't be helped. You simply didn't get the right kind of treatment.
Most OCD sufferers have tried multiple therapists who didn't do the right therapy and felt disappointed. They feel skeptical that anything will work.
Almost always, well-intentioned family members inadvertently enable their loved one with OCD by endlessly reassuring them and accommodating their compulsions and avoidant behaviors. They can't accept they have a problem if everyone's trying to prevent upsetting them.
Finally, many fear the therapist will force them to face their worst fears, but treatment is never pressured and moves in baby steps. You'll never do anything you don't want to, and you're in total control of the therapy at all times. Some people start by simply writing a single word on a piece of paper. The therapist always asks the client what they feel ready to do. In fact, sometimes clients say they want to do something more challenging "to get it over with," but the therapist suggests starting with something much easier. It's normal for many hesitant people to fear therapy will actually make the problem worse; I have never seen that in my entire career and I'll make sure that never happens to you!
WHAT ARE GOOD BOOKS OR MOVIES ABOUT OCD?
There are many books about OCD. One that we recommend is Confronting the Bully of OCD, by my former client, Linda Maran, and offers a insider's view of what it's like being a client in therapy with Dr. Brodsky. It's one of the few books written by someone who actually had OCD, instead of by a professional. It's available on Amazon.com.
Two others are:
When Once Is Not Enough (by Gail Steketee)
Stop Obsessing (by Edna Foa)
The TV shows "Obsessed," "Hoarders," and "Monk" and the movies, "The Aviator" and "As Good As It Gets," depict OCD sufferers, but are very oversimplified. Reality TV shows like "Hoarders" are frankly exploitive.
Click to preview or order this book by a former client about drug-free therapy with Dr. Brodsky.
Click to preview or order this book edited by Dr. Brodsky about Cognitive Behavioral Therapy.
Dr. Brodsky is featured in another book for teenage readers, Anxiety: It Happened To Me, about many types of anxiety, including OCD. It's written from the first person experiences of actual teens who suffered and recovered from anxiety.
Another book edited by Dr. Brodsky coming out in the near future is An Idiot's Guide to Cognitive Behavioral Therapy. This covers a broader number of conditions that are helped by CBT.
Click to preview or order this book for teenage readers featuring Dr. Brodsky on OCD, Panic, and Social Anxiety.
If you have further questions feel free to email a question to Dr. Brodsky or request a free consultation within 24 hours to learn about the drug-free cure for Obsessive Compulsive Disorder. It's completely confidential. Only Dr. Brodsky will ever read your questions or speak to you. If you feel ready to get started, you can make an appointment online now or just call 212-726-2390.