I was in psychodynamic therapy for 6 years with a therapist who said I had OCD, but who didn't have a plan to treat my OCD beyond having me avoid my triggers. Previous to that I had several other therapists who didn't really have a clue about my OCD. Here are some things to watch out for--hopefully this will help you find help more effectively and not have to go through the delay I experienced in finally getting Exposure and Response Prevention(ERP) therapy.
- Affirmations. If a therapist tells you to repeat affirmations about being a good person, good father, good teacher, good Christian, good whatever, in order to counteract scary, violent, disturbing thoughts, this just feeds the fire, prompting ever more desperation in trying to prove it to yourself that you are not a monster or a danger to others. This is different from having a compassionate therapist who asserts your value as a human being and encourages you to take your life back from the OCD and any other negative deeply held beliefs about your worth, by doing exposure therapy.
- Deeper Issues. If a therapist tells you there are deeper issues you need to deal with, and then somehow your OCD thoughts will resolve or disappear once you've dealt with the issues, you can be in for a long long stint of therapy. Yes, there may be deep issues in your life, but resolving them is not a treatment for OCD, since the compulsions often complicate any attempts at resolution, and even if you gain a deeper understanding of your psyche, OCD can be incredibly resistant to magically disappearing.
- Thought Stopping. Snapping a rubber band everytime you have an unwanted thought, or imagining a giant stop sign will sensitize you to the thoughts even more. Mental compulsions, on the other hand, can be stopped(even if it seems impossible), which leads to the next point.
- Confusing obsessive thoughts with compulsive thoughts. Pure O isn't pure. I discovered with the help of my ERP therapist, that I have mental compulsions for trying to "undo" my intrusive obsessive thoughts, like freezing(and doing nothing until I solve the issue), retracing my thoughts or actions, analyzing, figuring out, avoiding all reminders of the thought, or researching.
- Disputing the thoughts ad infinitum. Cognitive Behavioral Therapy(CBT) is the larger category that ERP belongs to, but CBT applied to mental obsessions without an understanding of the nature of intrusive thoughts, perfectionism and "just right" feeling can turn dysfunctional thought analysis into compulsions. I would get sidetracked into figuring out whether I'd done a thought record thoroughly enough, and even if I disputed all the errors in my thinking, it didn't seem to stick.
Finding a good therapist for OCD in the US and Canada