Recognizing the Signs of OCD in Your Clients: A Guide for Therapists

As therapists, our primary goal is to help our clients navigate the intricate web of their emotions, thoughts, and behaviors. One condition that often eludes the untrained eye but can severely impact a person's life is Obsessive-Compulsive Disorder (OCD). Detecting the signs of OCD early is crucial for providing effective support and treatment. In this blog post, we'll explore how to recognize these signs in your clients so that you can offer the help they need.

Before diving into identifying signs, it's essential to have a clear understanding of OCD. OCD is a mental health disorder characterized by persistent, unwanted thoughts or obsessions, followed by repetitive behaviors or mental acts known as compulsions. These behaviors are often performed to reduce the distress caused by the obsessions. Let's dive a bit deeper into specific areas you can look at.

• Spotting Obsessions

Obsessions are the persistent, intrusive thoughts that impact individuals with OCD. They can take many forms, but common themes include fears of contamination, harming others, or being responsible for terrible events. Keep an eye out for clients who frequently talk about irrational fears or disturbing thoughts that they cannot seem to control. Some examples may include clients seeking reassurance around a specific topic for multiple sessions, or asking for multiple resources to review in between sessions.

• Recognizing Compulsions

Compulsions are the repetitive behaviors or rituals individuals with OCD engage in to alleviate the distress brought on by their obsessions. These rituals can be physical actions or mental processes. Some common compulsions include excessive hand washing, counting, checking, or researching topics for several hours. If your client mentions performing these actions to an excessive degree or expresses distress when they cannot complete them, it may be a sign of OCD.

• Time-Consuming Behaviors

Clients with OCD often spend an inordinate amount of time on their obsessions and compulsions. They may describe hours spent cleaning, arranging, or ruminating over their thoughts. Inquire about the amount of time your clients spend on these behaviors and whether it interferes with their daily lives.

• Avoidance Behaviors

Clients with OCD often engage in avoidance behaviors to prevent triggering their obsessions. They may avoid certain places, situations, or people that they associate with their intrusive thoughts. Pay attention to your clients' explanations for avoiding specific situations, as this could be an indication of underlying obsessions and compulsions.

• Difficulty with Uncertainty or Doubt

Clients suffering from OCD often time have difficulty around things that are not black and white. Perhaps they do not trust their own judgement, or even trust their memory. I find there is often difficulty around things that we truly can not define such as amount of love, sexuality, memory, medication, health, cleanliness, or social appropriateness just to name a few.

Case example: A client comes to therapy reporting symptoms of lifelong anxiety including; panic attacks, marked fear, repetitive thinking, difficulty leaving her home, difficulty focusing, and a decrease in social functioning. After one or more sessions, she endorses feeling a low self worth as it relates to her marriage. She shares that she often times finds that she feels unsure if she married the correct person, and even at times feels her partner does not love her. or may not be THE ONE. Upon further assessment, she reports a healthy marriage, no history of trust concerns, and in fact shares that she loves qualites her partner has. When assessing things that she has done to support her marriage (like have open communication, increase dates, or even see a couples therapist) she reports they have done all of these things (maybe even multiple times.) The client proceeds to share that she often even directly will ask the partner if they love her, or do daily check-ins around "if we are okay." This might be where I ask, "are there any other things you do to ensure or check on the marriage?" The client then reports having done research into relationships, reviewed their partners phone or social media to ensure no cheating, or the client reports spending hours to ensure the home and themselves are "perfect" to maintain their partners satisfaction. This is a perfect case example where I may introduce relationship OCD and gather more historic information.

OCD is chronically misunderstood and as therapists, our ability to recognize the signs of OCD in our clients is crucial in providing timely and effective treatment. By broadening your understanding of OCD, you can better serve clients, and be more prepared to notice the signs and symptoms.

Once you suspect that a client may have OCD, it's essential to refer them to a qualified mental health professional for a comprehensive evaluation and diagnosis. With early detection and appropriate treatment, individuals with OCD can learn to manage their symptoms and lead fulfilling lives. Your support and expertise can make all the difference in their journey to recovery. I recommend using the international OCD foundation website to increase understanding, or seek local referrals in your area.