If they find that looking at the tissue did not cause disease, therapy can progress to more provocative exposures like touching the tissue, etc., until they overcome their unrealistic fear of contamination. In particularly anxious patients, this therapeutic approach is often combined with a drug that counteracts depression or anxiety.
One silver lining of the pandemic is that it may have allowed more people to seek remote treatment through online health services. “With telemedicine, we are able to treat patients very effectively, regardless of where they live in relation to the therapist,” said Dr. Paint. “I can visit patients in 20 states without ever leaving central Oklahoma. Patients do not need to be within 30 miles of the therapist. Telemedicine is a real game changer for people who do not want to or cannot leave their home. “
For severely impaired obsessive-compulsive patients who have had nothing else to do, the newest option is transcranial magnetic stimulation, or TMS, a non-invasive technique that stimulates nerve cells in the brain and helps redirect neural circuits involved in obsessions and compulsions.
“It’s like the brain is stuck in a dead-end street, and TMS is helping the brain’s circuits take a different path,” said Dr. Paint. As with exposure and reaction prevention, he said, TMS uses provocative exposures but combines them with magnetic stimulation to help the brain respond to the urge to respond more effectively.
In a study published in May of 167 severely affected OCD patients at 22 clinical sites, 58 percent continued to offer significantly improved coverage after an average of 20 sessions with TMS.
Where can I get help?
Bradley Riemann, a psychologist with the Rogers Behavioral Health System in Oconomowoc, Wisc., Said his organization, with 20 locations in nine states, relies on treatment teams that include psychologists, psychiatrists, nurses, and social workers to provide both outpatient and inpatient treatments for OCD. Patients as early as 6 years of age. Too often, said Dr. Riemann, parents inadvertently exacerbate the problem by clearing a path for their child to avoid their obsessive fear and the resulting compulsive reaction. For example, they could routinely open doors to a child who is afraid of contagion.
The Boston-based nonprofit International OCD Foundation can help patients and families find therapists and support groups for those struggling with the disease. A message can be left at 617-973-5801.
