OCD involves obsessions, which are unwanted, intrusive urges or thoughts. It also usually involves compulsions, which are repetitive physical or mental acts performed to reduce anxiety. Common presentations include contamination fears with excessive washing, doubt about safety leading to repeated checking, intrusive violent or sexual thoughts and a need for symmetry or order.
The OCD psychiatrist team at the Greenwich location of Principium Psychiatry has specialized training in assessment and evidence-based protocols.
Exposure and Response Prevention (ERP) represents the gold standard of psychotherapy for OCD. This structured form of cognitive behavioral therapy involves gradual, systematic exposure to feared situations while preventing the compulsive response.
At Principium Psychiatry, ERP OCD therapy in Greenwich involves our providers helping you to create a hierarchy of triggers, practice exposure exercises during sessions and complete homework assignments between appointments.
Selective serotonin reuptake inhibitors (SSRIs) form the pharmacological foundation for treatment. These medications reduce the intensity and frequency of intrusive thoughts, making it easier to engage in ERP. The psychiatrists at Principium Psychiatry carefully monitor response and adjust dosing, using pharmacogenetic testing, if required, to help guide medication decisions.
For treatment-resistant OCD, our Greenwich location may offer advanced interventions that can include Transcranial Magnetic Stimulation (TMS) therapy, which targets specific brain circuits involved in symptom generation.
SPRAVATO™ (esketamine) and ketamine represent another option we can explore for severe cases.
Our providers are often asked the following questions about OCD treatment:
This can vary widely between patients, depending on co-morbidities, other treatments undertaken at the same time and individual differences. The process requires active participation between sessions, as homework completion strongly predicts outcome.
While medication can reduce symptom intensity, research shows that combining SSRIs with ERP can produce superior outcomes compared to medication alone. Many patients use medication to make engaging in exposure work more manageable.
ERP proceeds at a carefully controlled pace determined collaboratively between you and your therapist. The exposure hierarchy starts with situations that produce moderate anxiety rather than beginning with the most distressing scenarios. Gradual progression allows your nervous system to learn that anxiety decreases without performing compulsions.
Our services include specialized assessment, evidence-based therapy and advanced interventions for complex, difficult-to-treat symptoms. The psychiatrists at Principium Psychiatry create treatment plans addressing your specific situation. Contact our office to schedule an evaluation and begin the process of breaking free from OCD.
