OCD: A New Misunderstanding?

Earlier this month while I was traveling for a Pokémon tournament, I came across a magazine published by VeryWell Mind called OCD: A New Understanding. As I mention in the "letter to the editor" below, at first, I was excited to see an entire edition of a magazine being devoted to OCD. As I perused the pages of t he magazine, however, I became disappointed with VeryWell's failure to acknowledge exposure with response prevention as the "gold standard", and even worse, its recommendation of "thought stopping" as an "effective" OCD treatment.

I've included my original "letter to the editor" below for you to read. Please let me know what you think in the comment section of this post or on my Instagram (@ocd_lemmonaide)!

"Dear VeryWell Mind Magazine Editorial Team,

Hello! My name is Summer Contreras-Lemmon, and I am an International OCD Foundation Advocate (you can find me amongst the other IOCDF Advocates at https://iocdf.org/advocate-program/) living with obsessive-compulsive disorder in San Diego, CA. While traveling, I came across your special “OCD: A New Understanding” edition of VeryWell Mind at a convenience store in the Indianapolis International Airport. At first, I became excited, as it is rare that OCD is highlighted in this way. As I dove into the content of the magazine, however, I noticed some concerning differences between this magazine and how the International OCD Foundation (IOCDF) understands OCD and its effective treatment. The IOCDF is the world’s largest nonprofit organization dedicated to serving the OCD and related disorders community including individuals with lived experience, their loved ones, clinicians, and researchers (https://iocdf.org/about/). While I want to first discuss what the magazine communicates well about OCD, I want to also highlight a particular section of the magazine I believe may mislead certain readers into ineffective treatment.

First, I want to highlight what I believe the magazine does well.  Wonderfully, the magazine includes an introductory essay written by David Adam, a journalist, mental health advocate, and OCD sufferer who wrote the OCD-focused book, The Man Who Couldn’t Stop, and who gave the keynote to the 2016 OCD Conference in Chicago (https://youtu.be/KccklYNpTus?si=d82OQZkPh02Wkhql). I believe it is important to include the voices of those with lived experience like Adam’s as they often give the most accurate portrayal of what living with OCD is like, and what OCD is not like. Second, though the discussion of OCD subtypes is not exhaustive and does not include less-familiar OCD subtypes like existential OCD and pedophilia OCD, it does highlight a good number of other OCD subtypes. This includes contamination OCD, order and symmetry OCD, sexual orientation OCD, and even the lesser-known relationship OCD. Third, it talks about the specific cognitive distortions involved in OCD, like all-or-nothing thinking and generalization. And finally, the magazine includes coverage of other OCD-spectrum disorders as well, such as hoarding, skin-picking, body dysmorphic disorder, and trichotillomania.

However, there is one large section of this magazine I believe to be factually inaccurate and misleading, and that is the section in Chapter 3 (“Feeling Better”) called “Interrupting Unwanted Thoughts” and “Alternatives to Thought Stopping.” In the article published on the IOCDF website titled “Ineffective and Potentially Harmful Psychological Interventions for Obsessive-Compulsive Disorder”, written by world-renowned OCD expert Jonathan Abramowitz, PhD, Dean McKay, PhD, and Eric Storch, PhD (https://iocdf.org/expert-opinions/ineffective-and-potentially-harmful-psychological-interventions-for-obsessive-compulsive-disorder/), the authors discuss a common problem amongst OCD sufferers seeking treatment: they are often told their OCD will be treated effectively, only to be given something other than the “gold standard” treatment of exposure and response prevention (ERP). The authors specifically discuss “thought stopping” which has been “well known for a long time now” to actually worsen OCD. VeryWell spends a significant number of words/paragraphs on thought-stopping; however, experts in the field of OCD like Abramowitz have stated that this “treatment” makes OCD worse.

In addition, though the VeryWell Magazine discusses ERP in some places, it does not appear to acknowledge that ERP, a type of cognitive behavioral therapy, is the “gold standard” for OCD treatment. (Please correct me if I am wrong about the magazine not highlighting this fact.) According to the IOCDF, about 70 percent of people with OCD will benefit from ERP and/or medication. OCD is known to have a more effective treatment than other psychological disorders. It is important that individuals with OCD know about this effective treatment, and I am honestly disappointed that the magazine does not devote an entire section to ERP.

Thank you for your time and I hope this initiates a conversation about how we can best serve the community of those with OCD and related disorders and lead them to the most effective, evidence-based treatment possible.

Respectfully,

Summer Contreras-Lemmon"