How a Diagnosis of OCD Can Help You--Or Harm You

Finally your healthcare professional delivers the three little words. Obsessive compulsive disorder. 

You might have heard. “You have OCD.” Or “Your child has OCD.”

The diagnosis of OCD does not have magical powers. Your brain wiring is the same the day before and after a health care professional delivers the diagnosis.

However, the meaning you ascribe to the diagnosis and what you do with a diagnosis can radically transform your life.

So today, let’s discuss:

• Why a diagnosis is so important, especially when a diagnosis describes how neurodiverse brains work. 
• What is the value of an accurate diagnosis?
• How and why do people use the diagnosis against themselves and do more harm than good?

Click here to learn more about ERP. Click here to go to NOCD and find an ERP practitioner.

Click here to learn more about the OCD Freedom Formula Bootcamp.  This 28 day program kicks off 5/7/24. 

Connect with Dr. Vicki Rackner:

• Website: FreeMeFromOCD.org
• Social Media: Follow Dr. Rackner on Instagram and Facebook for more insights and resources on managing OCD.

Transcript

The three words, obsessive compulsive disorder or OCD, hold power. What's the value of a diagnosis of OCD? How can it serve you? And how can you avoid being harmed by the diagnosis of OCD? That's what we'll be talking about in this week's podcast episode.

Welcome to the Free Me From OCD podcast. If you or someone you love has OCD, you know that OCD can hold you hostage. OCD can get in the driver's seat of your life. Here, you'll find the information, tips, and tools to put you back in the driver's seat of your life. I'm doctor Vicki Rachner, your host.

I call on my experience as a mother of a son diagnosed with OCD when he was in college, physician, and life coach to help you evolve into the best and highest version of yourself. Let's dive into today's episode. Well, finally, your healthcare professional helps you understand what is going on with your child. You might have heard you have OCD or your child has OCD. The diagnosis of OCD itself doesn't have magical powers.

The brain wiring is exactly the same the day before and the day after a healthcare professional delivers the diagnosis. However, the meaning you ascribe to the diagnosis and what you do with the diagnosis can radically transform your life. That can be real magic. So today, let's discuss why a diagnosis is so important, especially when a diagnosis describes how neurodiverse brains work. What's the value of an accurate diagnosis?

How and why do people use the diagnosis against themselves and do more harm than good? So let's begin by understanding the difference between symptoms, a diagnosis, and a treatment plan. I know that this sounds basic, but when the diagnosis addresses the behavior of neurodiverse brains, whether it's OCD or ADHD or autism, the waters quickly get muddied. Having clarity about all of these concepts can help you be freed from OCD. Alright.

Well, why do you seek medical care? It's usually because you have a sense that something's not right. The symptoms are the way that you describe the not rightness to your doctor. It might be a headache or chest pain or a sore shoulder. Often the primary symptom is a form of pain that keeps you from doing the things you wanna do.

So what's the natural response to pain? Your brain tells you make the pain stop. You might try to treat your symptoms by taking over the counter pain medication. Sometimes the pain gets better, but not always. Why?

Well, treating the pain is different than treating the underlying cause of the pain. If you want your yard free of dandelions, you don't just snip off the yellow flower. You pull the dandelion up by the root. The root cause leading to your symptoms is the diagnosis. An accurate diagnosis will help you understand why you have the symptoms.

Further, an accurate diagnosis leads to the most effective path to pain free living. The diagnosis is the doctor's description of the underlying cause. Let's say that you have a symptom like chest pain. You're worried because your father died of a heart attack at your age, and you remember your dad having chest pain. However, chest pain is a symptom, not a diagnosis.

There are lots of things that cause chest pain other than heart problems. You could have gotten hit in the chest with a soccer ball and feel the pain of blunt trauma. You could have a COVID infection and feel pain when you take a deep breath. You might have esophageal reflux. So here are the three reasons doctors get to the root cause of your symptoms and deliver an accurate diagnosis.

1st, it helps you explain the symptoms you're observing. 2nd, you might be able to predict what your future will hold. Blunt trauma of the chest will usually resolve on its own. Esophageal reflux and heart disease will get worse over time. 3rd, the diagnosis guides the most effective treatment.

So the treatment for heart disease is different than the treatment of acid reflux. Okay. So far so good. The symptoms are clues that ultimately lead to the correct diagnosis, and the correct diagnosis is on the path back to health. When the symptoms involve the brain instead of the elbow or the abdomen, the stakes go up.

We have an attachment to our brains. It's the seat of who we are. Now you might be worried about your brain if you notice headaches or slurred speech or a loss of memory. All of these are symptoms that might lead your doctor to order a CT or an MRI. And then this study might show evidence of a stroke or a brain tumor or Alzheimer's.

However, if you have a neurodivergent brain, things get more complicated. The symptoms are often about the pain of areas of your life that are not working. You might have a hard time making and keeping friends. You have a hard time learning in class. Maybe teachers remove your child from the classroom because of problematic behavior.

Now I'm gonna take a huge risk here and disclose that I have a neurodivergent brain. When I was about 45, I was diagnosed with ADHD. My symptom was that my life wasn't working. Now I know that sounds kind of vague, so let me give you a specific example. I had a long history of what I call stumbling at the finish line.

I'd get a project mostly done, and then at the very end, things fell apart. I failed. For example, there was a time in which I served as an expert in medical litigation. I remember one specific day when I threw myself into prepping to testify in court. On the way out of the courtroom, the lawyer who hired me told me what a great job I did.

As I walked to the parking garage, I had a little private celebration. I worked hard and made some great points I knew would help this plaintiff win his case. The celebration was cut short though when I realized I couldn't find my car in the parking garage. I had spent several years in therapy trying to get to the root of what my therapist called my self sabotaging behavior. Was I replaying a family of origin drama?

Was I afraid of success? Was I a bad person? Was I lazy? As I walked through that parking garage, I berated myself as I so often did. You always screw up.

What's wrong with you? Then around that time, 3 people told me about their new diagnosis of ADHD. I bought the book Driven to Distraction by my now friend Nat Halliwell and took and scored the quiz. I said to myself, oh my God, I have ADHD. So at age 43, after years of watching chapters of my life not ending as I hope, I finally had an explanation for why I stumbled at the finish line.

I had an attention problem. On the day I testified, I was so focused on the case at hand that I simply didn't pay close attention to where I parked. I also didn't notice that there were 2 mirror side by side parking garages, and when I went back to my car, I went into the wrong one. So my real problem that led to so much pain and suffering was my failure to understand how my brain worked. My brain hyper focuses on things that hold its interest.

It also ignores things that are not interesting, like where my car is parked. I often didn't even notice what I didn't notice. When my son was very young, I'd walk into the kitchen and find cabinets and drawers open. This bothered me and it was potentially dangerous. So I kept on telling my son to shut cabinets and drawers after he opened them.

However, when he was at summer camp, I continued to walk into the kitchen and find open cabinets. Even though I was the only one living in the house, I was the cabinet culprit, and I didn't even know it. I cannot tell you how much the diagnosis of ADHD helped me. Suddenly, I understood why I struggled my whole life. It wasn't a moral failing or a character flaw.

There were consequences of this brain wiring. It explained why I had problems with certain tasks and why I excelled in other places of my life. More importantly, there was a hope for a better tomorrow. Between medication, life management skills, and a willingness to ask for help, I could create a life that worked. And here's the biggest point.

The major symptom for people living with neurodiverse brains is the pain that their lives are not working. They have a hard time getting what they want. Behavior is a symptom, not a diagnosis. With a clear understanding of how your brain is uniquely wired and the right skills and tools, you can get what you want. Often, the most helpful intervention is not the intervention you think it should be.

For me and my ADHD brain, I have a problematic relationship with time. I chronically run late. I often make deadlines by the hair of my chinny chin chin because I'm overly optimistic about how long a task will take. I assume I won't run into traffic. Now I've taken time management classes and bought apps and purchased new day timers, but they didn't help on a sustained basis.

Why? My faulty internal time manager that leads me to be chronically late is a symptom just like chest pain or headaches. It's a clue that points to the root of the problem. I don't pay attention all the time. When I learned how to manage my attention more effectively, it became much easier to get to places on time.

So having the diagnosis doesn't mean that all of my attention problems are fixed. However, I know that I can manage my attention with intention so that there's the highest likelihood that I'll get what I want in life. When I mess up, and I do, I try not to beat myself up. If I witness myself beating myself up, I try to disrupt the internal mean girls conversation by saying, oh, how human of my ADHD brain. Now let's turn to the diagnosis of OCD.

OCD describes a different kind of brain wiring seen in neurodiverse brains. And by the way, all brains, even normal brains, and I've got air quotes around normal brains, have wiring glitches. I remember the moment I learned that my son had OCD. The diagnosis was made on the basis of a complete neuropsych evaluation and a brain scan. Just like his mom, my son's neurodiversity was atypical.

I have the inattentive type of ADHD. I wasn't the hyperactive kid bouncing off the walls. I was in my own little world in the back of the classroom. My son has OCD themes that are very atypical. So being atypical led to the delay in diagnosis for both of us.

Once the doctor told my son, you have OCD, I felt a huge sense of relief. Now we knew what we were dealing with. It all made sense. Well, this is where my son's OCD story and my ADHD story diverge. When I was diagnosed with ADHD, I knew exactly what I needed to do to live a better life.

With OCD, it can take some time to finally arrive at the right evidence based treatment that actually makes OCD better and not worse. The treatment is ERP, and you can find an ERP practitioner through the organization NOCD. And I will leave links so that you can learn more. So very briefly, let's talk about what OCD is. I think the easiest way to understand OCD is by imagining an OCD monster setting up housekeeping in the brain and hijacking its function.

The OCD monster offers up these deeply disturbing thoughts or images that elicit intense uncomfortable feelings. These thoughts or images are the obsession. The themes of the obsession can shift over time. In an effort to get temporary relief from the intensely uncomfortable feeling, a person learns to engage in compulsions. These are activities often suggested by the OCD monster.

So over time, the cycle of obsessions and compulsions become more intense. They become habits, and you know how difficult habits are to change. Some of the painful consequences of unmanaged OCD include things like poor school performance, social isolation, and challenges even leaving the house. As a parent, you might think that good grades are very important. So you decide you're gonna hire a tutor for your child and you might find that this doesn't work very well.

It's like plucking the dandelion flowers from the lawn. As a parent, you might feel strongly that you want your child's compulsions to stop. Efforts to stop the compulsions are like my taking time management classes. Again, this is like plucking the dandelion flowers. It doesn't work on a sustained basis.

All of these behaviors are clues. They're symptoms. You wanna get to the underlying cause. Now your child will tell you that the way that they are gonna get better is just by getting rid of the obsessions. Just make them go away.

No obsessive thoughts mean no unpleasant feelings and then no need for the compulsion. Problem solved. If only we could. This probably is not going to happen in the near future. However, I would like to offer a vision of what successful OCD management looks like.

There was a time in which I bought a house in July. I love the home and the garden. It was my peaceful refuge. Then September rolled around and I realized I'd made a huge mistake. There were 2 schools in the area and twice a day there was noise and traffic congestion as school started and let out.

I focus on how awful the noise and congestion were. I talked to my friends about it. After a while, I got tired of listening to myself complain about the noise. One day, I had to ask myself the tough question, would I move or would I learn to manage the noise differently? I decided to find a way to make my life work in a house I loved even in the presence of noise.

So I got a white noise generator and played soothing music. I planted more greenery between my house and the street. I made sure that I didn't try to leave my driveway a half hour on either side of the school day. Over time, the noise that had consumed my attention became the background noise in my life. I figured out how to make the adjustments to not let the noise run my life.

I watch those with OCD struggling with the noise of the obsession. It has power over them. It's possible that one day, the obsessions will be like the background noise of light. It's like mosquitoes buzzing around your head. You can tolerate it and still go on with your life.

So the three little words, obsessive compulsive disorder can be a gift. It can help you understand why your child or if you have OCD yourself do the things that they're doing. It replaces judgment and shame with understanding. And if you get connected to the right community, it offers a path to a full and meaningful life. You might not be there today.

Other people in your life might not be there either. Some people don't believe that OCD is real. Some people don't believe their health care professionals who deliver the diagnosis of OCD. Some people deny that their child has OCD. Some people resist the idea that their child's brain is not normal.

Some people get angry about the diagnosis. Some people mourn the loss of the identity of a normal child. What I will say is that efforts to deny or resist or fight against the diagnosis of OCD are all normal and understandable responses. However, the best way to be freed from OCD is to accept it. It's to accept that this is how my brain is wired.

Left to its own devices, here's what my brain will do. Here's how I'm going to manage my brain to create a life that works. Some people use the diagnosis of OCD as a way of beating themselves up. You might talk with yourself about what you did to cause your child's OCD. You might say that a diagnosis of OCD means that your child is broken.

You might feel judgment or shame about the symptoms. All of these reactions are also completely understandable. But you get to decide which thoughts you have about what a diagnosis of OCD means. I suggest that you make it mean that now you have a way of understanding how your child's brain works so that they can learn how to manage their brains effectively. Some people are worried about the consequences of having a label like OCD for insurance or employment purposes.

If you feel strongly about this, you don't even have to use the words. Use the idea. Help your child understand, look, this is how your brain is wired and here is how this kind of wiring can lead to problems, but we can learn how to get around these challenges. You don't have to give it a label. In summary, the diagnosis of OCD can be a gift.

It helps you understand behaviors that didn't make sense. It allows you to replace judgment and shame with insights, and it offers a path for a better tomorrow. A diagnosis of OCD positions you to have your own back rather than beating yourself up. This is the best way to be freed from OCD. Well, I hope you found this information helpful.

Please feel welcome to pass along this podcast to family, friends, and other people who are helping your child manage OCD. If you would be kind enough to leave a review, this really helps other people. So I'll look forward to seeing you in the next podcast episode. You've got this.