When Treatment is Stuck: Resistance in OCD Therapy
Most cases of OCD treatment ebb and flow with progress. However, we are occasionally met with significant resistance. Although we hope to externalize OCD as a separate voice from one’s true self, OCD often can be deeply entrenched in our personalities. Sometimes, we cannot imagine who we are without our OCD behaviors and we lean on this predictable mode of reacting to the world. The temporarily easier path is to stay in your OCD.
In cases where our clinicians and clients find themselves stuck, we must ask ourselves the following questions.
Should we consider other modalities?
OCD treatment is not one-size-fits-all. Despite the fact that we have exposure handbooks, and treatment manuals with step-by-step plans for various fears, we cannot and should not try only one approach. I often have multiple clients with similar presenting issues who respond to completely distinct treatment approaches. Finding the best approach requires both creativity and humility on the part of a clinician, as well as a good relationship with our client for them to be able to tell us straight: This isn’t working.
2. Should we consider medical interventions?
If OCD therapy is at a plateau, we most likely need to partner with a medical provider to suggest supplements, medicines, labwork, or lifestyle changes that will support growth and change. At Kairos, we partner with multiple holistic medical providers to expand beyond our offerings. Treatment can and should look at the whole body, including brain chemistry.
3. Is the family system accommodating the OCD?
The family system’s behavior deeply influences the outcomes of OCD therapy. In the case where treatment doesn’t involve the family, we tend to see delayed results. Family systems tend to protect the homeostasis. In other words, families naturally move back into a familiar equilibrium, which prevents any particular family member from having significant growth.
4. Does the client need to meet others with OCD?
We have robust group offerings at Kairos because we find that it can often influence treatment resistance to meet others at various stages of OCD recovery. Connecting with someone with more severe OCD can give a client a sense of where things can go if OCD is unchecked (as OCD has a tendency to snowball over time). Conversely, meeting an individual in recovery can give a spark of hope for positive change. Treatment resistance can be worked through in group, as other individuals going through the process can offer insights that clinicians may lack.
Contact us today to learn more about OCD Therapy and how we can help you get ‘un-stuck’.
