This is the fourth and final part of an interview series on OCD with specialist Jon Hershfield. Read the other installments “Defining OCD,” “More On OCD,” “An OCD Therapist’s Story,” and please comment on this post with your feedback.
Bud Clayman: I’ve been told that it takes anywhere from 10 to 15 years to be diagnosed with OCD and get into treatment [at least that’s what it took for me]. If that’s true, how does someone reading this interview recognize if they even have OCD [and why does it take so long to recognize that you have the disease]?
Jon Hershfield: I think it goes back to your earlier question about what are some of the misconceptions about OCD. People hear the word disorder and they think weird, sick, handicapped, and depraved. Completely unnecessary and irrelevant stigma attached to the diagnosis of OCD. I can’t speak about the experience of other disorders, but I can tell you from my experience working with OCD patients, the vast majority of them are far more normal than any of these so called normal [people] that I meet in regular everyday life.
People are afraid that if they reach out for help that this is a sign of weakness. I should be able to do it on my own. I should be able to tough it out. I should be better than this or if I’m sick it’s because I’m doing something wrong. This is really unfortunate because there can’t be any greater demonstration of strength in my opinion than to say, “I need to see an expert on this. I need to learn the tools for mastering this thing. I am not going to let this thing take my life away and I’m not going to be in this weaker position of constantly telling myself, ‘oh, I should be able to do it on my own without really learning how to do it on my own.’”
Bud Clayman: Where does that come from? [There is] a stigma in society against therapy and getting help because I always tell people [I] know [that they] would really benefit from seeing a therapist and they tell me, “Well, I can go it on my own. I don’t need a therapist.” I know from my own experience, therapy has just changed my life if you get the right therapy.
Jon Hershfield: I think part of it is that the right therapy hasn’t always been around and there was a time when people probably got the wrong therapy. In fact, still today I see it where people come to me saying I need help with my OCD and my old therapist said if I don’t get a handle on these thoughts, somebody’s going to get hurt or my old therapist thought that these intrusive sexual thoughts mean that I’m burying some suppressed urge to do whatever etcetera, etcetera. That can be really traumatizing and damaging to that person. I think for a long time people were getting the wrong therapy and some people still are getting the wrong therapy. There’s a lot of fear. Nobody wants to open themselves up to another human being and be abused. It’s not always the therapist’s intention to cause harm. But if they’re treating OCD and they’re not using cognitive behavioral therapy (CBT) to do it, then they probably are causing harm. I think it’s important that therapists get trained to treat the disorders that they want to be able to treat and there’s a very specific training for OCD. In fact, the International OCD Foundation provides a lot of different avenues for getting that training, so there’s really very little excuse now for not using CBT for OCD as a clinician.
Bud Clayman: How do we erase that stigma, what do we do?
Jon Hershfield: Well, I think you’re doing it right now. I mean you made this wonderful film, OC87, which is not only a good film, but is also an example of how a person can make a decision to create something and actually just execute it despite having all these other challenges while dealing with all this other stuff and say well, “I’m not going to let this stuff get in the way of me leading a fulfilling life.”
I think the key is really sufferers making the choice to do the work that it takes to get as well as they can and then going out into the community and saying, “Look, it can be done. You can get better. Here’s how I did it. Let me help you. Let me help guide you to resources. Here’s the International OCD Foundation. Here’s a great online discussion board. Here’s a good therapist that I can recommend. Here’s a great book to read.” I think OCD sufferers should –
Bud Clayman: Seek that out.
Jon Hershfield: I don’t want you to think I’m starting a revolution but –
Bud Clayman: Why not, I would like you to start a revolution in this country about getting help with people’s issues. That’s how I feel, if you have an issue and it’s stopping your life, you need to get help.
Jon Hershfield: People are very funny when it comes to issues of the mind and brain. Nobody tells you if you sprain an ankle or break a leg that you should just walk it off. When something isn’t quite working right in your head the assumption, and I have no explanation for where we got the assumption, but the assumption is that that’s your problem, deal with it. That’s not accurate.
There are a lot of people out there right now, perhaps somebody reading this interview, suffering needlessly and not a little either, but a lot, keeping themselves from having relationships, keeping themselves from working and help really is available.
Bud Clayman: Where is that help available? Somebody reading this, where do they go for treatment? Who do they turn to? What’s their first step?
Jon Hershfield: I said help is available and that’s mostly true. Treatment costs money. If you have insurance hopefully you can find a therapist who treats OCD in your insurance company, but the state of affairs as it is right now, a lot of specialists don’t, so that can be very challenging. The first place you should go is the International OCD Foundation. They have a great treatment provider list, which is broken down by geography so you can just put in your zip code and anybody who comes up on there is someone who is able to present themselves as doing cognitive behavioral therapy (CBT) for OCD. I would start also by reading several of the great books out there on OCD.
Bud Clayman: And those are?
Jon Hershfield: They have good book lists on the International OCD Foundation website. And talk to people about it. Talk to people that you really trust. That doesn’t necessarily have to mean your friends and family if you think that they really don’t understand what it’s like or what it means to be struggling with a disorder or mental illness, or a mental health challenge, whatever you want to call it.
Talk to somebody you trust. Talk to a teacher. Talk to your general practitioner. Get information. Collect information. Go online. Be careful online because there’s a lot of room for doing compulsions and getting reassurance, and things like that but I think if you start with OCfoundation.org and branch out from there, you’ll be in pretty good shape. That would be the most direct portal for finding good treatment.
If you’re in a [major] city, there’s probably somebody doing OCD therapy. So you could probably just type in OCD and the name of your city, and that would be a good way to find a provider, as well. [If you’re not in a major city, look up treatment providers in your state and see who is willing and able to do treatment online.]
Editor’s Note: One of the groundbreaking and important books on the treatment of OCD is Freedom From Obsessive Compulsive Disorder by Dr. Jonathan Grayson, PhD.
Bud Clayman: Cool. Do you have any final words you’d like to add as we close out the interview?
Jon Hershfield: No, I just wanted to thank you for reaching out to me. I’m a fan of yours and I appreciate you being a fan of mine.
Bud Clayman: I’ve become a fan of yours definitely.
Jon Hershfield: Thanks a lot and yeah, I look forward to perhaps future collaborations down the line.
Bud Clayman: Definitely!
The Mindfulness Workbook for OCD: A Guide to Overcoming Obsessions and Compulsions using Mindful and Cognitive Behavioral Therapy by Jon Hershfield MFT, Tom Corboy MFT, and James Claiborn PhD ABPP (Foreword) will be released on December 1, 2013.
Jon Hershfield, MFT is a psychotherapist in private practice in Los Angeles and the associate director of the UCLA Child OCD Intensive Outpatient Program.