OCD Services

at Level Up Wellness Group

Comprehensive OCD Treatment and Support

At Level Up Wellness Group, we specialize in providing comprehensive treatment for Obsessive-Compulsive Disorder (OCD). Led by Dr. Melody, who has been working with OCD professionals for 14 years, our approach integrates the latest research and evidence-based practices to ensure the best possible outcomes for our clients. Dr. Melody understands the complexities of OCD from both a professional and personal perspective, as her adult daughter struggles with OCD, PANDAS/PANS, and Lyme disease. Her passion for proper OCD treatment drives her commitment to ongoing education, attending yearly training with experts in the United States, holding numerous certifications, and having completed an inpatient treatment program in a specialized facility in the U.S with her daughter. She oversees all OCD-related work at Level Up Wellness Group and offers ongoing mentoring and teaching within our organization.

Information to know about OCD

On average, it takes between 14-17 years for individuals to receive a proper diagnosis of OCD.
The gold standard for the treatment of OCD is exposure and response prevention (Ex/Rp). You must treat the obsessions and most importantly the compulsions
Part of the successful treatment of OCD, regardless of age, is also to identify family accommodation with the OCD cycle.
When there is a high degree of family accommodation, the severity of OCD in the individual is more likely to be more severe.
Family accommodation helps the OCD to grow.
When the OCD is moderate-severe, pharmacotherapy and Ex/Rp is the best approach. Our nurse practitioner team can support appropriate medication support.
OCD is the “doubting disorder”

More information at: https://iocdf.org/

Understanding Obsessions and Compulsions in OCD

Obsessive-Compulsive Disorder (OCD) is a mental health condition characterized by persistent and intrusive thoughts, images, urges (obsessions) and repetitive behaviors or mental (internal) or external behaviours (compulsions) aimed at reducing the distress caused by these thoughts. IT is important to note that avoidance and reassurance seeking are also compulsions. Understanding the nature of these obsessions and compulsions can help both sufferers and their families manage the condition more effectively.

Obsessions

Obsessions are unwanted, intrusive thoughts, images, or urges that cause significant anxiety or distress. These thoughts are often irrational and go against the person’s values and beliefs. Common obsessions include:

Contamination: Fear of germs, dirt, or contamination by touching objects or people.
- Example: A person might fear that they will contract a deadly illness by touching a doorknob.
Harm: Fear of causing harm to oneself or others, either intentionally or accidentally.
- Example: A parent might obsess over the thought of harming their child, even though they have no desire to do so.
Symmetry and Order: A need for items to be arranged in a specific way or for things to be symmetrical.
- Example: An individual may feel extreme distress if objects on their desk are not perfectly aligned.
Forbidden or Taboo Thoughts: Intrusive thoughts that are violent, sexual, or morally unacceptable.
- Example: Someone might experience unwanted sexual thoughts about inappropriate subjects.
Doubts: Constant worry that something has been overlooked or done incorrectly.
- Example: A person might obsess over whether they locked the door or turned off the stove, leading to repeated checking.

Compulsions

Compulsions are repetitive behaviors or mental acts performed in response to obsessions, intended to prevent or reduce anxiety or prevent a feared event. These actions often become ritualistic and can significantly interfere with daily life. Common compulsions include:

Cleaning and Washing: Excessive hand washing, showering, or cleaning to remove perceived contaminants.
- Example: Washing hands repeatedly until they are raw to feel clean and germ-free.
Checking: Repeatedly checking that something has been done correctly, such as locking doors or turning off appliances.
- Example: Checking the front door multiple times before leaving the house to ensure it is locked.
Repeating: Performing a behavior or saying something multiple times.
- Example: Touching a light switch a specific number of times before feeling comfortable leaving the room.
Ordering and Arranging: Ensuring items are placed in a specific order or symmetry.
- Example: Organizing books on a shelf so that they are perfectly aligned and evenly spaced.
Mental Compulsions: Repeating phrases, praying, or counting in one’s head to reduce anxiety.
- Example: Silently counting to a certain number every time an intrusive thought occurs.

OCD Subtypes

Contamination and Cleaning OCD

Characteristics: Individuals with this subtype experience an intense fear of germs, illness, or contaminants. They may believe that certain objects or environments are contaminated and can cause harm.
Common Compulsions: Excessive cleaning, washing hands repeatedly, avoiding places or objects perceived as dirty, and using disinfectants excessively.
Research Insight: Studies have shown that individuals with contamination OCD often have heightened disgust sensitivity and an overactive threat perception system (Menzies et al., 2008).

Harm OCD

Characteristics: This subtype involves intrusive thoughts about causing harm to oneself or others, often leading to significant distress.
Common Compulsions: Checking behaviors (e.g., ensuring no one is harmed), seeking reassurance, avoiding situations where harm could occur, and mental rituals to counteract harmful thoughts.
Research Insight: Research indicates that individuals with harm OCD have difficulties distinguishing between thoughts and actions, leading to excessive guilt and responsibility (Rachman, 2003).

Symmetry and Ordering OCD

Characteristics: A strong need for order, symmetry, and exactness characterizes this subtype. Individuals may feel uncomfortable until things are arranged in a particular way.
Common Compulsions: Arranging objects symmetrically, repeating actions until they feel “just right,” and counting or tapping rituals.
Research Insight: Neuroimaging studies suggest that individuals with symmetry OCD show heightened activity in brain areas associated with visual processing and spatial organization (Mataix-Cols et al., 2003).

Checking OCD

Characteristics: Fear of causing damage or harm through negligence, leading to compulsive checking behaviors.
Common Compulsions: Repeatedly checking locks, appliances, and safety measures; retracing steps to ensure no harm was done.
Research Insight: Cognitive-behavioral models highlight that individuals with checking OCD have inflated responsibility and difficulty tolerating uncertainty (Salkovskis, 1985).

Sexual and Relationship OCD

Characteristics: Intrusive, unwanted sexual thoughts or doubts about relationships. These thoughts are often inconsistent with the individual’s values and can cause significant distress.
Common Compulsions: Seeking reassurance from partners, avoiding triggers (e.g., certain people or situations), and mental rituals to neutralize thoughts.
Research Insight: Studies have shown that sexual and relationship OCD is often underreported due to shame and stigma, emphasizing the need for sensitive and specialized treatment approaches (Dèttore et al., 2013).

Pure Obsessional OCD (Pure O)

Characteristics: Intrusive, distressing thoughts without visible compulsions. Individuals engage in mental rituals to neutralize these thoughts.
Common Compulsions: Mental checking, reassurance-seeking, and thought suppression.
Research Insight: Pure O is often misdiagnosed due to the lack of observable compulsions, highlighting the importance of thorough clinical assessment (Williams et al., 2011).

Religious and Moral OCD (Scrupulosity)

Characteristics: Intense fear of religious or moral failure, leading to compulsive behaviors related to religious practices or moral behavior.
Common Compulsions: Excessive praying, confessing, seeking reassurance from religious figures, and avoiding perceived immoral activities.
Research Insight: Scrupulosity is linked to high levels of guilt and fear of divine punishment, requiring interventions that address these specific cognitive distortions (Abramowitz & Jacoby, 2014).

Hoarding OCD

Characteristics: Difficulty discarding items, leading to cluttered living spaces and significant distress or impairment.
Common Compulsions: Saving items, difficulty organizing possessions, and excessive acquisition.
Research Insight: Hoarding disorder is now recognized as a distinct but related condition to OCD, with unique cognitive and behavioral profiles (Mataix-Cols et al., 2010).

Perinatal/Antenatal/Postpartum/Postnatal OCD

Both men and women can experience peri/postnatal OCD.
In females postnatal exacerbated previous OCD in 8-70% of suffers.
New onset of OCD during the postpartum period in females ranges between 2-22%
OCD is underdetected in pregnancy and postpartum.
There is a hesitancy to disclose information due to fear of child being removed from care and shame/guilt.
Common themes: unwanted thoughts/images that you may accidentally cause harm to the baby, intentionally cause harm to baby, the safety of the baby

More info: https://www.postpartum.net/perinatal-mental-health/#OCD

Understanding Family Accommodation in OCD

What is Family Accommodation?

Family accommodation refers to the ways in which family members and loved ones may inadvertently support or reinforce the obsessive-compulsive disorder (OCD) behaviors of their loved one. This can include participating in rituals, providing reassurance, modifying routines, or avoiding certain situations to prevent triggering the person’s OCD.

Why Do Families Accommodate OCD?

Dr. Eli Lebowitz’s work highlights several reasons why families might accommodate their loved one’s OCD:

Desire to Reduce Distress: Family members often accommodate OCD behaviors to reduce immediate distress for the person with OCD and for themselves.
Misunderstanding of OCD: Families might not fully understand OCD and believe that accommodating is helping.
Avoiding Conflict: To avoid arguments or distressing situations, family members might find it easier to comply with OCD demands.
Emotional Strain: The emotional toll of seeing a loved one in distress can lead family members to accommodate as a way to provide short-term relief.

The Impact of Family Accommodation on OCD

Lebowitz’s research suggests that while family accommodation may provide temporary relief, it can have long-term negative consequences:

Reinforcement of OCD Cycles: By accommodating, family members reinforce the OCD behaviors, making them more persistent and difficult to treat.
Increased Severity: Accommodation can contribute to the severity of OCD, as the person with OCD may become more reliant on these behaviors to manage their anxiety.
Family Distress: The ongoing need to accommodate can lead to increased stress and tension within the family, affecting relationships and overall well-being.
Treatment Resistance: Accommodation can make it harder for individuals to engage in effective treatments, such as exposure and response prevention (ERP), which require confronting and managing OCD triggers without accommodation.

Breaking the Cycle of Accommodation

To reduce family accommodation and its impact on OCD, it’s important to:

Educate the Family: Understanding OCD and the effects of accommodation can empower families to make healthier choices.
Set Boundaries: Establishing clear boundaries can help prevent accommodation while still providing support.
Engage in Family-Based Therapy: Therapy can help families learn how to support their loved one without accommodating OCD behaviors.
Support Treatment Plans: Encouraging adherence to treatment plans and participating in family therapy sessions can improve outcomes.

For parents and loved ones, supporting someone with OCD involves understanding the nature of the condition, being patient, and encouraging them to seek professional help. It’s important to avoid enabling compulsive behaviors and instead, help them adhere to their treatment plan. Open communication and empathy are crucial in providing the necessary support.

Our Approach

Our team employs a combination of Cognitive Behavioral Therapy (CBT), Exposure and Response Prevention (Ex/RP), and other evidence-based treatments to address the unique needs of each individual. We are committed to creating a supportive, empathetic environment that empowers our clients to manage their symptoms and improve their quality of life. Treatment is tailored: for example- play and creative based techniques will be integrated in our approaches with EX/RP

How Level-Up Supports children, teens, adults, parents, families, and schools in understanding OCD

Individual assessment treatment
Level Up Wrap around program
SPACE Program
Medication support and management with our nurse practitioners
Family Counselling
Couples Counselling

Nurse Practitioner Team:

Our nurse practitioners, who are well-versed in OCD and the latest research, can collaborate with you, your child, and your family to explore how medication can effectively support OCD treatment. By following best practices, our nurse practitioner and therapist teams can promptly schedule appointments to help reduce the suffering you’re experiencing. There’s no need to wait for psychiatry or work with professionals unfamiliar with OCD. Instead, work with a team that truly understands and is equipped to support your needs.

For more on medication from the experts in OCD, click here: https://iocdf.org/about-ocd/treatment/meds/

Get Started

If you or a loved one is struggling with OCD, contact us to schedule an initial consultation. Our team is here to help you navigate the challenges of OCD with compassion and expertise.