Shining a Light on the Challenges of OCD

Available with English captions and subtitles in Spanish.

Elizabeth McIngvale, PhD, LCSW, talks about the nuances and complexities of obsessive compulsive disorder, addresses advocacy in and out of the doctor’s office, and answers audience questions about OCD.

OCD doesn’t have a one-size-fits-all approach to treatment. As a clinician, you may find yourself in challenging situations regarding diagnoses and the need for specialized treatment regarding OCD and associated anxieties. As a patient, you may understand the need for tailored treatment that works for you. For both, it may be difficult to know how to address OCD and its related disorders with those around you. How can we navigate OCD as providers, patients, or sometimes both?

This content is also available in Spanish.

Audience Questions

Dr. McIngvale answers questions on topics including:

  • How do we, as family members or clinicians, know when intrusive thoughts are OCD or real concerns?
  • Can you provide more insight into YBOCS assessment and how to access the screening test?
  • Has it been more difficult to diagnose OCD with widespread fears about COVID-19 spread?
  • Can you please comment on the ways families can be supportive of family members struggling with contamination OCD without enabling them to continue the routine?
  • How has ERP (exposure and response prevention therapy) changed in this new world of telehealth visits?
  • Without getting into specifics, which types of medications are typically successful in helping manage OCD symptoms?
  • Can you explain how clinicians can best differentiate between OCD and severe GAD (generalized anxiety disorder)?
  • Has anyone looked at using mindfulness or dialectical behavior therapy (DBT) for treating OCD?
  • I have a patient who was on the autism spectrum who ruminates on certain topics and asks endless questions even after getting an answer. Any suggestions around helping with these obsessive thoughts?
  • Please speak briefly about the overlap between autism spectrum disorder and OCD. Should treaters of both types of disorders consider the possibility of co-occurrence?
  • I have a patient who isn’t making progress as quickly as she would like to and is losing hope. She gets more depressed and feels like she will always struggle with her awful thoughts. How can we as clinicians encourage and continue to motivate someone in this position?
  • When doing an exposure, like touching a doorknob, I know a patient is supposed to sit with their anxiety, but can they do deep breaths or should they think of a happy thought? I know they shouldn’t do mental compulsions.
  • Any suggestions for patients or family members in denial about their symptoms but who clearly need residential care?
  • Can you speak to the link between OCD and hormonal changes associated with pregnancy?
  • Are you aware of options to be screened for OCD?
  • You mentioned that you have OCD. It seems that OCD never goes away. At which point can someone feel that they are “recovered?”
  • What is the connection between perfectionism and OCD?
  • How does ERP work? Can you share how OCD and avoidance of engaging in socializing are addressed through exposure and ERP?
  • Is body dysmorphic disorder a form of OCD?
  • Based on your professional and personal experiences, could you summarize your biggest takeaways from this session?

The information discussed is intended to be educational and should not be used as a substitute for guidance provided by your health care provider. Please consult with your treatment team before making any changes to your care plan.


You may find this additional information helpful:

About Dr. McIngvale

Elizabeth McIngvale, PhD, LCSW, is the director of the OCD Institute of Texas, founder of Peace of Mind, a nonprofit foundation dedicated to OCD, and manager of, a self-help website for OCD. Dr. McIngvale was the first-ever national spokesperson for the IOCDF and now serves as a board member. She was diagnosed with OCD at age 12 and underwent both inpatient and outpatient therapy.

Dr. McIngvale engages in clinical work, research, and advocacy aimed at improving OCD treatment and access to care. Her life goal is to make a difference in the lives of those with OCD.

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Originally aired on September 10, 2020