Jake is a 16 year old male who sought treatment due to significant interference in his life from symptoms of OCD. Jake’s compulsions occurred mostly when he was reading but would occur also in conversation and when listening to someone else speak. He would feel the need to count the amount of vowels in a given word or sentence. At times he would feel the need to count the amount of letters in a word or the amount of words in a paragraph. This compulsion significantly interfered with Jake’s ability to complete homework and tests in a timely manner and to focus in the moment during class or even during regular day to day conversations. Utilizing exposure and response prevention (E/RP), his therapist and him worked on purposely messing up the number of letters or vowels or sentences when he experienced the urge to count. He also used index cards when reading to help block the previous sentences and words with the goal of learning to move on and continue the task despite feeling anxious. Jake did not have a disastrous consequence but felt highly anxious when he did not count or know the amount of vowels in a word. He would also use coping statements when compulsions would arise when he was reading to help him continue reading and focusing on the topic at hand. Over the course of 6 months of E/RP therapy and with the assistance of the right medication, Jake’s symptoms significantly improved and he was soon able to read and be present in conversations without feeling the urge to count.
As you can tell from this case example, OCD can be quite varied from person to person. With the right combination of E/RP and medication when needed, individuals can and do improve significantly.