38: Why is OCD Treatment Resistant?
Obsessive compulsive disorder (OCD) is said to be one of the most challenging mental health conditions to treat because it is treatment resistant.
To better understand what’s going on with kids struggling with OCD, we must first know how to provide them help, and how to get the best treatment. I’m here to help you dispel common myths and misconceptions about OCD.
Obsessive compulsive disorder is often misdiagnosed
The first and common reason as to why obsessive compulsive disorder is treatment resistant is misdiagnosis. Obviously, if your kid’s condition is misdiagnosed, they won’t be able to get the right treatment. In line with this, having the wrong treatment also causes the resistance of your kid to treatments.
Oftentimes, people with OCD opt for cognitive behavioral therapy or talk therapy. However, the best recommendation for treatment which has been proven to be effective is Exposure and Response Prevention which will be discussed in another episode.
The more we form a habit, the more likely it is to stay.
The first thing we need to do is to make sure that we have a proper diagnosis for our kids. Like what we’ve said, proper diagnosis is important in getting the right treatment.
When we don't get that right diagnosis, we end up feeding the barking dog. Parents inadvertently accommodate their kids’ constant questioning. But we have to remember that the more we form a habit, the more likely it is to stay.
It’s similar to your sleeping patterns becoming a habit. We get used to the things we usually do. In this case, if we keep accommodating our kids, their actions will just get reinforced every time.
With OCD, we have something called negative reinforcement. It's the same thing as the rich get richer and the poor get poorer. The more we do something, the more likely it will happen. Conversely, the less we do it, the less likely it's going to happen.
The more you read, the better you get rid of your OCD ways. The same way that the more we engage in the obsessive thinking, intrusive thoughts, compulsions, and rituals, the more likely it's going to happen.
If you can visualize you have an intrusive thought, what happens?
Intrusive thoughts make it difficult for people with OCD to function in their daily lives. They can visualize these thoughts. Case in point, a kid keeps on asking his mom if it’s going to rain because he’s worried he’ll be struck by lightning. That’s what an intrusive thought is like for kids.
Once the kid’s mother confirms that it’s going to rain, the kid does everything in his power to avoid the lightning strike. There’s this high level anxiety prior to the confirmation of his mom. Then, the anxiety shoots down once the kid visualizes that intrusive thought.
What happens every time the mother confirms the kid’s question, the baseline goes up. And so, there’s a need for more reinforcement for the baseline to go down to the point of extinguishment or until it gets into a normal range.
Exposure and response prevention is the key.
Reinforcement requires persistence to unlearn old habits and learn new healthy habits. This is best done through exposure response prevention.
When you’re able to do it, what happens is that the brain has this recognition of whether or not something is going to happen or not. And so, the brain begins to relax once it’s reassured. As we’ve previously discussed in other episodes, the best way to calm the brain is through neurofeedback or PEMF.
Most people waste so much time on medication, but then there’s no progress with their condition. I highly recommend the exposure response prevention as it is the most effective treatment out there.
But we have to always take into consideration proper diagnosis to ensure proper treatment because once your nervous system is hijacked in that activated state, even Exposure Response Prevention is going to be hard. What you have to do is to calm the nervous system through PEMF and neurofeedback.
If you’ve been struggling with OCD for a long time, there are solutions.
Although OCD is said to be treatment resistant thus making it hard to treat, we shouldn’t lose hope because there are solutions even if you or your kid have been struggling with OCD for a long time.
Some attend therapies to work out their mental muscle and that’s good. But our best solution for that is exposure and response prevention. This is often used to kids especially those on the spectrum as it can be rigid and it’s a very structured type of psychotherapy.
No matter where you are in your journey, we have resources to help you:
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